HEALTH

Why strength training matters more after menopause

Strength training after menopause

If your idea of strength training involves grunting men, enormous barbells and mirrors in unfortunate places, it may be time for a rethink.

Strength training simply means making your muscles work against resistance – a dumbbell, a machine, a resistance band or your own body weight. And from midlife onwards, it becomes particularly useful.

Not because every woman needs sculpted shoulders. Not because menopause requires an entirely new personality involving protein shakers and Lycra. But because muscle, strength and bone become things we’re gradually more vulnerable to losing as we age – and the menopause transition appears to add something extra to that picture, on top of the ordinary passing of years.

The good news is reassuringly simple: muscle responds to being used, at any age. And resistance training works in women after menopause – recent reviews have found consistent improvements in strength, though the size varies a lot between studies, and a large analysis of exercise trials in postmenopausal women found genuine, if modest, benefits for body composition too.

You do not have to be young. You do not have to be fit already. And you definitely do not have to deadlift a small hatchback.

Why strength matters after menopause

It is easy to think about muscle as something cosmetic. In reality, muscle is useful equipment.

You use it to get out of a chair, climb stairs, carry shopping, lift a suitcase, garden, play with children, get up from the floor and generally move through the world without having to think too much about it.

Maintaining that ability becomes more important, not less, as we age. Ageing is associated with progressive losses in muscle mass and strength, and the two aren’t identical: strength can change independently of how much muscle you visibly have. This is one reason the goal shouldn’t simply be to “look toned”.

Resistance training is one of the most effective tools we have for pushing back against that decline. Evidence in postmenopausal women consistently shows resistance training improves strength – the direction of the effect is reliable even if the size varies a fair bit from study to study.

And there is an encouraging point if you are starting late: you haven’t missed the boat. Trials in much older adults, including people in their mid-seventies and beyond, show that resistance training can still increase both strength and muscle size. Your muscles do not stop responding because you’ve collected a certain number of birthdays.

It isn’t just about muscle

Strength training may also improve body composition. One substantial analysis pooling 101 trials and nearly 5,700 postmenopausal women found that exercise increased fat-free mass and reduced fat mass, body-fat percentage and visceral fat, with resistance and combined training best for muscle outcomes, and aerobic or combined training better for fat loss.

There is also evidence that exercise can improve some markers linked to insulin sensitivity in postmenopausal women, although the effects vary depending on the type of exercise and which marker is measured. So “strength training fixes your metabolism” would be a good deal stronger than the evidence allows.

Think of strength training less as a weight-loss hack and more as an investment in physical capacity.

The ability to carry your own bags at 75 is not a particularly glamorous fitness goal.

It is, however, an excellent one.

What happens hormonally?

This is where menopause information has a habit of becoming far too neat.

Oestrogen falls. Muscle disappears. Lift weights. Problem solved.

Biology is rarely that cooperative.

Oestrogen receptors are present in skeletal muscle, and there are plausible mechanisms through which oestrogen could influence muscle metabolism and repair. But ageing, activity levels, nutrition, illness and other factors are all changing at the same time, which makes it hard to isolate oestrogen’s own contribution.

A 2023 systematic review examining oestrogen and female skeletal-muscle ageing found that postmenopausal women tended to have less muscle mass and strength than premenopausal women, and a negative effect of oestrogen deficiency looked plausible – but evidence on what hormone therapy actually does for muscle was, in the reviewers’ own words, largely conflicting and inconclusive.

So it’s reasonable to say the menopause transition plays a role in changes to muscle and body composition. It’s much harder to pin a precise percentage of that change on oestrogen alone, separate from ageing itself.

One of the best pieces of evidence comes from the Study of Women’s Health Across the Nation (SWAN), which tracked women’s body composition through the menopause transition. Fat gain began accelerating and lean mass began declining around two years before the final menstrual period, and those trajectories didn’t flatten out again until roughly a year or two afterwards.

That is more useful than simply blaming “getting older”, because it suggests midlife is a particularly sensible time to start paying attention to muscle.

Bones are changing too

Bone deserves equal billing.

The menopause transition includes a period of distinctly faster bone loss, driven partly by oestrogen’s role in regulating bone turnover. SWAN research found the fastest phase begins around a year before the final menstrual period and continues for roughly two years afterwards, with losses running at around 2 per cent a year at the spine – noticeably faster than before or after.

