Spoiler: It’s not always a sign that Aunt Flo’s arrived.

As I’ve navigated through menopause, in addition to hot flashes, mood swings, and other not-so-fun symptoms, I began to notice changes in my body’s physical appearance.

I’ve always worked out several times a week, but once I hit menopause, my muscles weren’t as firm, my midsection was expanding, and my clothes weren’t fitting well anymore. Even upping my usual weekly regimen of cardio, yoga, Pilates, and a day or two of strength training squeezed in—the same routine that helped me get back in shape after two pregnancies—gave me zero results.

And it wasn’t just me—many of my friends and numerous posts on social posts on menopause support groups I’m in echoed similar experiences and frustrations.

As it turns out, when estrogen levels plummet in menopause, our go-to workouts might not cut it anymore.

The good news: There are ways to gain muscle and change your body composition in menopause—as long as you’re willing to do some heavy lifting.

Read on to find out more about strength training during menopause.

Why it’s harder to build muscle in menopause

In menopause (defined as going one year without a menstrual period), declining hormones, especially estrogen, are associated with changes in body composition. This includes a decrease in muscle mass and strength, and an increase in fat mass, according to a small 2023 study in BMC Women’s Health that examined the effects of strength training during menopause and perimenopause.

While none of us in menopause will be surprised to hear that, the question is: Why is this happening? As it turns out, estrogen (or lack of) has profound direct effects on muscles, says Patrick Diel, PhD, a professor at the German Sport University Cologne Institute of Cardiology and Sports Medicine and co-author of the BMC Women’s Health study.

“We know skeletal muscle has estrogen receptors,” Dr. Diel says. “Estrogen has anabolic [muscle-building] activity like testosterone, although not as strong as that of testosterone, and activates satellite cells.”

Satellite cells are muscle stem cells essential to muscle growth, repair, and regeneration, according to the National Institutes of Health.

Estrogen is key in satellite cells’ ability to maintain and renew muscle, per a 2019 study in Cell Reports. Take away estrogen, and satellite cells lessen in number and efficiency, leading to a deterioration in muscle mass, strength, and regeneration for those in menopause.

How menopause affects your metabolism

In addition to its role in repairing and building muscle, estrogen also is essential to metabolism, and a key factor in regulating weight, energy expenditure, and body fat distribution, according to a notable 2012 review in Molecular Endocrinology.

“The function of estrogen is not only to regulate fertility, but to regulate metabolism. That’s one of the main things the estrogen hormone does,” Dr. Diel says. Without estrogen, metabolism slows, making it harder for our bodies to burn calories, fat, and glucose.

Fortunately, losing estrogen in menopause doesn’t mean you’re doomed to riding an exercise hamster wheel where you go round and round but get nowhere. Strength training has been shown to improve satellite cell renewal in older adults, per a 2023 review in Cell Journal. What’s more, a notable 2012 study in Current Sports Medicine Reports found that when inactive adults completed 10 weeks of strength training, they gained muscle, lost fat, and increased their resting metabolic rate up to 7 percent.

However, due to the loss of estrogen (and testosterone, which also drops during menopause) people going through menopause need to train differently, putting the focus on strength training at higher intensity to see results, says Michele Cuffe, CPT, a certified personal trainer and certified wellness coach in Tampa, Florida.

“Our hormones are depleted and we need to work harder to get them to work,” Cuffe says. “Heavier strength training is what’s going to shape our bodies, raise hormones naturally, and build muscle and bone,” which is also important as we age.

“You can build muscle naturally with heavy weight training at any age, even in your 60s, 70s, and beyond. Strength training is the rock we want to build our house on for health and longevity.” —Michele Cuffe, CPT

Strength training during menopause: What your routine should look like

It all made sense why my preferred method of low-intensity strength training with maybe a day or two of heavier (but brief) lifting sessions per week was no longer garnering the results I got 10 or 20 years ago—I needed to pump up my strength training (pun intended).

Strength training during menopause should be done at a high enough intensity so you’re creating micro-tears in the muscle that your body will need to call on estrogen and testosterone to repair, according to Cuffe. “If you’re lifting weight at a repetition range of 15 to 20, that’s not heavy enough. You want to get to a weight where after six or so reps, you start fatiguing,” she says.

Dr Di

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