At The Menopause Society’s 2026 annual meeting in San Diego, researchers from Mayo Clinic Florida presented a real-world analysis asking whether women who take menopause hormone therapy (HT) lose more weight on a GLP-1 medication than women who do not. Headlines ran with a version of “hormone therapy might boost weight loss.” The study itself is more careful than that, and the gap between the two framings is the useful part.
What the study did
The work was led by Regina Castaneda, MD, and is a retrospective cohort study using electronic health records from February 2017 through December 2025.
- Women were 45 or older, had a BMI of 27 or higher, and had taken semaglutide or tirzepatide for at least 12 months.
- Women with prior bariatric surgery, active cancer, or other concurrent obesity medications were excluded.
- HT meant oral or transdermal estrogen, with or without progesterone.
- Researchers matched each HT user to two non-users on age, starting BMI, prior obesity medication use, and type 2 diabetes status.
- The final groups were 2,379 women on semaglutide (793 using HT) and 1,476 on tirzepatide (492 using HT). Average age was 57 and average BMI was 36.
What it found
On semaglutide, women using HT had lost more, on average, at each checkpoint:
- At 12 months: 11.0% vs 9.5% of total body weight.
- At the last follow-up (a median of 26 months): 11.9% vs 10.9%.
- Slightly more HT users reached 10% or more loss (55% vs 51%).
On tirzepatide, the pattern mostly disappeared. There was a small difference at three months (6.6% vs 5.9%), but no significant difference at later time points.
What it does not establish
It cannot show that hormone therapy caused anything. The authors and the reporting are explicit: the observational design does not establish a causal relationship, and the findings do not show that starting HT improves obesity treatment outcomes. Women who choose, and are prescribed, HT may differ from those who are not in ways records do not capture: how closely they are followed, how consistently they take their medication, how they eat and move, and their overall health. Matching on four variables cannot remove all of that, and the authors acknowledge residual confounding.
The gap is small and shrinks over time. A 1.5-point difference at one year narrowed to about one point at last follow-up. A statistically significant difference across thousands of women is not the same as a difference that matters to any one person.
Key details were not analyzed. The abstract did not break results down by menopausal stage, HT formulation, medication dose, or adherence. Those are exactly the variables you would want before reading anything into the result.
The two drugs disagree. If hormone therapy had a reliable effect on weight loss, you would expect to see it with both medications. Seeing it mostly with semaglutide is a reason for caution, not a finding to explain away.
Only people who stayed on treatment for a year were included. Requiring at least 12 months of use leaves out everyone who stopped earlier, so the results describe people who continued, not everyone who started.
It is a conference presentation. It has not been peer reviewed, and the reporting we reviewed did not state who funded it. Treat it as a hypothesis for a prospective trial, which the authors say is needed.
Why an average is not your result
Averages hide wide ranges. Within every group in this study, some women lost far more than the mean and some lost little. Whether hormone therapy is appropriate is a separate medical question, with its own benefits and risks, that a licensed clinician weighs against your history. It should not be started, stopped, or adjusted for the sake of a weight-loss figure from an observational abstract.
The part that applies to compounded medications
This study looked at users of branded, manufactured semaglutide and tirzepatide products. The same is true of the trials that established those medications’ profiles. That evidence covers those products and does not transfer to a compounded preparation, which is made by a state-licensed pharmacy for an individual patient, is not FDA-approved, and has not been through an equivalent trial. We explain the distinction in our GLP-1 education guide.
If you are curious how an evaluation with a licensed provider works, including how your full health history gets reviewed, see how it works and our FAQ.
This post is general information, not medical advice. It does not describe a benefit of any NoBsRx program, and it is not a recommendation to start, stop, or change any medication, including hormone therapy. Compounded medications are not FDA-approved. Treatment is never guaranteed, and individual results vary. Eligibility and every treatment decision are made by independent licensed providers based on an individual clinical assessment, and availability varies by state. Talk to a licensed clinician before changing any treatment.