**Abstract**

Obesity and its related severe consequences have been a major public health problem worldwide. A significant weight gain and intra-abdominal adipose tissue accumulation are observed as women begin the menopausal transition. A number of clinical and basic research indicate that ovarian hormone may play a crucial role. However, the underlying mechanisms are largely unknown. In this chapter, we aim to systematically review the literature in the influences of ovarian hormone on the physiology of lipid and glucose metabolism, obesity-related hormone, and the regulation of body weight by the dietary intake, feeding behavior. A variety of research modalities have been used to explore the effects of MHT in perimenopausal women. Hence, we will also summarize the latest progress of MHT use on the effect of body mass, body fat redistribution, and insulin resistance, which lead to protective cardiometabolic effects.

**Keywords:** menopause, ovarian hormone, estrogen, metabolism, obesity, menopausal hormone therapy, adipose distribution, insulin resistance, leptin, growth hormone, dietary intake
