5 Ways Strength Training Can Help Manage the Worst Menopause Symptoms

If you're going through menopause, you've probably noticed some changes. Many of these can be credited to the drop in estrogen, one of the primary female sex hormones.

"Until you go through menopause, you don't realize that estrogen affects a lot more than just [your reproductive system]," Tina Tang, CPT, a certified personal trainer who specializes in menopause, tells LIVESTRONG.com.

In addition to regulating your period, estrogen also helps with bone formation, keeping heart tissue healthy and blood pressure stable as well as improving muscle mass, per the Cleveland Clinic.

Once your body quits stocking estrogen, your period stops, your bones favor breaking down over rebuilding, your muscles weaken, your risk of heart problems increases and your metabolism slows. Plus, you can experience symptoms like fatigue, muscle aches and hot flashes.

Lots of these effects are just plain annoying (night sweats, anyone?). Others, like weak muscles and bones, can spell trouble for long-term health.

Ready for some good news? You can prevent and mitigate many of the side effects of menopause with strength training. Read on to learn how.

Estrogen plays a role in muscle protein synthesis, or the process of creating new muscle protein, per a June 2019 review in ‌Bone‌. When estrogen levels drop during menopause, building and maintaining muscle becomes harder, eventually leading to muscle loss.

"On top of that, all of us are naturally losing muscle because of the aging process, so it's kind of like a double dose effect for [people in menopause]," Tang says. Age-related muscle loss, also known as sarcopenia, starts after the age of 30. This is the point when we begin losing approximately 3 to 5 percent of our muscle mass per decade, according to Harvard Health Publishing, with things speeding up after the age of 60.

The downside to losing muscle is that strength declines as well, which makes everyday activities more challenging. If your muscles keep shrinking year after year, you'll eventually reach the point where the simplest tasks — like getting out of bed and walking — are beyond your abilities.

You'll also find it harder to maintain your balance, increasing your risk of falls. And falls are the leading cause of injury and injury-related death among adults 65 and over, the CDC warns.

You can prevent all of that with the help of resistance training. Lifting weights is one of the best ways to build and maintain muscle mass, helping ward off and even reverse sarcopenia and hormone-related muscle loss.

"It's never too late to start strength training," Paula Amato, MD, professor of obstetrics and gynecology at the OHSU School of Medicine in Portland, Oregon, says. A meta-analysis published in April 2021 in ‌Aging Clinical and Experimental Research‌ found that resistance training three times per week for 16 weeks on average led to significant increases in muscle mass in women ages 50 to 80.

Menopause is the time to consider your osteoporosis risk. Osteoporosis is a disease that weakens the bones and makes them easier to fracture.

Normally, your body breaks down old bone tissue and replaces it with new tissue with the help of estrogen. But once estrogen levels dip, your body has a tough time building bone and you wind up breaking it down faster than you can replace it. This is why the risk for osteoporosis increases drastically after menopause.

In fact, research published in March-April 2019 in the ‌Brazilian Journal of Physical Therapy‌ estimates that 30 percent of postmenopausal people in the U.S. and Europe have osteoporosis.

Enter: Strength training. This is one of the best strategies for building bone, Dr. Amato says.

Strength training works by pulling and pushing on bone and forcing you to move against gravity while your skeleton supports a heavier weight. These actions tell your bones to shift into "build" mode so you're able to handle similar loads and prevent fractures in the future, according to the ‌Brazilian Journal of Physical Therapy‌ review.

It doesn't take much to see benefits, either. In the results from a clinical trial published in October 2017 in the ‌Journal of Bone and Mineral Research,‌ postmenopausal people with osteoporosis improved bone density and strength with just two 30-minute strength sessions per week for eight months.

Strength training may even improve insulin resistance, a condition where your cells stop responding to insulin (a hormone that regulates blood sugar). When left unchecked, blood sugar stays elevated in the bloodstream, which can eventually lead to diabetes, per the CDC.

This is especially worrisome during menopause. Estrogen affects how your cells respond to insulin, and drastic changes in hormone levels after menopause can trigger blood sugar spikes, notes the Mayo Clinic. Your blood sugar levels may fluctuate more than they did pre-menopause, putting you at greater risk for diabetes or diabetes-related complications.

