Menopause and physical activity: why loss of strength is not inevitable

Menopause brings real physiological changes, but progressively losing strength and physical capacity is not an inevitable consequence. Between the ages of 45 and 60, many women begin to notice differences that previously seemed minor: recovering after physical effort may take longer, certain movements may feel less easy, and everyday activities that had never been a problem can become more demanding.

At this stage, movement becomes even more important. The goal is not simply to "stay active", but to provide muscles and bones with sufficient stimuli to preserve their capabilities. Walking, cycling or swimming are useful activities, but when it comes to muscle strength during menopause, another often overlooked element should also be considered: resistance training.

A properly designed programme can help preserve strength, independence and confidence in movement. Physiotherapy and therapeutic exercise can become valuable tools, especially when pain, previous injuries or long periods of inactivity make it difficult to know where to start.

As we age, muscle mass and strength tend to gradually decrease. The menopausal transition can contribute to this process through hormonal changes, together with other factors such as physical activity levels, nutrition, sleep quality and lifestyle.

This does not mean that after menopause muscles stop responding to training.

Muscle tissue retains its ability to adapt to stimuli. When subjected to appropriate exercises that progressively become more challenging, it can continue to develop strength and improve its function.

The real difference is therefore also determined by what we ask the body to do. If muscular stimuli become progressively lower over the years, the loss of capacity may accelerate. If, on the other hand, the body continues to receive appropriate loads, there is considerable potential to maintain and improve physical performance.

A woman may walk every day, go hiking at weekends and lead an active lifestyle while still not providing her muscles with enough stimulus to increase their strength.

Aerobic activity remains important for general health, but it has different objectives from resistance training.

To work on muscle strength during menopause, muscles need to be asked to progressively produce greater amounts of force. This can be achieved using weights, resistance bands, machines or appropriately adapted bodyweight exercises.

This does not necessarily mean lifting extremely heavy loads. It means using resistance that is sufficiently challenging in relation to individual abilities and adjusting it over time as the body adapts.

Strength training is not only useful for sport.

Getting up from a chair, climbing stairs, carrying shopping bags, moving an object, walking on uneven ground or getting up from the floor all require muscular capacity.

When available strength decreases, these activities require an increasingly large percentage of a person's resources. A simple movement can therefore gradually become more demanding.

Having a good strength reserve means being able to manage everyday life with greater capacity. It also means continuing to enjoy the activities you love without perceiving every physical effort as something to avoid.

The goal of exercise is not to pursue an aesthetic ideal, but to maintain a capable body.

Menopause is a stage during which bone health also deserves particular attention. The reduction in oestrogen levels can contribute to a decrease in bone mineral density and, in some people, increase the risk of osteoporosis over time.

Physical exercise is one of the useful tools for supporting musculoskeletal health.

Resistance exercises and weight-bearing activities produce mechanical stimuli that affect not only the muscles but also the bones. The programme must naturally be adapted to the individual's situation, especially in the presence of diagnosed osteoporosis, previous fractures or other clinical conditions.

Training more does not automatically mean training better: the choice of exercises, intensity and progression are what make the difference.

Lower back pain, knee discomfort, joint stiffness or shoulder problems can lead people to progressively reduce their physical activity.

This is understandable, but avoiding all movement risks creating an unfavourable cycle: you move less, lose strength, certain activities become more difficult and, as a result, you move even less.

The presence of pain does not necessarily mean that exercise must be stopped. It is often possible to modify movements, loads and ranges of motion in order to continue training in a way that is compatible with the situation.

A physiotherapy assessment can be particularly useful when you are unsure which exercises to choose or are concerned that movement could make the problem worse.

An effective programme should not be a standard sequence that is identical for everyone.

Age, training experience, any existing medical conditions, pain, goals and starting level can significantly change the way the programme should be structured.

A programme may begin with relatively simple movements and progress towards more demanding exercises. Adapted squats, lower-limb exercises, pushing and pulling movements, calf exercises and balance exercises can be combined in different ways.

The central principle is progression: when an exercise becomes easy to manage, the stimulus needs to evolve.

It is this transition that transforms simply "being active" into genuine muscle strength training during menopause.

One of the most limiting beliefs is that if you have never done strength exercises before, starting after the age of 50 will make little difference.

This is not the case.

Training can also be introduced for people who have spent many years without structured physical activity. Naturally, the starting point will be different from that of a woman who already trains regularly, but the principle remains the same: provide an appropriate stimulus and increase it gradually.

There is no need to make up for years of inactivity in just a few weeks. Trying to do so can actually unnecessarily increase fatigue and the risk of overload.

Consistency matters far more than rushing.

There is no single amount that is appropriate for everyone. Frequency and intensity depend on the initial condition, individual goals and other activities performed during the week.

An effective programme must also allow sufficient time for recovery. Training consistently does not mean working the same muscle groups every day.

It is useful to observe how the body responds in the hours and days that follow: normal muscle fatigue is different from increasing pain or symptoms that persist and limit activities.

Progression should follow the individual's ability to adapt, not a rigid schedule.

At TI-FISIO in Mendrisio, strength training starts from the person's actual abilities, not from their chronological age or a pre-designed programme.

The assessment makes it possible to identify any limitations and establish a practical starting point. The programme may then include:

• assessment of strength and mobility;
• resistance exercises adapted to the individual's level;
• balance and movement control exercises;
• gradual progression of loads;
• adaptation of exercises in the presence of pain;
• restoration of function after periods of inactivity or previous injuries.

Physiotherapy therefore becomes a tool for building capacity, not simply for treating a symptom. The goal is to progressively make the person more independent and confident in physical activity.

Menopause represents a period of change, not a boundary beyond which a progressive loss of physical abilities must be passively accepted.

Training the muscles means investing in the ability to continue walking, travelling, practising sport, managing everyday activities and maintaining independence over the years.

Muscle strength during menopause can be trained with programmes designed around the individual's starting level and progressively adapted over time. Even those who have never performed resistance exercises can start, provided they do so according to criteria appropriate to their individual condition.

If you want to start strength training, resume physical activity after a period of inactivity or are experiencing pain and are unsure which exercises are most suitable, contact TI-FISIO in Mendrisio. A physiotherapy assessment can help you build a personalised, progressive and sustainable programme, turning movement into a practical resource for staying strong and active over time.

+41 91 940 10 20

info@ti-fisio.ch

Via Ceresio 42, Pregassona.

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+41 (0)91 229 69 80

mendrisio@ti-fisio.ch

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