Body weight was measured, and body fat distribution was determined by dual energy x-ray in early postmenopausal women given either oral calcium (500 mg/day; control group; n = 12) or hormonal replacement therapy (HRT), a combination of estradiol valerate (2 mg/day for 21 days) with cyproterone acetate (1 mg/day in the last 10 days of the treatment cycle; n = 15). There were no differences in basal body weight or body fat distribution in the two groups before the study. In the control group, a significant (P < 0.05) increase in body weight (from 63.6 +/- 2.2 to 65.2 +/- 1.9 kg [corrected] after 12 months) paralleled a slight, but significant (P < 0.05), increase in total body fat mass (from 23.8 +/- 2.2 to 24.7 +/- 2.2 kg), with an increase in fat in the trunk (from 10.2 +/- 0.4 to 11.3 +/- 0.4 kg; P < 0.01) and arms (from 2.4 +/- 0.5 to 2.7 +/- 0.2 kg; P < 0.05). These findings demonstrate a shift to a prevalent central android fat distribution after 12 months of observation in untreated postmenopausal women. Conversely, in the HRT group, total body bone mineral showed a significant (from 1089 +/- 28 to 1106 +/- 29 mg/cm2; P < 0.05) increase after 12 months, with no significant increase in body weight (from 62.2 +/- 1.6 to 62.7 +/- 1.6 kg), and no modifications in trunk (from 10.0 +/- 0.2 to 9.8 +/- 0.3 kg) and arm (from 2.43 +/- 0.2 to 2.5 +/- 0.1 kg) fat, but a significant increase in leg fat (from 7.1 +/- 0.3 to 8.3 +/- 0.4 kg; P < 0.05). The present results suggest that HRT can counteract at least in part the postmenopausal increase in body weight and body fat and prevent central body fat distribution after menopause.