May 2020 research from the ‌Journal of Diabetes Research‌ shows that resistance training improves insulin sensitivity and helps shuttle sugar out of your blood and into your cells to be used for energy. And because your muscles use up hefty amounts of sugar, boosting muscle mass can dramatically help maintain healthy blood sugar levels, the authors add.

Another perk of strength training is it can help prevent unwanted weight gain, a common side effect of menopause.

In general, strength training doesn't burn as many calories ‌during‌ the workout as cardio activities like running. Harvard Health Publishing estimates that a 30-minute weightlifting session burns 90 to 126 calories, whereas running at five miles per hour for the same length burns 240 to 336 calories.

However, strength training can help keep your weight in check by building muscle. After all, muscle loss is a major contributor to age-related weight gain, per an August 2021 report in ‌Science‌.

According that report, muscle is metabolically active tissue, which means that your body needs energy (calories) to maintain it. Adding muscle might help you burn more calories throughout the day and prevent your metabolism from slowing down.

Menopause causes several uncomfortable side effects, the most common of which is hot flashes. In fact, research from June 2023 in the ‌Journal of Clinical Medicine‌ suggests that 75 percent of menopausal people experience them.

Strength training might help. In one May 2019 study in ‌Maturitas‌, postmenopausal people who completed a 45-minute resistance workout three times a week had half as many hot flashes as inactive people after 15 weeks. The study authors theorize that neurotransmitters released during lifting may help our brains control and stabilize body temperature, ultimately cutting back on the number of hot flashes.

While strength training offers plenty of benefits during menopause, not all strength moves were created equal.

"You'll get the most bang for your buck doing compound lifts, which are exercises that use more than one muscle group," Tang says. Examples include:

• Squats
• Bench presses
• Deadlifts
• Bent-over rows
• Overhead presses

Compound moves are better for building muscle and bone than exercises that target a single muscle group (isolation exercises), such as bicep curls, triceps extensions, lateral raises and calf raises. Why? Because they challenge your muscles and bones to a greater extent. And the greater the challenge, the greater the effect.

None of this is to say you can't do isolation exercises or that targeting a single muscle group doesn't carry perks. Still, Tang encourages you to think of compound moves as the meat and potatoes of your strength routine. Sprinkle in a few isolation exercises if you want to beef up a specific muscle group.

In addition, the authors of the ‌Brazilian Journal of Physical Therapy‌ review, which included an evidence-based guide to exercise for the prevention of osteoporosis, encourage you to do strength moves from a standing position as much as possible. Standing forces your body to fight harder against gravity than sitting or lying down, which means more bone-building benefits.

The guidelines for progressing your strength workouts don't change just because you've entered menopause. As with any other phase of life, you should consider your fitness level and strength experience when determining how to progress, Tang says.

If you're new to strength training, simply focus on learning the movements and aim for consistency with your routine. That might mean keeping your workouts short (15 to 20 minutes) so they're easier to incorporate into your schedule and feel more approachable, Tang notes.

Dr. Amato says two to four strength sessions per week is ideal, making sure you target all the major muscle groups (back, chest, shoulders, arms, hips and legs).

Once you get the hang of things — or if you've already been lifting for months or years — you'll have to tweak your approach to keep seeing results. "Your body adapts to challenges," Tang explains.

So, how can you tell if it's time to progress your routine? A surefire indicator is feeling like you could have completed an additional two or three reps at the end of your sets, Tang says.

If that rings true, you have plenty of options for making your workouts more challenging. The simplest method is to lift heavier weights. For example, if you usually use 10-pound dumbbells, try lifting 12- or 15-pound dumbbells for the same number of reps.

If you don't have access to many weight options, the next size up might be too heavy for you to lift for the exact rep count. In that case, reduce the reps so you can do each with the proper form. Or, stick to your usual weight and increase your rep count. So, instead of doing three sets of eight reps, try three sets of 10 or 12 reps, Tang suggests.

And if you've exclusively been doing Pilates, yoga or barre, it's time to hit the weight room: While those workouts can build strength, you'll have to eventually add resistance to keep seeing gains — and benefits.