Objective The aim of this review was to summarize the literature regarding the impact of the menopause transition on body weight and body composition. MethodsWe conducted a search of the literature using Medline (Ovid, 1946 -present) and PubMed (1966PubMed ( -2012 for English-language studies that included the following search terms: ' menopause ' , ' midlife ' , ' hormone therapy ' or ' estrogen ' combined with ' obesity ' , ' body weight ' or ' body composition ' .Results Whereas weight gain per se cannot be attributed to the menopause transition, the change in the hormonal milieu at menopause is associated with an increase in total body fat and an increase in abdominal fat. Weight excess at midlife is not only associated with a heightened risk of cardiovascular and metabolic disease, but also impacts adversely on health-related quality of life and sexual function. Animal and human studies indicate that this tendency towards central abdominal fat accumulation is ameliorated by estrogen therapy. Studies mostly indicate a reduction in overall fat mass with estrogen and estrogen -progestin therapy, improved insulin sensitivity and a lower rate of development of type 2 diabetes. ConclusionThe hormonal changes across the perimenopause substantially contribute to increased abdominal obesity which leads to additional physical and psychological morbidity. There is strong evidence that estrogen therapy may partly prevent this menopause-related change in body composition and the associated metabolic sequelae. However, further studies are required to identify the women most likely to gain metabolic benefi t from menopausal hormone therapy in order to develop evidence-based clinical recommendations.

The pregnancy outcome was independent of the first-trimester 25(OH)D status. Overall, the 25(OH)D levels significantly decreased in the third trimester. More research in this area is warranted.

In this Latin American middle-aged series, VMS prevalence was high, persisting into the late postmenopausal phase in a high rate and severely impairing quality of life. HT use was related to a lower risk of severe VMS.

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