Tirzepatide and Hormone Therapy May Boost Weight Loss After Menopause
For many women in menopause, weight gain becomes more stubborn as hormonal shifts slow metabolism and redistribute fat. Yet new research suggests that one therapeutic approach—combining tirzepatide, the weight-loss medication sold as Zepbound and Mounjaro, with menopause hormone therapy—may offer a meaningful edge.
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In a January 2026 study published in The Lancet Obstetrics, Gynecology, and Women’s Health, researchers analyzed the health data of postmenopausal women who were categorized as either overweight or obese and were treated with tirzepatide for at least 12 months.
Tirzepatide is currently the most effective FDA-approved medication for obesity, but its effects on postmenopausal women—and more specifically, those taking hormone therapy—have so far been limited.
The study included 120 postmenopausal women, 40 of whom were also using systemic hormone therapy. To ensure a fair comparison, each hormone therapy user was matched to two non-users based on “age, BMI, age at and type of menopause, previous obesity medication use, and diabetes status,” the study states.
Researchers then tracked weight changes and cardiometabolic markers over time using electronic health records provided by Mayo Clinic Health System.
The team ultimately found that combining hormone therapy with tirzepatide yields significantly greater weight loss than either approach used alone.
At their last follow-up visit, women using both tirzepatide and hormone therapy lost an average of 19.2 percent of their total body weight, compared with 14.0 percent among those using only tirzepatide. Women on hormone therapy were also more likely to achieve clinically meaningful milestones, with some participants losing up to 30 percent of their total body weight.
Even more encouraging, the benefits weren’t limited to the scale. Both groups showed improvements in blood sugar control, blood pressure, and liver enzyme levels, reflecting better overall metabolic health. However, the hormone therapy group experienced additional gains, including greater reductions in diastolic blood pressure, triglyceride levels, and markers of liver health.
As Harvard Health Publishing writes, these improved cardiometabolic metrics translate into lower risk of heart attack or stroke—both leading causes of death among both women and men in the U.S. They note that just 6.8 percent of the American population is in prime cardiometabolic health, and that excess body weight and high blood sugar are the two most common reasons we fall short.
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While the findings are promising, the researchers caution that this was an observational study, not a randomized controlled trial—meaning it can show associations, but not prove cause and effect. Larger, prospective trials will be needed to confirm whether hormone therapy directly enhances tirzepatide’s weight-loss effects and to clarify the biological mechanisms involved.
Still, for postmenopausal women struggling with obesity, the results highlight an important possibility: addressing hormonal changes alongside modern weight-loss medications may lead to better, more comprehensive outcomes.