Why Does Menopause Cause Muscle Loss?

Understanding Menopause and Muscle Health

Menopause marks a significant transition in a woman's life, bringing various hormonal and physiological changes that impact overall health. One of the lesser-discussed but critical effects of menopause is muscle loss, also known as sarcopenia. This decline in muscle mass and strength can affect mobility, increase the risk of falls and injuries, and reduce overall quality of life.

But why does menopause contribute to muscle loss? The answer lies primarily in hormonal shifts, particularly the decline of estrogen and its impact on muscle protein synthesis, inflammation, and metabolism.

The Role of Estrogen in Muscle Maintenance

Estrogen plays a crucial role in maintaining muscle mass and strength. Research indicates that estrogen has anabolic (muscle-building) effects, helping regulate protein metabolism and muscle repair (Greising et al., 2009).

When estrogen levels decline during menopause, several physiological processes occur:

• Decreased Muscle Protein Synthesis: Estrogen influences the rate at which muscles synthesize new proteins. Reduced estrogen levels slow down this process, making it harder for women to maintain or build muscle mass.

• Increased Muscle Breakdown: Studies suggest that estrogen has a protective effect against muscle degradation. Without sufficient estrogen, the rate of muscle breakdown increases, leading to accelerated loss of lean tissue (Collins et al., 2019).

• Altered Muscle Fiber Composition: Estrogen helps maintain the balance between fast-twitch and slow-twitch muscle fibers. With its decline, there is a shift toward more fatigable muscle fibers, leading to reduced endurance and strength (Lowe et al., 2010).
  

How Menopause-Related Muscle Loss Affects Daily Life

Muscle loss during menopause isn’t just about aesthetics or athletic performance—it has profound effects on daily activities and long-term health:

• Reduced Strength and Mobility: Tasks like carrying groceries, climbing stairs, or even standing up from a chair can become more challenging.

• Increased Risk of Falls and Fractures: With declining muscle mass comes reduced balance and coordination, increasing the likelihood of falls, which is especially concerning given that menopause also affects bone density.

• Slower Metabolism and Weight Gain: Since muscle tissue is more metabolically active than fat, losing muscle can contribute to weight gain and a higher percentage of body fat, particularly around the abdomen.
  

How Physical Therapy Can Help Combat Muscle Loss

The good news is that muscle loss is not inevitable, and physical therapy plays a crucial role in mitigating its effects. A structured program focusing on strength training, mobility, and functional exercises can help postmenopausal women maintain and even regain muscle mass.

Strength Training and Resistance Exercises

Engaging in resistance exercises at least 2-3 times per week has been shown to significantly improve muscle mass, strength, and function in postmenopausal women (Fragala et al., 2019). Physical therapists design personalized progressive resistance training programs tailored to each patient’s needs, ensuring exercises are both effective and safe.

Balance and Functional Training

Since menopause-related muscle loss can contribute to poor balance and coordination, neuromuscular training and functional exercises (such as single-leg balance, core stabilization, and proprioceptive drills) can reduce fall risk and enhance daily movement patterns.

Nutritional and Lifestyle Guidance

A comprehensive approach to preventing muscle loss includes dietary strategies as well. Generally speaking, increasing protein intake (at least 1.0-1.2 g/kg of body weight per day) and ensuring adequate vitamin D and calcium levels support muscle preservation (Bauer et al., 2013).

Why Choose Physical Therapy at Nashville Physical Therapy & Performance?

At Nashville Physical Therapy & Performance, we specialize in helping women navigate the changes that come with menopause through individualized treatment plans that focus on strength, mobility, and overall well-being. Unlike insurance-based clinics, our cash-based model ensures you receive one-on-one, high-quality care without restrictions.

If you're noticing muscle weakness, reduced endurance, or increased difficulty with daily activities, now is the time to take action. Contact us today to start a physical therapy program designed to keep you strong, active, and thriving through menopause and beyond.

References

• Greising, S. M., Baltgalvis, K. A., Lowe, D. A., & Warren, G. L. (2009). Hormone therapy and skeletal muscle strength: a meta-analysis. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 297(3), R962-R966. https://doi.org/10.1152/ajpregu.90742.2008

• Collins, B. C., et al. (2019). Estrogen regulates the skeletal muscle transcriptome and protects against global metabolic dysfunction. American Journal of Physiology-Endocrinology and Metabolism, 316(4), E578-E593. https://doi.org/10.1152/ajpendo.00291.2018

• Lowe, D. A., Baltgalvis, K. A., & Greising, S. M. (2010). Mechanisms behind estrogen’s beneficial effect on muscle strength in females. Journal of Applied Physiology, 109(6), 1666-1674. https://doi.org/10.1152/japplphysiol.01211.2009

• Fragala, M. S., et al. (2019). Resistance training for older adults: Position statement from the National Strength and Conditioning Association. Journal of Strength and Conditioning Research, 33(8), 2019-2052. https://doi.org/10.1152/japplphysiol.00174.2019

• Bauer, J., et al. (2013). Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. Clinical Nutrition, 32(6), 921-927. https://doi.org/10.1016/j.clnu.2013.04.002