Strength training for perimenopause and menopause

I'm forty-six. The scale hasn't moved in a year. My jeans have.

That isn't in your head, and it isn't only your age. Here's what the menopause transition does to muscle and bone, what strength training changed in the trials, how much is enough, and how to start safely. One topic a week, every number sourced. Subscribe, and the next one finds you.

The SWAN study scanned women's bodies year after year through the transition. Before it began, lean mass was still growing. When the transition started, lean mass began to fall, and the rate of fat gain doubled. Both kept going until about two years after the final period. Weight rose at the same pace the whole time. That's why the scale missed it. And muscle loss isn't only an old-age problem. A 2023 review estimates that between eight and thirty-six percent of people under sixty already have sarcopenia, the loss of muscle mass and strength.

Bone follows the same calendar. In SWAN, spine bone density fell more than ten percent over the ten years around menopause, and over seven percent of that went in just three years around the final period. Muscles pulling on bone tell it to rebuild. In the LIFTMOR trial, a hundred and one postmenopausal women with low bone mass lifted heavy under supervision, twice a week for eight months. Their spine bone density rose two point nine percent. In the group doing a gentle home program, it fell one point two percent.

In a Swedish trial, women with frequent hot flashes did strength training three times a week. After fifteen weeks, moderate to severe hot flashes were down forty-three point six percent, against two percent in women who didn't change anything. That's one encouraging trial, not proof. Walking and other aerobic exercise haven't cut hot flashes in trials, but in pooled data from more than five hundred women, aerobic exercise improved insomnia scores. A week with both covers both.

A review of trials in nearly six thousand postmenopausal women found exercise added muscle, and reduced body fat, waist size and visceral fat, the deep belly fat linked to heart disease. Lifting did the most for muscle. Aerobic work did the most for fat. Doing both did both.

In twenty-seven trials of women aged forty to sixty, the most muscle came from three strength sessions a week, kept up for at least six weeks. Programs longer than twelve weeks did better still. US guidelines set two days a week as the minimum, plus a hundred and fifty minutes of moderate activity, like thirty minutes of brisk walking on five days. Six movements cover the whole body: a squat, a hip hinge, a push, a pull, a lunge or step-up, and a loaded carry. Pick a weight you can lift eight to twelve times with good form. When the last reps feel easy, add weight. Write it down. And feed it. Experts recommend at least 1.2 grams of protein per kilogram of body weight a day for people who exercise. For a woman who weighs seventy kilos, about a hundred and fifty-five pounds, that's about eighty-four grams, easiest to reach with protein at every meal.

Lifting after forty isn't reckless. In trials of resistance training in more than four hundred postmenopausal women, no serious adverse events were reported. Start lighter than you think, and learn the movement before you load it. If you have osteoporosis, keep lifting, but differently. A UK expert consensus advises avoiding deep forward bending of the spine, and after a spinal fracture, keeping impact to the level of brisk walking. Ask which loads suit you. If you leak when you lift, breathe out on the effort, and work on your pelvic floor before adding jumps. Chest pain, fainting or severe breathlessness during exercise: stop, and call 911.

Before your first session, take four tests, so you can see what changes. How many times you can stand up from a chair in thirty seconds. How many good push-ups you can do, against a wall, a counter or the floor. How long you can hold a side plank on each side. And how long you can carry the same two bags before your grip gives out. Repeat them after six weeks, and after twelve.

Perimenopause is when muscle and bone start to slip, so it's the time to start lifting, not the time to stop. Find your stage in two minutes at perimenostage.com. Week one of our strength plan is free there too.

Same scale. Same jeans. Different reason to get up from the chair.

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