As an Endocrinologist and specialist in weight management, I have observed how oestrogen significantly influences fat distribution in both men and women. Understanding hormonal effects, especially oestrogen, is important to prevent obesity and obesity-related medical conditions. 

Oestrogen is primarily a female sex hormone that plays an important role in both men and women. 

In females, oestrogen is crucial in directing fat storage to subcutaneous areas, or the gynoid fat distribution patterns, particularly around the hips, buttocks, and thighs, leading to the characteristic pear-shaped body. This distribution pattern does not give the shape, but it serves many biological functions, such as during pregnancy and lactation, the fat provides energy.

When oestrogen levels decline during menopause, there is a shift toward more central or abdominal fat distribution, increasing visceral fat. The redistribution has been linked to increased cardiovascular risk and metabolic disorders. This suggests that oestrogen’s role in fat distribution is complex and influenced by the interplay with other hormones.  

In Women who are going through menopause, hormone replacement therapy may reduce the redistribution of fat and also the risk of metabolic diseases. Hormone replacement therapy may not be a suitable treatment for everyone. The risks and benefits should be carefully evaluated before starting it. 

Lifestyle modifications, including a balanced diet and regular physical activity, are important to follow. 

In males, the balance between testosterone and oestrogen is important. Oestrogen is produced naturally in men through the aromatisation of testosterone, primarily in the adipose tissue in smaller quantities and has a role in fat distribution.

When this balance is disrupted, it can be due to ageing, obesity, or other conditions. Men may experience increased subcutaneous fat deposition, mainly in the breast tissue and around the hips. The changes in fat distribution due to hormonal shifts might include testosterone replacement therapy. It is important to monitor and address factors like diet, exercise, stress, and sleep, which can influence hormonal balance and fat accumulation. 

Oestrogen significantly impacts distribution in both sexes, with implications for overall health and disease risk. For people who undergo hormone replacement therapy for gender reassignment surgery, changes in fat distribution are among the most favourable physical effects.


Kripa, is a Specialist Dietitian at The London Obesity & Endocrine Clinic. She has helped many patients overcome weight management barriers. ©Simplyweight


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