GLP-1 Medications in Perimenopause & Menopause: Benefits, Challenges & What Happens When You Stop

GLP-1 receptor agonists—such as semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro)—have become powerful tools for weight loss and metabolic health.

For women in perimenopause and menopause, GLP-1 medications often feel like a lifeline, helping counteract hormone-driven changes in appetite, fat distribution, insulin resistance, and body composition.

But there’s a crucial piece many women aren’t prepared for: The transition off these medications requires careful planning, strategy, and ongoing support—because midlife changes in hormones, metabolism, and body composition make maintaining results more challenging.

Whether you’re still using GLP-1s or starting to think about “life after,” understanding how they interact with menopause is key.

GLP-1 Benefits for Midlife Women: Beyond Weight Loss

GLP-1 medications offer far more than appetite control. Research increasingly points to benefits beyond weight loss, especially for women in their 40s, 50s, and 60s:

1. Inflammation Reduction

Low-grade inflammation increases during peri- and post-menopause, partly due to declining estrogen and the loss of its natural anti-inflammatory effects. This rise in inflammation contributes to weight gain, joint pain, insulin resistance, and fatigue. GLP-1s may help lower inflammatory markers, making metabolic health easier to manage.

2. Cardiovascular Protection

After menopause, cardiovascular risk climbs—due in part to declining estrogen. Estrogen naturally helps protect the heart by supporting healthy blood vessels, maintaining favorable cholesterol levels, and reducing arterial inflammation.

GLP-1s can support:

• Lower blood pressure

• Improved cholesterol

• Reduced cardiovascular disease risk

These benefits are huge for midlife women navigating the menopause transition.

3. Cognitive Support

There’s emerging evidence that GLP-1 medications may support brain health by:

• Improving insulin signaling in the brain

• Lowering neuroinflammation

• Possibly reducing cognitive decline risk

Declining estrogen and progesterone during perimenopause and menopause can affect memory, focus, and cognitive function. Progesterone also supports brain health by protecting neurons, reducing neuroinflammation, and regulating mood.

These GLP-1 benefits are particularly meaningful for midlife women experiencing forgetfulness or ‘brain fog.’

GLP-1 Use With vs. Without Hormone Therapy (MHT)

Your hormone status—including whether you’re using menopausal hormone therapy (MHT)—plays a major role in how your body responds to GLP-1 medications and how smoothly you transition off them.

Using GLP-1 With MHT

Women on menopausal hormone therapy often find:

• Weight loss on GLP-1s is more predictable

• Appetite regulation feels steadier

• Muscle maintenance is easier

• Coming off GLP-1s leads to fewer rebounds

Estrogen improves insulin sensitivity and helps regulate fat distribution—key factors for metabolic stability.

Using GLP-1 Without MHT

For women not using hormone therapy:

• Appetite rebound can be more intense

• Stronger appetite rebound or food noise when stopping

• Higher risk of weight regain, particularly around the abdomen

• Greater fluctuations in energy, mood, and metabolic rate

You absolutely can maintain your results without MHT—but it usually requires structured nutrition, movement, and lifestyle foundations.

Life After GLP-1: What Midlife Women Can Expect

Coming off GLP-1 medications is a real adjustment—especially in peri- and post-menopause. Once the medication stops, appetite signals, food noise, and cravings begin to return, and the support GLP-1s provide for blood sugar control starts to fade. Midlife hormonal shifts can make this transition feel stronger than it does for younger women.

Here’s what many women notice:

1. Appetite & Food Noise Rebound

GLP-1s quiet hunger and food preoccupation. After stopping, both can return—often more intensely when estrogen and progesterone are fluctuating.

2. A Slower Metabolism

Menopause naturally reduces muscle mass and resting metabolic rate.

3. Changes in Body Composition

Weight can come back more easily, particularly around the midsection—where declining estrogen tends to push fat storage.

4. Blood Sugar Variability

GLP-1s keep blood glucose levels stable. Once stopped, swings may reappear, especially if insulin resistance or disrupted sleep are already in the picture.

5. Old Habits Resurfacing

With appetite no longer suppressed, familiar patterns around snacking or emotional eating can creep in quickly.

Strategies for a Smooth Transition Off GLP-1s

Women can absolutely maintain their results after stopping GLP-1 therapy—especially with a strong plan and strategies that work with, not against, their midlife hormonal shifts.

Here’s what works:

1. Prioritise Protein & Fibre for Balanced Blood Sugar: Include at least 30g protein at every meal, high-fibre vegetables, nuts, seeds & legumes and whole grains for slow-burning carbs to stabilise appetite and support metabolism.

2. Lift Weights: Resistance training helps preserve lean muscle, boost metabolism, and prevent weight regain—your hormone-friendly superpower.

3. Build Sustainable Habits: Focus on habits that support metabolism and appetite—because good routines are easier to maintain than relying on willpower alone. Consistent meal timing, mindful eating, stress management, quality sleep, and moderating alcohol all make a real difference in midlife.

4. Get Targeted Guidance: Short-term support from a practitioner familiar with menopause and GLP-1 transitions can help you create a personalised plan, prevent common pitfalls, and stay consistent during this vulnerable period.

5. Personalise Your Approach to Hormones: Whether you’re on MHT or not affects your strategy. The goal is to work with your current hormonal needs, not what worked in the past.

The Bottom Line: You Can Thrive After Stopping GLP-1s

GLP-1 medications provide tremendous benefits for women in peri and post menopause—from weight loss and metabolic support to cardiovascular and cognitive protection. But midlife hormonal changes create unique challenges when transitioning off them.

A thoughtful plan, evidence-based strategies, and the right level of support help you:

• Maintain weight loss

• Keep appetite manageable

• Protect metabolic health

• Build long-term habits you can sustain

• Feel strong, clear, and confident in your body

  
  

That’s exactly what the Life After GLP-1  approach is designed to do—support midlife women through a healthy, empowered transition off medications and into long-term metabolic health.

You don’t need medication forever. You just need a plan that matches your midlife physiology.

If you’re preparing to transition off a GLP-1 medication or want expert support to maintain your results, now is the perfect time to get a plan in place.

Book a Discovery Call to talk through your goals with me.

From one-on-one consultations to structured packages and the Life After GLP-1 Reset Program, we’ll find the approach that supports your metabolism — and your lifestyle.

Melissa x