The Effect of Estrogen on Appetite

Disclosures

Medscape General Medicine. 1998;1(3) 

In This Article

Relationship of Estradiol to Food Intake in Women

Menses-Related Changes

Human research suggests that women also experience a variation in food intake during the menstrual cycle.[5,6] The clearest change is that total daily food intake is significantly reduced during the periovulatory period (Fig. 3). Lyons and colleagues[7] studied women living at home who prepared and weighed their own food. Cycle phases were determined by analysis of urinary luteinizing hormone and menses. The researchers found that food intake was significantly lower during the ovulatory phase. Similarly, Gong and associates[8] investigated women living in a dormitory who self-selected their food. Cycle days were numbered backwards from the onset of menses. These findings also showed that food intake declined in the periovulatory phase of the menstrual cycle.

Figure 3. Daily food intake and phase of menstrual cycle in healthy, normal-weight women. Studies show significant decrease in food intake in ovulatory phase.

Some studies also suggest that women eat more during the luteal phase than during the follicular phase. Whether this fluctuation is a result of increased eating late in the luteal phase or early in the follicular phase, as suggested by the rat data, is not known.

Patterns of macronutrient intake may also change during the menstrual cycle; however, this phenomenon remains poorly characterized.[5] Some studies show an increased fat intake premenstrually, whereas others suggest an increased carbohydrate intake. The incidence of food cravings also increases during the premenstrual phase. Both patients with depression and those with premenstrual syndrome exhibit an increased incidence of food cravings.[5] Whether food cravings are related to increases in total food intake or to macronutrient selection, however, has not been established.

Menopause

Data from the National Health and Nutrition Examination Surveys[9] have led to a provocative suggestion that the end of a woman's reproductive life is associated with significant body weight gain. The prevalence of overweight women with a body mass index (BMI) of greater than 27.3 (BMI=weight divided by height squared, kg/m2) increased 14.4% from age 50 to 59 -- by far the sharpest increase after age 30 for either gender. Despite the sharp increase in overweight women in the perimenopausal years, however, analysis of data from women who had surgical oophorectomy and those who completed natural menopause have not revealed the magnitude of hyperphagia or increased body weight that one might be tempted to predict on the basis of the animal data or on the basis of such studies as those of Lyons and others[7] and Gong and colleagues.[8]

Only slight increases in weight and no changes in food intake have been detected in perimenopausal or postmenopausal women. For example, in 1 well-designed, longitudinal study, age-adjusted BMI increased from a premenopause value of 26.2 to 26.9 during perimenopause.[10] Similarly, women who remained premenopausal during a 6-year study increased fat mass by 1.0±1.5kg and decreased fat-free mass (lean tissue and bone) by 0.5±0.5kg, whereas women who entered menopause during the study increased fat mass by 2.5±0.2kg and lost 3.0±1.1kg fat-free mass.[11] Interestingly, the results of a recent placebo-controlled, randomized clinical trial indicated that oral conjugated equine estrogen therapy reduced postmenopausal weight gain. Placebo-treated women gained 2.1±0.4kg within 3 years, whereas estrogen-treated women gained 1.1±0.3kg during that same period; addition of progesterone to the estrogen had no effect.[12]

Finally, no reports have been published associating menopause with altered eating.

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