Menopause is a Muscle Story, Too: Why Strength Matters More Than Ever
Menopause tends to get framed as a hormone story. Hot flashes. Sleep changes. Mood shifts. Weight gain. Changing estrogen levels.
But there’s another important part of the story that deserves much more attention: muscle.
Dr. Gabrielle Lyon, a board certified family medicine physician founded the term “muscle centric medicine” and specializes in longevity and metabolism. She emphasizes that menopause is not just about what happens to your hormones. It’s also about what happens to your skeletal muscle—and that matters for how you metabolize carbohydrates, maintain bone health, stay strong, prevent falls, and preserve your ability to live the life you want.
The goal isn’t simply to get through menopause. The goal is to live well and live long.
Menopause Is Coming—But You Can't Predict Exactly When
Menopause is defined as the permanent cessation of menstruation and is diagnosed retrospectively after 12 consecutive months without a period. The average age is around 51, but the timing varies considerably from woman to woman.
Unlike the popular topic of pregnancy, there isn't a universally familiar roadmap called What to Expect When You're Expecting Menopause.
That means many women reach their 40s and 50s without realizing that changes in body composition and muscle may already be underway. One of the challenges during this stage of life is distinguishing changes driven by menopause from those associated with the natural aging process.
Research from the Study of Women's Health Across the Nation (SWAN) suggests that changes in muscle and fat can begin in the years surrounding the menopause transition—with muscle declining and fat increasing in the period before the final menstrual period. This creates an important window of opportunity.
Muscle Loss Doesn't Have to Change Your Life
Muscle mass naturally changes with age. However, this does not mean that there is nothing we can do about it. If you do nothing, age-related muscle loss can begin as early as your mid 30s and accelerate as you get older. During the menopause transition, hormonal changes may add another layer to this process. Anabolic resistance is the idea that muscle can become less responsive to the signals that normally stimulate muscle protein synthesis, including dietary protein and resistance exercise.In other words, the same things that helped you build or maintain muscle when you were younger may not produce exactly the same response later in life.
That doesn't mean your body can't build muscle at 50. It absolutely can. It means that muscle needs to become a more intentional part of your health strategy.
Why Does Muscle Matter So Much?
We often think of muscle as something that helps us look toned or lift heavier weights. But skeletal muscle is much more than that. Think of your muscles as one of your body's largest metabolic organs.
Muscle:
Helps regulate blood sugar
Supports insulin sensitivity
Provides a major place for the body to dispose of glucose
Helps the body shift between using carbohydrates and fat for fuel
Produces myokines, signaling molecules involved in regeneration and repair of tissues
Provides strength and power for everyday movement
Helps protect against falls and frailty
Supports joints and functional mobility
Helps protect vital organs
This is one reason muscle becomes increasingly important as we age.
Muscle and Bone Are Connected
There's another reason to pay attention to muscle during menopause: bone health. Muscle and bone are closely connected through movement and mechanical loading. As muscle mass and strength decline, bone health can also be affected. Low muscle mass may also be an early indicator of low bone density, making changes in muscle an important signal to pay attention to. This matters because declining bone density increases the risk of fractures—and a fracture later in life can have a profound effect on mobility and independence.
The mindshift change that needs to happen is going from “How much do I weigh?” to “How strong am I?” As hard as a transition as that can be, the shift will help you think about what your body is capable of doing.
Menopause Changes the Body. It Doesn't Have to Change Your Life.
During menopause, estrogen levels decline and body composition can shift. Many women experience a tendency toward increased visceral fat, changes in energy expenditure and fat oxidation, and changes in metabolic markers. One of the most useful questions to ask as you enter into midlife is: “What do I want my body to be capable of doing for the rest of my life?”
Can you:
Get down on the floor and get back up?
Carry groceries?
Climb stairs?
Lift something overhead?
Get out of a chair without using your hands?
Pick something up from the ground?
Walk, hike, travel, play, garden, or participate in the activities you love?
These aren't abstract fitness goals. They're measures of independence.
And the way we maintain those abilities is by practicing the movements and building the strength required to perform them.
Strength Training Is Not Optional
For women navigating perimenopause and menopause, resistance training deserves a permanent place in the weekly routine.
A practical goal is two to three days per week of full-body strength training, incorporating different planes of movement and challenging the major muscle groups.
That might include movements such as:
Squats
Lunges
Pushing
Pulling
Carrying
Hinging
Rotational movements
Getting down to and up from the floor
Remember: your muscles will adapt to what you ask them to do.
The Bigger Picture
Menopause is a transition. Your hormones change. Your body composition may change. Your metabolism may change. But these changes don't have to dictate what the next decades of your life look like.
At Healthy Core, that's the goal: not simply to add years to your life, but to help you live well and live long—with strength, confidence, and the capacity to keep doing the things you love. As physical therapists, we can help you achieve these goals!
Give us a call at (330) 528-0034 to schedule an appointment or talk to one of our movement experts.
References:
Lyon G. The Forever Strong PLAYBOOK: A Six-Week, Science-Based Plan to Sharpen Your Mind, Strengthen Your Body, and Get Healthy at Any Age. Atria Books; 2026.
Lyon G. Menopause is a muscle problem, not just a hormone problem. The Dr. Gabrielle Lyon Show. Episode 240. Published September 24, 2026.
Greendale GA, Sternfeld B, Huang M, et al. Changes in body composition and weight during the menopause transition. JCI Insight. 2019;4(5):e124865. doi:10.1172/jci.insight.124865.
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