Women over 50 may lose around 35 per cent more weight with hormone therapy and tirzepatide, study suggests

Postmenopausal women could see significantly greater weight loss when combining menopausal hormone therapy with the obesity medication tirzepatide, according to new research led by the Mayo Clinic.

The study found that women using both treatments lost, on average, around 35 per cent more weight than those taking tirzepatide alone. The findings, published in The Lancet Obstetrics, Gynaecology, & Women's Health, highlight a potential new approach to improving outcomes for women living with increased cardiometabolic risk after menopause.

Weight gain is common after menopause, alongside a higher risk of conditions such as cardiovascular disease and type 2 diabetes. Declining oestrogen levels are thought to play a key role in these changes, affecting metabolism, fat distribution and overall health.

Menopausal hormone therapy is widely used to manage symptoms such as hot flushes and night sweats, which affect up to three-quarters of postmenopausal women. However, its potential role in supporting weight management has been less clear.

Researchers analysed data from 120 adults living with overweight or obesity who had been treated with tirzepatide for at least 12 months. Outcomes were compared between those also receiving hormone therapy and those who were not.

The results showed a notable difference in weight loss between the two groups. However, the authors caution that the study was observational, meaning it cannot confirm that hormone therapy directly caused the additional weight loss.

Other factors may have contributed. Women using hormone therapy may have experienced improved sleep and quality of life, making it easier to maintain lifestyle changes such as diet and physical activity.

Early evidence suggests there may be a biological explanation for the findings. Oestrogen may enhance the appetite-regulating effects of GLP-1-based medications like tirzepatide, potentially leading to greater reductions in food intake and body weight.

While this possible synergy is promising, further research is needed to better understand how these treatments interact.

The findings open the door to more personalised approaches to obesity management in postmenopausal women, a group that often faces complex and overlapping health risks.

Randomised clinical trials are now needed to confirm the results and to explore whether the combination also improves wider cardiometabolic outcomes, beyond weight loss alone. If validated, this approach could help shape future treatment strategies for millions of women navigating weight gain and health risks after menopause.