Resistance training can help, although the effects on bone density are generally modest. A Cochrane review of 43 trials in postmenopausal women found small but statistically significant benefits at some skeletal sites, with the results depending on the type of exercise. Combined exercise programmes produced a 3.22 percentage-point greater change in spine bone mineral density compared with control groups, while high-force resistance training produced a 1.03 percentage-point greater change at the femoral neck. Across all types of exercise combined, the average difference at the spine was 0.85 percentage points in favour of exercise.

Those numbers need some perspective. They describe differences in the percentage change in bone mineral density between exercise and control groups, not a 3.22% or 1.03% reduction in a woman’s risk of osteoporosis or fracture. And although the bone-density findings are encouraging, the review did not find a statistically significant reduction in fractures across exercise programmes. Exercise is an important part of protecting bone health, but it isn’t a guarantee against osteoporosis or fractures.

And if you have osteoporosis requiring medical treatment, exercise is an addition to that treatment, not a replacement for it.

How much strength training do you actually need?

You do not need to live in the gym.

Current Irish, UK and World Health Organization guidelines all recommend muscle-strengthening activity for the major muscle groups on at least two days a week, alongside regular aerobic activity – one doesn’t substitute for the other.

That is a useful starting point.

A simple whole-body programme might include movements such as:

  • a squat: sitting down and standing up, goblet squat or leg press
  • a hinge: hip hinge or deadlift variation
  • a push: wall press-up, chest press or overhead press
  • a pull: resistance-band row, cable row or dumbbell row
  • a step or lunge: step-ups, split squats or lunges
  • some form of bracing or carrying, for trunk strength and stability

You do not need every possible exercise. You need enough movements to challenge the major muscle groups, performed consistently and progressed over time.

For women new to strength training, the Royal Osteoporosis Society suggests working towards 8 to 12 repetitions of an exercise, using a resistance that makes the muscles work hard enough that continuing with good technique becomes difficult.

That is much more useful than being told women over 50 should lift a particular number of kilograms. A weight that is challenging for one woman may be ridiculously light for another.

Do you have to lift heavy?

Eventually, you need to challenge yourself. That does not mean you need to start heavy.

Research comparing resistance-training loads – mostly in general populations rather than postmenopausal women specifically, though there’s little reason to think the physiology differs much – suggests a fairly wide range of loads can build muscle, provided the exercise is genuinely challenging. Heavier loads tend to have the edge when the specific goal is maximising strength rather than muscle size.

This gives you options.

If you’re starting with bodyweight squats and they are genuinely difficult, that’s resistance training. If 12 repetitions with a 3kg dumbbell are challenging, that’s useful too.

But six months later, if those same 12 repetitions with the same 3kg dumbbell feel effortless, your muscles have adapted. To keep giving them a reason to get stronger, the challenge generally needs to progress.

That is progressive overload, a phrase that sounds far more dramatic than it is. You can progress by increasing the resistance, doing more repetitions, adding a set, using a harder exercise variation, or improving the range and control of the movement.

The important bit is progression. Not suffering.

How to start safely

If you currently do no strength training, two manageable sessions a week is a perfectly respectable place to begin.

You could start at home with bodyweight movements, bands or a couple of dumbbells. You could use resistance machines in a gym. You could work with a qualified trainer while you learn the movements.

The equipment matters much less than consistency and appropriate progression.

Start with exercises you can perform comfortably and with control. Learn the movement before worrying about the weight. Once you can complete your planned repetitions comfortably with good technique, increase the challenge gradually.

And don’t assume a workout only “counts” if you are incapacitated afterwards. Some muscle soreness when doing something new is common. Being unable to sit on the loo without negotiating with your quadriceps is not a required sign of progress.

When to get individual advice

Most women can strength train safely, but generic internet advice cannot account for every medical history.

If you have osteoporosis, that does not automatically mean weights are off limits – most people with osteoporosis can exercise safely, and strength exercise is something clinical guidance actively recommends rather than merely permits. Bone-strengthening exercise is also considered unlikely to cause a fracture and generally doesn’t need special adaptation for low bone density.

The main exception is a previous vertebral (spinal) fracture: UK clinical consensus recommends lower-impact options there – brisk walking rather than jumping – plus individualised physiotherapy advice before building up load or impact. The same goes for multiple fragility fractures, a recent fracture, or significant balance problems: a GP or physio can help tailor a programme, and where falls are already a concern, supervised balance-and-strength work is specifically recommended rather than going it alone.

