The science of change - Why strength matters more than ever

During perimenopause and menopause, declining oestrogen levels initiate widespread physiological changes that influence your muscle tissue, bone density, metabolism and pelvic floor function.

Understanding these changes is key to working with your body, not against it.

Muscle Loss Acceleration

Women can lose between 3–8% of muscle mass per decade after the age of 30 - a rate that can double after menopause.

Oestrogen plays a critical role in muscle protein synthesis and tissue repair. When oestrogen levels decline, the body’s ability to build and maintain lean muscle decreases. This shift tilts the balance toward muscle breakdown exceeding muscle repair, especially in women who are not engaging in regular resistance training.

Declines in growth hormone and insulin-like growth factor-1 (IGF-1) also impair muscle regeneration, leading to slower recovery and reduced strength over time.

Resistance training directly counteracts these effects, stimulating muscle protein synthesis and restoring anabolic balance.

Bone Density Decline

Oestrogen is essential for maintaining bone homeostasis - it regulates the balance between bone reabsorption (breakdown) and bone formation.

When oestrogen levels fall during perimenopause, this balance shifts: osteoclast activity increases (cells that break down bone), while osteoblast activity decreases (cells that build bone).

The result? A gradual decline in bone mineral density (BMD) and a significantly higher risk of osteopenia and osteoporosis, particularly at the spine, hips, and wrists.

Progressive resistance training applies mechanical loading to the bones, activating osteoblasts and promoting new bone formation - effectively reversing bone loss trends and enhancing skeletal strength and balance.

Metabolic Support & Midlife Weight Management

As lean muscle mass declines, basal metabolic rate (BMR) also decreases - meaning the body burns fewer calories at rest.

Resistance training increases lean muscle, which is metabolically active tissue. More muscle mass means a higher resting metabolic rate, enabling your body to utilize energy more efficiently throughout the day.

Hormonal changes can also reduce insulin sensitivity, increasing the risk of insulin resistance and type 2 diabetes. Regular strength training improves insulin sensitivity by enhancing glucose uptake in skeletal muscle, improving blood-sugar regulation and energy stability.

The result: improved energy levels, better body composition, and enhanced metabolic resilience through midlife.

Pelvic Floor & Bladder Health

When appropriately supervised, resistance training can enhance pelvic floor function, not compromise it.

Appropriately prescribed exercise supports optimal intra-abdominal pressure regulation, improves abdominal wall coordination, and strengthens the muscles that support the bladder and pelvic organs.

This can reduce or prevent:

• Stress urinary incontinence

• Pelvic organ prolapse

• Core and pelvic instability

It’s not about lifting heavy - it’s about lifting intelligently.

And that comes down to appropriate progression and appropriate loading and NOT over thinking cues and contractions (that is our job to watch and adjust).