TIRZEPATIDE IN THE CONTEXT OF MENOPAUSE: EFFECTS ON METABOLISM, BODY COMPOSITION, AND HORMONAL PARAMETERS

Abstract

Menopause is a significant endocrine transition characterized by the permanent cessation of ovarian function and a progressive decline in estrogen production; it is associated with significant changes in energy metabolism, body fat distribution, body composition, and cardiometabolic risk. In this context, there is an increased predisposition to greater visceral adiposity, reduced muscle mass, insulin resistance, dyslipidemia, and weight gain. Tirzepatide, a dual agonist of the glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors, represents a pharmacological strategy of growing interest for treating obesity and associated metabolic alterations. This study aims to review the available evidence regarding the effects of tirzepatide on metabolism, body weight, adiposity, body composition, and potential impacts on hormonal parameters in perimenopausal and postmenopausal women. This is a narrative literature review based on clinical studies, systematic reviews, and scientific publications concerning tirzepatide, obesity, menopause, and metabolic changes. Available evidence demonstrates that tirzepatide promotes significant reductions in body weight and adiposity, as well as improvements in insulin sensitivity and glycemic and metabolic parameters. However, data specifically regarding the menopausal population remain limited, particularly concerning direct effects on the hypothalamic-pituitary-gonadal axis and levels of estradiol, FSH, and other sex hormones. Thus, its benefits during menopause appear to be primarily related to improvements in metabolic phenotype and body composition, rather than acting as a form of hormone replacement therapy. Further studies specifically involving menopausal women are needed to determine the magnitude and clinical relevance of these effects.