Precision MD Wellness and Weight Loss

Estrogen decline during perimenopause changes where the body stores fat and how well it responds to insulin, pushing weight toward the belly. Muscle naturally declines too, and muscle is what keeps resting metabolism high. Add in cortisol from poor sleep and chronic stress, and the body holds onto weight even harder.

Two things help address this at the source. Hormone replacement therapy restores estrogen, which supports fat distribution and insulin sensitivity again. A GLP-1 improves how the body responds to insulin and regulates appetite, working alongside the changes already happening in your hormones instead of fighting them.

Nutrition and strength training still matter here. But for a lot of women in this stage, treating the hormonal shift directly is what finally moves the needle.

This caught my attention this week.

A new Stanford Medicine study found that women who had used estrogen-only menopausal hormone therapy had lower odds of dementia and Alzheimer’s-related changes in the brain.

That’s interesting, especially given how much the conversation around estrogen has changed over the last several years. But it’s important to understand what the study does and doesn’t tell us.

The researchers found an association. They did not prove that estrogen prevents Alzheimer’s disease. And this study looked specifically at estrogen-only therapy, which is generally used in women who have had a hysterectomy. It doesn’t answer the same question for women taking estrogen plus progesterone.

So should women start taking estrogen to prevent dementia based on this study? No.

But it is another interesting piece of research suggesting that the effects of estrogen may extend well beyond hot flashes and night sweats.

Hormone therapy isn’t one-size-fits-all. The decision to use it should consider your symptoms, medical history, risks, benefits and where you are in the menopause transition.

I’ll be watching this research closely as we continue to learn more about menopause, estrogen and women’s long-term health.

Source: Stanford Medicine, August 2026