Technique matters too, particularly as loads get heavier. There is no single weight at which lifting suddenly becomes unsafe – the guidance consistently points towards gradual progression and good technique, not a universal safe number.

Common mistakes

1. Staying too light forever

Light resistance is a sensible starting point, but it doesn’t have to be your permanent address. If you finish every set feeling you could happily do another 20 repetitions, the exercise may no longer be providing much of a strength stimulus. Progress gradually as you get stronger.

2. Assuming walking covers everything

Walking is excellent physical activity – keep walking. But walking and strength training do different jobs: Irish and UK guidelines recommend aerobic activity and muscle-strengthening work as separate components, not one standing in for the other. The same distinction applies to bone – walking is weight-bearing, but programmes combining resistance with suitable impact or other weight-bearing activity provide a broader skeletal stimulus.

3. Changing your workout constantly

Your muscles don’t need to be surprised. They need to be challenged. Repeating the same core movements gives you a chance to learn them and see whether you’re actually getting stronger – novelty can be enjoyable, but it isn’t the same thing as progression.

4. Thinking soreness equals success

A workout can be effective without leaving you walking downstairs sideways for three days. Soreness is influenced by novelty, exercise choice and other factors – it isn’t a reliable scorecard for how productive a session was.

5. Treating exercise as punishment for your body

This may be the most important one. Strength training doesn’t have to be compensation for eating, ageing or gaining weight. There’s a much better reason to do it.

To remain strong.

What about protein?

Strength training gives your muscles a reason to adapt. Nutrition provides some of the raw materials required to do it.

Protein therefore matters, particularly as we get older, but the internet has managed to make the subject approximately 400 per cent more complicated than necessary.

There is ongoing research into optimal protein intake for preserving and building muscle in older and postmenopausal women, and needs vary with body size, diet, activity and health.

So we’re giving protein its own guide rather than squeezing an arbitrary number into this one.

Read next: Protein in menopause: how much do you actually need?

FAQs

Is 50 too late to start strength training?

No. Nor is 60, 70 or even 80 automatically too late. Trials in older adults show that resistance training can improve strength and muscle size even in people aged 75 and over. Your starting programme should match your current ability rather than somebody else’s age.

Do I need a gym or special equipment?

No. Resistance can come from your body weight, bands, dumbbells, household objects or gym equipment – all recognised by the Royal Osteoporosis Society as suitable ways to do strength exercise. A band is enough on its own if it provides genuinely challenging resistance; a gym mainly helps by giving you easier access to progressively heavier loads as you get stronger.

Is Pilates strength training?

It can provide some muscle-strengthening benefit, depending on the type, the exercises and your starting level – the HSE includes Pilates and yoga among its examples of muscle-strengthening activity. But if your goal is to substantially increase strength, you’ll still need enough resistance and progression to keep challenging the muscles.

How many days a week should I lift weights?

At least two days a week, working the major muscle groups, as covered above. More isn’t automatically better – recovery, training volume, intensity and your other activity all matter.

Do I need to lift really heavy weights to build muscle?

No. As covered above, both lower and higher loads can build muscle when the effort is genuine – heavier loads just have the edge for maximal strength. “Heavy” is also relative: your challenging weight is your challenging weight.

Will strength training stop osteoporosis?

No. Exercise can help maintain or improve bone density, but it cannot guarantee osteoporosis won’t develop, and good evidence that it directly prevents fractures is still fairly thin. If osteoporosis medication is indicated, exercise is an addition to treatment, not a replacement for it.

Does HRT protect muscle too?

Less clearly than it protects bone. One meta-analysis found a small benefit of hormone therapy for muscle strength, around 5 per cent; a larger, more recent analysis found no significant effect on lean muscle mass. Overall the evidence is inconsistent and trial quality is generally low. HRT should not be treated as a substitute for using your muscles.

The bottom line

Strength training after menopause does not require becoming obsessed with the gym.

It means regularly asking your muscles to do something difficult enough that they have a reason to remain strong.

The evidence is strongest for a simple conclusion: resistance training improves muscular strength in postmenopausal women, can support muscle and physical function, and forms an important part of maintaining bone health alongside other appropriate activity.

Start where you are. Work the major muscle groups at least twice a week. Learn the movements. Increase the challenge as you get stronger.

The point isn’t to train like you’re 25.

It’s to build a body that’s still extremely useful to you at 75.

Sources

This article is for general information and does not replace individual medical advice. If you have osteoporosis, previous fractures or a medical condition that may affect exercise, seek advice appropriate to your circumstances.