How Resistance Training Transforms Women’s Health During Perimenopause and beyond.

Navigating the waters of perimenopause can feel like embarking on a new and unfamiliar voyage. For women

35 and older, understanding the physiological changes that accompany this phase is crucial, particularly when it

comes to maintaining muscle mass. This article aims to shed light on why gaining and preserving muscle is

essential during perimenopause and beyond. We will specifically be looking at the benefits offered by resistance

training regarding the management of vasomotor symptom, decreased lean muscle mass, increased adiposity (fat

mass).

Some exciting and promising research demonstrates how resistance training can play a pivotal role in reducing

the severity of hot flashes, night sweats, and other vasomotor symptoms commonly associated with

perimenopause by regulating body temperature and stabilising hormonal fluctuations. Building lean muscle

mass through consistent resistance exercises helps in metabolic health, boosts strength, and enhances daily

functional abilities. This is especially important as muscle mass naturally declines with age, leading to

sarcopenia (weakening and loss of muscle mass). Furthermore, reductions in adiposity (body fat) not only

contribute to a leaner physique but also decrease the risk of developing various health conditions such as

cardiovascular disease, insulin resistance, diabetes.

By incorporating regular resistance training sessions, women can also significantly lower their risk of falls,

which become more prevalent as muscle strength and coordination decrease during aging. Overall, resistance

training offers a holistic approach to maintaining overall health and well-being during perimenopause and

beyond.

Understanding Perimenopause and Its Impact on Muscle Mass

Estrogen plays a crucial role in maintaining muscle mass, acting as both protective and anabolic (growth) for

women. This hormone supports muscle repair, maintenance, and growth, thereby playing a pivotal role in

sustaining physical strength and body composition. As women approach their mid-30s and enter perimenopause,

the natural decline in estrogen levels can have a profound impact on these functions. This hormonal reduction

can lead to increased muscle breakdown and a decrease in the synthesis of new muscle proteins, ultimately

contributing to muscle mass loss. Such changes necessitate heightened attentiveness to maintaining muscle mass

through lifestyle modifications, including resistance training and dietary adjustments.

The good news is that with a strategic approach, women can counteract the decline and support their physical

health, staying strong and resilient as they transition through these critical years, particularly through self-

education and enlisting the support of a women’s health exercise physiologist, who can offer significant insights

and support in navigating the complexities of perimenopause and beyond.

Vasomotor Symptoms

Vasomotor symptoms can manifest in various forms amongst individuals and can include one or more of the

following: Hot flashes, night sweats, flushed skin, profuse sweating, increased heart rate, anxiety, heart

palpitations, dizziness, chills, and disrupted sleep. A 2020 study by Woods et al, delved into the connection

between lean body mass (LBM) and vasomotor symptoms (VMS), offering a fresh perspective on managing

menopausal symptoms.

This research included a diverse group of women from across the United States, and highlighted that

maintaining lean mass can provide a protective effect against the onset of VMS during menopause. These

findings have significant implications given the ongoing hesitance towards hormone replacement therapy (HRT)

for symptom relief. Now I am going to slightly sidetrack here to suggest that this is presumably in reference to

the 2002 Women’s Health Initiative (WHI) Hormone Therapy Trials, which had a profound impact on the

perception of HRT. The initial outcomes suggested potential detrimental side effects, generating considerable

fear among clinicians and the public. This in turn led to a significant decline in the use of HRT as a treatment for

menopause symptoms. Despite subsequent research highlighting the benefits and safety of HRT for many

women, the shadow of the WHI findings still lingers. As a result, a generation of clinicians and women remains

hesitant to embrace hormone therapy. For more information on the pros and cons of hormone therapy, I

encourage you to visit either the Australasian Menopause Society or Jeans Hailes, for some fabulous educational

resources.

Now back to the study by Woods et al, which underscores the potential of resistance training programs in

preventing symptoms by preserving LBM. The research points to maintaining lean body mass as the most

effective strategy for reducing menopausal symptoms, presenting a promising non-hormonal approach for

women navigating this life transition. But perhaps an even better outcome for women who can and choose to use

a combined resistance training and hormonal replacement approach.

