Building Muscle After Menopause: What the Research Says

Can you build muscle after menopause?

Yes. A 2021 meta-analysis in Aging Clinical and Experimental Research by Thomas and colleagues pooled 26 studies of resistance training in 745 healthy postmenopausal and older women aged 50 to 80, with an average age of about 66. The programs typically ran for about 16 weeks, about three times a week. Lean mass rose by a small to moderate amount, about 4.8% on average across the studies, and the benefit held regardless of age or how long the programs lasted. Only three of the studies were randomised controlled trials, so the evidence is weaker than it sounds, but the direction is consistent.

A smaller 2023 trial shows how the response can differ. Isenmann and colleagues (BMC Women's Health) put 31 women aged 40 to 60 on a 10-week free-weight program: two sessions a week and 6 to 8 sets per muscle a week. Strength on the squat and bench press rose by a similar amount in women before and after menopause, and a front thigh muscle grew in every group. But only the premenopausal women gained measurable muscle mass overall. The authors suggest postmenopausal women may need more training volume (more than 6 to 8 sets per muscle a week) to change their body composition, though they present this as an idea to test, and the groups were small (9 to 12 women each).

What that means for you:

• Expect strength to rise first. In the Isenmann trial, it rose within 10 weeks.
• Give muscle size longer, and be prepared to build up the amount of training over time.
• Judge progress by your training log, measurements and photos, not by the scale alone.

How to train after menopause

The principles are the same as at any age; the margin for error is smaller.

1. Lift on at least 2 days a week. That is the NHS guideline for adults, and the NHS menopause advice specifically mentions resistance exercise such as using weights. Three days makes it easier to fit in enough sets.
2. Build up the number of sets. Start with a few hard sets per muscle a week and work towards about 10. A 2017 meta-analysis by Schoenfeld, Ogborn and Krieger linked 10 or more sets per muscle a week with more growth than fewer than 5.
3. Make the sets challenging. Stop most sets about 1 to 3 reps short of failure. Light weights you could lift 30 times will not do much if you stop at 12.
4. Add weight or reps gradually. Progressive overload is what keeps muscle growing.
5. Use exercises that suit your joints. Machines such as the leg press, dumbbells and cables all build muscle and can be kinder to achy joints than heavy barbell work.
6. Keep walking. The NHS lists walking among the weight-bearing exercises that help keep bones healthy, and daily steps add to the energy you use.

If you are new to lifting, weight training for women covers the first steps, including how to choose a weight.

Lifting and your bones

Bone matters as much as muscle after menopause. The NHS lists loss of bone density among menopause symptoms and recommends weight-bearing exercise and resistance exercise, such as using weights, to help keep bones strong.

The best-known trial on heavy lifting for bone is LIFTMOR (Watson and colleagues, 2018, Journal of Bone and Mineral Research). It included 101 postmenopausal women, average age 65, who already had low bone density. About half of them did 30-minute supervised sessions twice a week for eight months: heavy lifting in sets of 5 reps, plus impact training. Compared with a group doing a gentle home program, their spine bone density rose by about 2.9% while the other group's fell by about 1.2%, and their physical function improved. Only one minor injury, a back spasm, was reported.

Two cautions. The women were screened for health problems before they started, and every session was supervised. If you have osteoporosis, low bone density or a history of fractures, speak to your doctor or a physiotherapist before lifting heavy, and build up gradually with someone checking your technique.

Protein, calcium and vitamin D

Protein. A 2018 meta-analysis by Morton and colleagues (British Journal of Sports Medicine) found that the muscle-building benefit of protein levels off at about 1.6 g per kg of body weight a day, with 2.2 g/kg covering nearly everyone. It also found that the benefit of extra protein got smaller with age, so getting enough matters more, not less. Include a good portion of protein at each meal rather than saving most of it for dinner. The protein calculator works out your daily target. If you have kidney disease or another condition that affects your diet, speak to your doctor before increasing your protein.

Calcium and vitamin D. The NHS advises a healthy, balanced diet with plenty of calcium-rich foods, such as milk, yoghurt and kale, and says sunlight on your skin helps your body make vitamin D, which you can also take as a supplement. Ask your GP or pharmacist if you are unsure what suits you, especially if you take any medicines.

Sleep, joints and recovery

The NHS lists trouble sleeping and muscle and joint aches among common menopause symptoms, and both can make training feel harder.

• Protect your sleep. The American Academy of Sleep Medicine and the Sleep Research Society recommend 7 or more hours a night for adults.
• Judge recovery by performance. If your weights and reps are holding or rising, you are recovering, even if you feel stiff.
• Ease off when several things slide at once: lifts going backwards, poor sleep and low energy together. A lighter week often helps more than pushing through.

Where HRT fits

Hormone replacement therapy (HRT) is a treatment for menopause symptoms, and the NHS notes it can also help prevent osteoporosis. It is not prescribed to build muscle, and whether it is right for you depends on your symptoms and your health. That is a decision for you and your doctor, not your coach. Strength training is worth doing either way.

When to speak to your doctor

Speak to your doctor or GP before you start lifting, or at any point, if any of these apply:

• you have menopause symptoms and want to know your treatment options;
• you have osteoporosis, low bone density or have broken a bone from a minor fall;
• you have a heart condition, high blood pressure, diabetes or a joint problem;
• you have palpitations (a fast heartbeat), or any vaginal bleeding after 12 months without a period: the NHS says to contact your GP about both.

How coaching helps after menopause

Building muscle after menopause works best with a steady plan that respects your joints, your sleep and your bones, and builds up gradually over months. With one-to-one coaching from CoachAk, your training program is written around your experience, equipment, schedule and injury history, with sets, reps, effort targets and coaching cues for every exercise, and you can send form-check videos for your coach to reply to. Your nutrition targets, including protein, live in the app. The weekly check-in takes about three minutes and covers your weight, training and nutrition adherence, sleep, energy and stress, with optional body measurements and photos. CoachAk replies with written feedback and adjusts your plan as you progress, and you can message your coach directly, with photos and voice notes, when a joint complains or a week goes sideways. Medical decisions stay with your doctor.

If you want help building strength and muscle through and after the menopause, apply for coaching.