Menopause marks a significant transition in a woman’s life, bringing with it numerous physiological changes that can affect health, mobility and quality of life. Among these changes, declines in muscle mass, bone density and balance present particular challenges. Research suggests that resistance training is a safe and effective strategy to counteract these effects.

For women navigating perimenopause and menopause, it is not just a savvy fitness choice, but a crucial intervention to improve strength, balance, lean muscle mass and bone health, thereby reducing the risk of falls and injuries while supporting healthy aging.

 

Physiological Challenges of Menopause

Perimenopause can last for two to 10 years leading up to menopause, which is officially marked by 12 months without a menstrual period. Menopause typically occurs between the ages of 45 and 55 and involves a natural decline in estrogen production. This hormonal shift accelerates loss of muscle mass (sarcopenia) and bone density (osteopenia or osteoporosis), both of which are critical factors for maintaining physical function and preventing injury.

“Once in menopause, we lose muscle and bone mass at a faster rate, so strength training helps counteract that loss,” explains . Dr. Brenda Heinecke, physical therapist and pelvic floor specialist based in Milwaukee, Wisconsin. Muscle weakness and decreased balance increase the risk of falls, a leading cause of injury in older adults, while reductions in lean body mass slow metabolism and contribute to weight gain.

 

Benefits of Resistance Training

Resistance training, also known as strength training, involves exercises that cause muscles to contract against an external force such as weights, resistance bands or body weight. Unlike aerobic exercise, which primarily benefits cardiovascular health, resistance training specifically targets muscle and bone strength.

A 2023 systematic review of 12 randomized controlled trials involving more than 800 women, published in the Journal of Clinical Medicine, reported that resistance training improved musculoskeletal health in menopausal women, highlighting its positive effects on muscle mass, bone density and functional outcomes like balance and mobility.

The authors noted that resistance training could effectively combat the muscle and bone loss accelerated by menopause, contributing to better overall health and reduced risk of fractures. They also found strength training to be positively associated with hormonal and metabolic improvements in menopausal women, including stabilized blood pressure and a reduction of hot flashes compared to inactive women in the studies.

 

Hip Strength and Fall Prevention

The hips play a vital role in balance and mobility, but hip strength diminishes significantly during menopause, affecting gait stability and increasing the likelihood of falls. A 2023 article in the Iranian Journal of Public Health reported on a Korean study of postmenopausal women that performed a variety of resistance exercises to target the large muscle groups of the lower body, including a band lateral walk, one-leg deadlift, side-lying hip abduction and squat deceleration, over the span of four weeks. The group that performed these resistance exercises significantly improved their gluteal muscle strength.

 

Lean Body Mass and Metabolic Health

Menopause-related declines in estrogen also contribute to reductions in lean body mass and increases in fat mass, which can negatively impact metabolism, insulin sensitivity and cardiovascular health. “Strength training not only helps increase muscle and bone mass, but it helps with other common issues of menopause such as cardiovascular disease; insulin resistance; and impairments to mood, cognitive function and sexual health,” Heinecke remarks. Resistance training helps to preserve and increase lean muscle mass, which in turn supports a healthy metabolic rate and reduced risk of type 2 diabetes.

A 2023 BMC Women’s Health study of premenopausal women highlights that maintaining lean body mass through resistance exercise helps mitigate common menopausal symptoms such as weight gain and fat redistribution.

 

Balance and Functional Independence

Balance naturally deteriorates with age due to changes in the nervous system and muscle function. The 2023 review in Journal of Clinical Medicine reinforces that resistance training not only strengthens muscles, but also improves neuromuscular coordination, which is critical for maintaining balance and preventing falls. Exercises such as squats, lunges and step-ups challenge both strength and balance systems, making them ideal components of a menopausal fitness program.

 

Starting a Resistance Training Program

Given its benefits, resistance training should be a cornerstone of menopausal health routines. However, many women may feel uncertain about how to begin or fear injury. “My personal recommendation would be to join a fitness class or hire a personal trainer for a few sessions,” shares Victoria Morse, a certified fitness instructor in Kona, Hawaii. “For most people, lasting change can be hard to achieve alone—they need accountability. Once we accept this truth, our chance of success increases dramatically.”

For those that are ready to add strength training to their routine, begin with light resistance and focus on proper technique, gradually increasing weight or resistance as strength improves. Aim for two to three sessions per week, targeting major muscle groups with these exercises:

• Squats, lunges and step-ups for lower body and hip strength
  
  
• Push-ups or chest presses for upper body
  
  
• Rows and shoulder presses for back and shoulders
  
  
• Core stabilization exercises such as planks or medicine ball rotations

Menopause introduces complex challenges, but resistance training offers a scientifically supported solution to some of the most significant concerns: loss of hip strength, balance and lean body mass. For women facing menopause, lifting weights or using resistance bands is more than just a fitness trend; it is an essential strategy to maintain mobility, independence and vitality for years to come.

 

Jordan Peschek has a background in personal training, yoga instruction and mental health nursing. She publishes the Milwaukee and Twin Cities editions of Natural Awakenings.

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