Muscle Matters

How women can reverse the effects of menopause on their bodies.

Sally O’Malley’s been working out

My friend Pattie, who's in her 60s and in great shape, takes medication for osteoporosis. Recently, she asked me whether strength training could be beneficial for her. My response? Absolutely.

Her doctor had recommended focusing on stability and building leg strength to help prevent falls. Pattie wondered if it would be harder for her to build muscle at her age.

My answer was, sure, it may be more challenging than if she were in her 20s (what isn’t?) but new research shows that women going through menopause can still build muscle and strength. After age 30, we lose about three to eight percent of muscle mass per decade, with the rate accelerating after age 60—a condition known as sarcopenia. The significant drop in estrogen during menopause is thought to contribute to this muscle loss, increasing the risk of falls and fractures.

This is what Pattie’s doctor had mentioned: strength training is crucial for preventing these issues. But the real question is: can sarcopenia be reversed—or at least halted? While research is still ongoing, emerging findings suggest the answer may be yes.

A German study from 2023 recruited 41 healthy women, ages 40 to 60, who then participated in a 10-week resistance training program. The women were divided into pre-menopausal and post-menopausal groups based on their hormonal profiles. Researchers measured grip strength and how much the women could squat and bench press—before and after the program.

The results showed that resistance training increased strength in both the upper and lower body for women in all age groups. The maximum weight the subjects were able to lift in one repetition of the bench press and the squat increased “significantly” for all the women, researchers said, regardless of whether they were in the low-intensity or the moderate-intensity training group

What does this mean? It proves that women of any age can—and should!—embrace strength training, and that you don’t have to kill yourself to start seeing results.

My coach, Tina Peratino, who has worked with over 100 women past the age of 40, says that while building muscle can become more difficult, it’s far from impossible. “With the right approach—progressive strength training, adequate protein intake, and consistency—women can build and maintain strength beyond menopause,” she told me.

Tina Peratino (Coach T) strikes a pose in her garage gym.

Most of the women Tina works with are in midlife. Many come from endurance sports backgrounds—marathon runner, triathletes—and have battled knee or joint injuries. “Once they started fueling their bodies properly, reversed undereating, and committed to lifting heavy, the transformation was incredible,” she says.

Such a transformation happened to my friend Laurie Cohen. A longtime runner who discovered weight training at Lifted in East Hampton, N.Y., Laurie, like many postmenopausal breast cancer survivors, takes hormone therapy that lowers estrogen levels, leading to osteoporosis—a condition that also runs in her family.

After hitting the gym at least four times a week, Laurie’s most recent DEXA bone scan showed significant improvement, moving her from an osteoporosis diagnosis to osteopenia (where bone density is still low, but not in the osteoporosis range).

“I believe strength training reversed my osteoporosis,” she says.

Lifted, founded by former professional basketball player Holly Rilinger, opened in May 2023 and has since seen a 65 percent increase in business. “The unintimidating environment is key,” Holly explains. “If a less-experienced woman walks into a gym and sees three men, she might think, ‘I’ll take the elliptical.’ But our space helps women feel confident to grab weights and hit the bench without fear of being judged.”

Holly Rilinger brings joy and muscles to women of all ages

Two More Reps: What the Numbers Are Saying

In February of last year, a group of Danish researchers explored whether resistance training could reverse age-related cellular-level changes in muscle. As muscle myofibers shrink with age, they tend to become more irregular in shape. After undergoing resistance training, individuals of all ages showed a three to four percent improvement in muscle fiber shape, suggesting that muscle atrophy is more about muscle disuse than age itself.

Another recent study, published last November, looked at 72 active women across pre-, peri-, and post-menopausal stages, who weren’t on hormone replacement therapy. Some followed a routine of 150 minutes of physical activity per week, while others completed a 12-week resistance training program. Those in the resistance training group showed significant improvements in hip function, lower body strength, flexibility, mobility, and muscle size compared to those who didn’t train.

The takeaway: strength training can be a game changer, no matter your age.