Sleep Fragmentation, Hypoestrogenism May Contribute to Menopausal Weight Gain

elderly woman can't sleep
elderly woman can’t sleep
Sleep fragmentation and hypoestrogenism were shown to alter fasting nutrient utilization in this study, but not resting energy expenditure.

The following article is part of our coverage of the Endocrine Society’s annual meeting (ENDO 2021) that is being held virtually from March 20-23, 2021. Endocrinology Advisor‘s staff will report on the top research in hormone science and clinical care. Check back for the latest news from ENDO 2021.


Weight gain in menopause may be caused by changes in fasting nutrient utilization linked to sleep fragmentation and hypoestrogenism, according to study results presented at ENDO 2021, held virtually from March 20 to 23, 2021.

Menopause and sleep disturbances have been independently associated with weight gain in women, which may be triggered by changes in resting energy expenditure (REE) and/or nutrient utilization. The objective of this study was to examine the effects of induced sleep fragmentation and pharmacologic estradiol (E2) withdrawal on REE and nutrient utilization in a fasting state in menopause.

In this study, researchers evaluated sleep patterns in premenopausal women who participated in 5-night inpatient studies repeated during the mid-to-late follicular phase (high-E2; n=21) and after leuprolide-induced hypoestrogenism (low-E2; n=9 completed second visit). During each visit, there were 2 nights of unfragmented sleep (8 hours spent in bed) and 3 nights of fragmented sleep (9 hours spent in bed). Participants consumed 3 meals and a snack totaling the same number of calories every day. Researchers assessed REE and nutrient utilization in the fasting state using indirect calorimetry and used linear mixed models to compare high- and low-E2 states after fragmented and unfragmented sleep.

Results revealed that the respiratory quotient (RQ) was increased by sleep fragmentation in the high-E2 state (RQ; +3%; P =.03) along with carbohydrate oxidation (+20%; P =.02), though fat oxidation decreased (-16%; P =.03). The same effect was observed in response to the withdrawal of E2 during unfragmented sleep, but sleep fragmentation had no effect on nutrient utilization in the low-E2 state or on REE.

The study researchers concluded that sleep fragmentation and hypoestrogenism may alter fasting nutrient utilization in menopause in a way that contributes to weight gain.

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Grant LK, Coborn JE, Cohn A, et al. Effect of experimentally induced sleep fragmentation and hypoestrogenism on fasting nutrient utilization in pre-menopausal women. Presented at: ENDO 2021; March 20-23, 2021. Presentation OR17.