Discover how resistance training protects muscle and bone during menopause. Evidence-based insights for MSK physios, sports therapists, and fitness professionals to confidently support midlife women.
Not detox teas.
Not hormone panic.
Not fear-driven social media messaging.
Muscle.
And when it comes to long-term health outcomes — particularly bone density, joint health, metabolic resilience, and injury prevention — resistance training is doing far more than just “keeping women active”. It is foundational.
For MSK physiotherapists, sports therapists, personal trainers and strength coaches, understanding the real relationship between menopause, muscle and bone is no longer optional. It’s essential clinical knowledge.
Some women do enter menopause with lower baseline muscle mass — and yes, that can increase vulnerability. But here’s the nuance that often gets lost online:
Menopause itself does not cause dramatic muscle loss.
In fact, many women make significant strength and lean mass gains in midlife when training is appropriately prescribed and symptoms are well managed.
Menopausal symptoms can complicate training, of course:
But these are modifiable barriers, not brick walls.
With informed coaching, symptom-aware programming, and collaboration with healthcare professionals, women can train effectively — and thrive — through menopause.
If we genuinely care about bone health, then how women train matters just as much as if they train.
Bone responds to mechanical strain — particularly when muscles pull on it from multiple angles. That means:
And yes — training close to failure matters.
We’re not talking about punishment or bootcamp-style exhaustion. We’re talking about 1–2 reps left in reserve, enough stimulus to tell muscle and bone to adapt.
This is not extreme.
This is evidence-based.
Both men and women lose muscle with age — roughly:
So does menopause accelerate this process?
The honest answer from the literature is: it’s complex.
Some studies suggest a small effect. Others don’t.
The large, well-designed SWAN (Study of Women’s Health Across the Nation) study gives us much-needed clarity:
That is not the catastrophic 10% muscle loss narrative often pushed online.
The menopause conversation online is often driven by algorithms, not accuracy.
You’ve probably seen the headlines:
Here’s the problem:
Declining physical activity is a far bigger driver of muscle loss than menopause itself.
Fear does not build strength.
Consistency does.
As professionals, we have a responsibility to replace panic with clear, evidence-based guidance.
The data is remarkably consistent:
Importantly for practitioners:
They need individualised, goal-oriented, evidence-based training, delivered in environments where they feel safe, supported, and taken seriously.
This point cannot be overstated:
Supervised resistance and impact training is one of the most robustly supported interventions for maintaining — and even improving — bone density in midlife women.
Yes, even in women with:
Strength training is not a contraindication.
It is an indication.
When appropriately prescribed and supervised, resistance and impact training is protective, empowering, and clinically essential.
Menopause is not a muscular death sentence.
It is not a metabolic cliff.
And it is certainly not a reason to “play it safe” and underload women.
With intelligent resistance training, adequate protein, and symptom-aware support, midlife can be a period of strength, confidence and resilience gains — not losses.
This is exactly why menopause education matters.
The Menopause Movement Menopause Foundation Course equips MSK physiotherapists, sports therapists and fitness professionals with:
If you want to be part of raising the standard of menopause care in health and fitness — this is where it starts.
Strength matters.
Education matters more.
Christien Bird
February 2026
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