GLP-1 Guidelines for Women in Perimenopause & Menopause

How to support hormone balance while using GLP-1 medications like Semaglutide or Tirzepatide

1. Understand Your Unique Physiology

During perimenopause and menopause, the hormonal landscape is shifting:

  • Estrogen and progesterone decline, affecting mood, sleep, metabolism, and body composition

  • Insulin sensitivity decreases, increasing the risk of blood sugar imbalances

  • Cortisol (your stress hormone) may be elevated, worsening inflammation and weight retention

  • Leptin and ghrelin (hunger/fullness cues) become dysregulated

  • Muscle mass naturally declines with age, and rapid weight loss can accelerate this

GLP-1 medications suppress appetite, which can lead to nutritional deficits, muscle loss, and worsened hormonal imbalances if not used intentionally.

2. Prioritize Protein to Protect Muscle and Hormones

With appetite reduced, every bite must count.

  • Aim for 90–120 grams of protein per day, spaced evenly across meals

  • Include 20–30 grams at breakfast to support blood sugar and cortisol balance

  • Prioritize complete protein sources: eggs, fish, poultry, grass-fed meats, collagen, and/or a clean protein powder if needed

  • Combine with resistance training to preserve lean muscle and bone density

3. Build Hormone-Supportive Meals

GLP-1 users often undereat or skip meals—avoid this by structuring intentional, nutrient-dense plates:

  • Protein: supports estrogen, insulin, and muscle health

  • Fiber: supports estrogen detox, gut health, and blood sugar

  • Healthy fats: needed for hormone production, brain health, and satiety

Sample plate: Grilled salmon + sautéed kale + roasted sweet potato + olive oil drizzle

4. Stabilize Blood Sugar for Hormone Harmony

Even on GLP-1s, blood sugar fluctuations can impact cortisol, sleep, and mood.

  • Avoid processed or refined carbs

  • Pair any carb with protein or fat

  • Choose fiber-rich carbs: lentils, quinoa, root veggies, berries

  • Walk after meals to support glucose control

5. Don’t Skip Strength Training

Weight loss on GLP-1s is not always fat loss. Without movement, you risk losing muscle and bone mass.

  • Strength train 2–3 times/week (even bodyweight counts)

  • Add walking, stretching, or yoga to regulate cortisol and support metabolism

  • Exercise helps balance estrogen, insulin, and thyroid function

6. Support Detox & Estrogen Clearance

In menopause, your body must work harder to eliminate excess estrogen and endocrine disruptors.

  • Eat cruciferous vegetables: broccoli, cauliflower, cabbage, arugula

  • Aim for 25–35 grams of fiber daily (flax, chia, lentils, greens)

  • Stay hydrated and sweat regularly (sauna, movement)

  • Limit alcohol, sugar, caffeine, and packaged foods

7. Sleep Is Your Superpower

GLP-1s may impact sleep, and hormone shifts already interfere with quality rest.

  • Create a wind-down routine: no screens 1 hour before bed

  • Magnesium glycinate or threonate may help

  • Keep the room cool and dark

  • Limit caffeine after noon

8. Supplement With Intention

With reduced food intake, strategic supplements can help fill gaps and support hormonal harmony:

  • Omega-3s: inflammation, cognition, hormone production

  • Vitamin D3 + K2: bone health, immunity, mood

  • Magnesium: sleep, stress, blood sugar regulation

  • Collagen or bone broth: joint and skin health, gut lining

  • B complex (methylated): energy, hormone detox

  • Adaptogens (as guided): ashwagandha, rhodiola, maca

9. Minimize Endocrine Disruptors

Your hormonal system is vulnerable during menopause.

  • Avoid plastics (use glass or stainless steel)

  • Switch to non-toxic skincare and cleaning products

  • Buy organic when possible to reduce pesticide exposure

10. Mindset Matters

Your worth is not tied to a number on the scale.

  • Nourishment is not just physical—it’s emotional and spiritual

  • Listen to your body’s cues with curiosity, not control

  • Rest, reflect, set boundaries, and protect your energy

  • This is not just weight loss—it’s a transformation

Ready for a Personalized Plan?

If you're looking to create a sustainable plan—whether you're on a GLP-1 now, considering it, or transitioning off—I’m here to help.

Let’s work together to craft a personalized roadmap that supports your unique goals, honors your body, and helps you feel truly empowered—not just about weight, but about your whole wellness story

I’m offering a free 30-minute call to help you navigate the risks, optimize your nutrition, and build a sustainable plan—whether you stay on GLP-1s or not.

Click HERE to schedule your call:

You don’t have to figure this out alone.

Let’s make sure you have a plan that works for you now and in the future.

Article by By Rebecca Kastin, NBC-HWC – Functional & Holistic Nutritionist

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GLP-1 Medications: What Are the Risks You Need to Know?