“Bone loss is silent, but it can have serious consequences.”
Menopause comes with a lot of maddening symptoms: hot flashes, diminished sleep quality, mood dysregulation, and weight gain, to name a few. But the most concerning change to our bodies — bone loss — is both harder to see and more damaging.
The good news is that there’s a way to mitigate some of the effects of that bone loss: strength training. And you don’t have to start scheduling “leg days” or spend hours at the gym to reap the benefits.
What happens to our bones during and after menopause?
Diminished bone density occurs once our bodies stop producing estrogen. “The first couple of years after the final menstrual period is when you have the biggest loss of bone,” explains Jennifer Howell, MD, an OB-GYN and certified menopause practitioner at Duke University. While you might not notice it at first (“Bone loss is silent,” cautions Dr. Howell), it can have serious consequences, like the onset of osteoporosis.
As they age, men and women experience a decrease in muscle mass known as sarcopenia. This has implications beyond the size of your biceps: Loss of muscle mass is associated with impaired movement and reduced mobility. Fall risks become a significant concern thanks to a loss of balance, which, when coupled with low bone density, can lead to fragility fractures that have consequences beyond the single injury. “Once you have a fragility fracture, it’s often what takes an otherwise independent, healthy, older woman to a place where they need help with activities of daily living,” says Dr. Howell. “It can mean the end of independence.”
How can strength training help during menopause?
Strength training, also known as resistance exercise training (RET), in which your body is exerting force against something — that can be your own bodyweight, resistance bands, cable machines, or a dumbbell/barbell/kettlebell, for example — is shown to be the most promising way to build, maintain, or increase bone density. That’s because when a load greater than we encounter during daily weight-bearing activities (like walking, for example) is applied to bones, it stimulates growth.
Traditionally, women have been told to engage in more gentle activities as they age, but Kate Ackerman, MD, a physician and the director of the Wu Tsai Human Performance Alliance and Boston Children’s Hospital Female Athlete Program, suggests that might be based on the assumption that older women are frailer, to begin with. “People used to be really scared about telling women that they should do too much,” she said. “So they would encourage them, ‘Well, at least be walking, at least be doing some water aerobics with some weights.’ But that’s a very different population than older women today, many of whom have always been physically active and [should focus on] maintaining their muscle mass.” It’s worth noting that walking on its own has been shown to have no significant impact on bone mineral density.
Engaging in any form of exercise will help mitigate some menopausal symptoms like poor sleep quality and mood swings (thank you endorphins), but beyond impacting bone density and increasing muscle mass, strength training is also a superhero when it comes to combating another symptom of menopause: involuntary weight gain.
“Oftentimes weight gain can happen as your metabolism slows down as you get older,” says Dr. Howell. “Because of the changes in body composition that come with age, where you can lose muscle mass, your weight can look exactly the same, but you’ve got more fat and less muscle, and your metabolism is lower. Strength training to build muscle helps with metabolism, and that can help keep you at a healthy weight as you age.”
How do I get started?
If you’re not already incorporating some kind of resistance training into your regimen, the most important thing you can do to start is change up your routine. That said, it’s also crucial to start in a place that’s right for your level of activity and ability.
“Going from 0 to 60 is not the answer,” says Dr. Ackerman. “It’s about significant weight training that’s difficult, but at the right level if you’re inexperienced.” Dr. Ackerman suggests working with a certified trainer who can help you engage in weight training that feels challenging but at a level that matches your ability and experience. A good trainer should assess your level of mobility, stability, and strength, talk to you about your goals, and create a program tailored to your unique needs.
Working out with the goal of maintaining or improving your bone density and muscle mass may not seem like the most exciting motivation, but maintaining independence, knowing that you can confidently carry your groceries or place your luggage in an overhead bin without help, and being able to play with and pick up your children or grandchildren for decades to come, might be.
Alyssa Ages is a journalist and the author of Secrets of Giants: A Journey to Uncover the True Meaning of Strength (Avery/Penguin Random House). She is a strongman competitor, endurance athlete, and former personal trainer and group fitness coach.