Decline in muscle mass

Sarcopenia, is characterised by age-related loss of lean muscle mass, including the wasting of fast twitch (that is

your power) muscle fibres and a reduction in type II fibres (endurance). The European Working Group on

Sarcopenia in Older People; defines sarcopenia as probable when low muscle strength is present, diagnosed with

low muscle quantity or quality, and severe if accompanied by reduced physical performance. In their research

article on The Musculoskeletal Syndrome of Menopause, Wright et al, concluded that potential interventions to

mitigate muscle loss include nutritional measures such as protein and vitamin D supplementation, creatine

intake, alongside resistance training. They particularly highlighted the significance estrogen plays in

maintaining muscle mass and strength; its decline, particularly through menopause, contributes to rapid muscle

loss and increased frailty. Menopausal Hormone Therapy (MHT), especially when combined with resistance

training, showed potential for counteracting these effects by enhancing muscle mass and muscle strength.

Increased belly fat and inflammation

As women age, especially during and after menopause, they tend to gain weight around the middle.

This can lead to higher levels of pro-inflammatory substances in the body. These play a role in causing

or reducing inflammation in the body and have been linked to a range of health issues, such as insulin

resistance, diabetes and heart disease.

In a study by Ward et al, they found that a 15-week supervised resistance training program for

postmenopausal women, when followed diligently, significantly decreased levels of inflammation in

the body. This suggests that resistance training might help reduce inflammation risks per the chronic

health conditions previously mentioned.

Another review by Nunes et al, indicated that both low-volume resistance training and high-volume

resistance training are beneficial strategies for decreasing menopause body fat, including total body

and belly fat. Additionally, both types of resistance training were found to reduce metabolic risk and

inflammation among overweight or obese postmenopausal and older women. These findings suggest

that resistance training should be recommended in public health guidelines as a primary non-

medicinal intervention for addressing obesity, metabolic risk, and inflammation issues.

In conclusion, resistance training emerges as a powerful tool for women navigating perimenopause

and beyond, offering substantial benefits that extend to various facets of health and well-being.

Through the promotion of lean muscle mass, this form of exercise not only mitigates the symptoms

associated with perimenopause and menopause, such as hot flashes and night sweats, but also

counteracts muscle loss and the risk of sarcopenia.

Resistance training effectively reduces adiposity, contributing to a leaner physique and lowering the

risk of chronic health conditions like cardiovascular disease and type 2 diabetes. Furthermore, the

practice of resistance training offers a non-hormonal approach to managing menopausal symptoms,

appealing to those who may be hesitant about hormone replacement therapy. By committing to

regular sessions, women can strengthen their bodies, enhance their metabolic health, and safeguard

against the deleterious effects of aging, thereby ensuring a higher quality of life during and after the

transition through perimenopause.

If you’re not sure where to start on your resistance training journey, why not reach out to the

wonderful community of women’s health-focused exercise physiologists featured here at She

Community? These experts are dedicated to providing support and guidance tailored to your specific

needs during perimenopause and beyond. By engaging with this knowledgeable community, you can

learn how to implement resistance training effectively in your routine, ensuring you thrive throughout

this significant phase of life. Don’t hesitate to seek out their expertise to optimise your health and

well-being.

References

Wright V, Schwartzman J, Itinoche R, Wittstein J. The musculoskeletal syndrome of menopause.

Woods R, Hess R, Biddington C, Federico M. Association of lean body mass to menopausal symptoms: The Study of Women's Health Across the Nation.

Isenmann E, Kalusza D, Havers T, Elbeshausen A, Geiser S, Hofmann K, Flenker U, Diel P, Gavanda S. Resistance training alters body composition in middle-aged women depending on menopause - A 20-week control trial.

Ward L, Nilsson S, Hammar M, Lindh-Astrans L, Berin E, Lindblom H, Spetz Hol A, Ruber M, Li W. Resistance training decreases plasma levels of adipokines in postmenopausal women.

Nunes P et al, Effects of resistance training volume on body adiposity, metabolic risk, and inflammation in postmenopausal and older females: Systematic review and meta-analysis of randomized controlled trials