A recent study published in the Journal of Cachexia, Sarcopenia and Muscle has revealed alarming data regarding muscle loss in women after menopause. According to the research, women lose an average of 5.7% of their lean muscle mass after menopause, with a significant portion of that loss occurring during the perimenopause stage. This accelerated muscle and strength loss during menopause has no equivalent in men of the same age.
Natalie Rouse, a registered nutritionist and Head of Nutrition at women’s wellness brand Free Soul, has shared her insights on how women can combat this muscle loss and reduce its impact later in life.
While men also experience muscle loss with age, they start with more muscle mass to lose. Additionally, women have lower levels of testosterone, a hormone that plays a crucial role in building and maintaining muscle. This explains why women experience an increased rate of muscle loss compared to men.
Further research from The University of Southampton’s Hertfordshire Cohort Study supports these findings, revealing that 7.9% of older women have sarcopenia, a clinical condition characterized by severe loss of muscle mass and strength that affects daily function. In contrast, only 4.6% of men have this condition.
Furthermore, women’s bodies become less efficient in responding to protein and resistance exercise after menopause. This is known as anabolic resistance and has been consistently observed in studies on muscle protein synthesis in older men and women. This decline in muscle-building ability is also attributed to lower levels of hormones, particularly estrogen, in women after menopause.
Apart from causing muscle loss, decreased muscle mass also leads to a reduction in basal metabolic rate, which is the energy the body uses at rest. This is why many women experience weight gain or an increase in body fat during midlife, even without changes in their diet and exercise routines.
However, Rouse emphasizes that while muscle loss is common, it is not inevitable. A combination of factors contributes to this, including lower hormone levels, natural age-related decline, a sedentary lifestyle, and poor diet quality. While hormone levels are beyond our control, the rest can be improved through lifestyle changes.
According to Rouse, there are three key areas that women should focus on at any age, but become particularly important after the age of forty.
The first is strength training. Rouse advises starting with nailing the movements before adding weights. Squats, push-ups, and lunges are excellent exercises to begin with, with an emphasis on proper form rather than heavy lifting. As women become more comfortable with the movements, they can gradually add light weights and increase the intensity. Rouse recommends two strength training sessions per week to build muscle while avoiding injury.
The second area is protein intake. Rouse suggests aiming for 25 to 30 grams of protein at breakfast, lunch, and dinner. Excellent sources of protein include eggs, Greek yogurt, tofu, fish, lentils, beans, and chicken. Protein powder can also be helpful, especially at breakfast, where most women fall short. It can be added to shakes, yogurt, or even used as a substitute for flour in baking. After menopause, the quality of protein becomes just as important as the quantity, and Rouse advises women to be generous with their portions.
The third area is recovery, which Rouse says is often overlooked or considered less important. However, proper recovery is crucial for muscle building. When lifting weights, small amounts of damage are created in the muscle fibers, and the repair and rebuilding process occurs during deep sleep when growth hormone is released and protein synthesis is at its peak. Muscles also need 48 to 72 hours of rest before being worked out again, which is why two or three strength training sessions per week are recommended.
Commenting on the study’s findings, Rouse said, “Women may not immediately realize that they are losing muscle mass, but instead, they start to experience a range of symptoms. They may notice slower recovery, low energy, changes in body composition, and not understand why or how to address it.”
Rouse also highlights the role of estrogen in muscle building, which many women are not aware of. “Estrogen supports the building of new muscle, slows the natural breakdown of muscle, and keeps systemic inflammation low. It also supports the function of mitochondria, the energy powerhouse of muscle cells. When estrogen levels decrease during menopause, all of these protective effects weaken, leading to a decline in muscle mass,” she explained.
While the numbers may seem alarming, Rouse reassures that taking action early on can make a significant difference. “For women who start in their forties, consistency in strength training and protein intake can prevent most of the muscle loss described in the data. For those starting later, it can help rebuild a meaningful amount of what has already been lost,” Rouse said.
