Dr. Seema Daksh
03-Sep-2026
Here is what women should know about metabolism and hormones.
By Dr. Seema Daksh, MBBS, MD (Internal Medicine), DM (Endocrinology), Consultant Endocrinologist
For many women, weight can feel surprisingly unpredictable. You may be eating the same way, exercising regularly, yet suddenly find the scale moving upward or weight becoming harder to lose. It is tempting to blame “hormones”—and sometimes hormones do play an important role. But the relationship between hormones, metabolism and weight is far more nuanced than the popular idea of simply having a “hormonal imbalance.”
Hormones act as chemical messengers that influence appetite, energy expenditure, fat distribution, blood sugar regulation, sleep and even how hungry or satisfied we feel after eating. So , definitely, changes in hormonal health can influence weight.
PMOS and Insulin Resistance: A Common Connection
PMOS (Polyendocrine metabolic ovarian syndrome), earlier named as PCOS, is one of the most common hormonal conditions affecting women of reproductive age. Insulin resistance is an underlying feature in many women with PCOS. When the body becomes less responsive to insulin, it compensates by producing more of it. Higher insulin levels can promote fat storage and, together with other hormonal changes, make weight management more challenging.
Women may also notice irregular periods, acne, increased facial or body hair, or infertility. Interestingly, PMOS can occur in women across different body sizes, so weight alone should never be used to diagnose it.
Rather than focusing only on the weighing scale, management should address the long term metabolic health.
Is Your Thyroid Really Responsible?
The thyroid is often the first hormone blamed when weight increases. There is some truth behind the association: thyroid hormones help regulate metabolic rate, and an underactive thyroid, or hypothyroidism, can reduce energy expenditure.
However, hypothyroidism usually causes modest rather than dramatic weight gain, and part of this may be related to water retention rather than body fat. Once thyroid hormone levels are appropriately treated and normalised, persistent excess weight should not automatically continue to be attributed to the thyroid.
Symptoms such as persistent fatigue, feeling unusually cold, constipation, dry skin, menstrual changes or unexplained weight change may warrant thyroid function evaluation.
Cortisol: When Stress Enters the Equation
“Cortisol belly” and “cortisol detox” have become popular phrases on social media, but cortisol itself is not the enemy. It is an essential hormone that helps the body respond to stress and regulate blood pressure, glucose and metabolism.
The bigger issue is the lifestyle that often accompanies chronic stress. Poor sleep, emotional eating, reduced activity and altered appetite can collectively make weight management more difficult. True medical cortisol excess, such as Cushing syndrome, is relatively uncommon and usually produces other characteristic clinical features.
So, rather than trying to “detox cortisol,” addressing sleep, stress, physical activity and eating patterns is far more meaningful.
Pregnancy, Postpartum and Menopause: When Biology Changes
Women experience major metabolic transitions throughout life. During pregnancy, insulin resistance naturally increases, and in some women this can progress to gestational diabetes. After delivery, sleep deprivation, stress, reduced activity and lifestyle changes can all influence postpartum weight retention.
As the estrogen level declines during menopause, fat distribution shifts, leading to increased abdominal fat storage. Abdominal or visceral fat is particularly important because it is associated with insulin resistance and cardiovascular risk. ?
This makes strength training, adequate protein intake, regular movement and good-quality sleep increasingly important during midlife—not simply for weight, but for maintaining muscle, bone and metabolic health.
What Should Women Focus On?
Instead of chasing quick fixes, detoxes or supplements marketed as “hormone balancing ,” over social media, focus on the fundamentals that support both hormonal and metabolic health: regular physical activity including strength training exercises, adequate protein and fibre, minimally processed foods, sufficient sleep, stress management and sustainable eating patterns.
One of the most important messages for women is that weight regulation is biological, not simply a matter of willpower. Genetics, age, medications, sleep, stress, food environment, physical activity, muscle mass, hormones all play an important role in regulating your weight.
And if weight changes are accompanied by irregular periods, excessive hair growth, persistent fatigue, unexplained bruising, marked muscle weakness, significant changes in appetite, or other new symptoms, seek medical evaluation rather than self-diagnosing a hormonal disorder.
The goal should not be to chase “hormone-balancing” trends , which is quite common over social media and has no scientific basis. It is to understand the biology behind your weight, consult an endocrinologist, who can help you identify genuine hormonal or metabolic problems when present.
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Dr. Blossom Kochhar
