Muscle loss in Menopause: Is it inevitable?

1 Oct

I was inspired by the England Women’s rugby team’d dominating performance last weekend. As a former rugby player myself I was well aware of how tough and strong those women are. Strength training and build muscle is having a bit of a moment but we don’t all need to be professional rugby players of gym bunnies to get the benefit. Particularly in menopause loss of muscle is a serious issue and one that should get more attention. Let me explain why.

Many women notice that as they move through menopause, their body shape changes. Muscle tone feels harder to maintain, strength declines, and everyday tasks such as lifting shopping bags or climbing stairs can feel more challenging. This gradual loss of muscle mass and strength is called sarcopenia, and while it is a normal part of ageing, the hormonal changes of menopause mean women are particularly vulnerable to it.

The good news is that sarcopenia isn’t inevitable. With the right strategies, you can protect your muscle strength, independence, and confidence well into later life.

What is sarcopenia?

Sarcopenia simply means a progressive loss of muscle mass and strength as we age. Research suggests we start to lose muscle from our mid 30’s onwards, often without realising it. By the time we reach our 70’s, some women may have lost up to half of their peak muscle mass if nothing is done to protect it.

This loss of muscle isn’t just about how toned our arms or legs look though; muscle is crucial for balance, posture, metabolism, bone health and even energy levels. When muscle declines significantly, it increases the risk of frailty, falls, fractures, and loss of independence in later life.

Why does menopause make it worse?

There are oestrogen receptors throughout the body and oestrogen plays a key role in maintaining both muscle and bone tissue. As oestrogen levels fall in the perimenopause and menopause, the natural decline in muscle mass can speed up.

What can women do to protect their muscles?

Lifestyle has a big impact on sarcopenia. Here are evidence-based strategies supported by the NHS and the British Menopause Society:

1. Strength training

This is the single most effective way to maintain and build muscle. You don’t have to join a gym or lift heavy weights (unless you want to!). Simple options include:

Resistance bands
Body-weight exercises such as squats, lunges, or push-ups
Pilates or yoga with a focus on strength and balance
Dumbbells or kettlebells, even at home

The key is consistency. Aim for strength-based exercise at least twice a week, starting gently and building up gradually. Remember something is better than nothing and once you have a habit of regular strength training, even if its only 10-15 minutes one or twice a week you can build from there!

2. A protein-rich diet

Muscle is made of protein, and as we age, our bodies become less efficient at using it. This means women in midlife and beyond often need more protein than they think. Try to include a good source with every meal, such as:

Lean meat, poultry, or fish
Beans, lentils, and chickpeas
Dairy products like Greek yoghurt or cottage cheese
Nuts and seeds
Eggs

As a guide, most women benefit from aiming for 20–30g of protein per meal (roughly the size of your palm in animal protein, or a cup of beans/lentils for plant-based).

3. Vitamin D and calcium

Bone and muscle health go hand-in-hand. Without strong bones, muscles can’t function properly, and without strong muscles, bones are less protected from injury.

Vitamin D helps the body absorb calcium and supports muscle function. In the UK, the NHS recommends a daily supplement of 10 micrograms of vitamin D, especially in autumn and winter when sunlight is limited.
Calcium is essential for bone health. Good sources include dairy products, fortified plant milks, tofu, leafy greens, and nuts.

4. Consider HRT

For some women, hormone replacement therapy can support muscle and bone health by replacing oestrogen. It is not a treatment for sarcopenia on its own, but for women struggling with other menopausal symptoms, such as hot flushes, sleep problems, or joint pains, HRT can make it easier to stay active, train regularly, and maintain muscle strength. Whether HRT is suitable depends on your individual health history and should be discussed with your GP or menopause specialist.

The bigger picture: looking after strength and independence

Sarcopenia can sound worrying, but it is important to remember that muscle is adaptable at every age. It is never too late! Even women who have never exercised before can build strength and resilience with the right approach. Small, regular steps such as a 15-minute walk, a few squats in the kitchen, an extra portion of protein at dinner all add up.

Protecting your muscles is not just about avoiding frailty later on. It’s about feeling stronger, more capable, and more confident in the here and now.

The bottom line

Sarcopenia is common, but it is not inevitable. Menopause may accelerate changes in muscle and bone, but lifestyle choices and support can make a profound difference. Strength training, a protein-rich diet, good vitamin D and calcium intake, and considering HRT where appropriate all help safeguard your health.

If you are worried about muscle loss, fatigue, or changes in your strength, don’t wait until it becomes a bigger problem. A consultation can help you understand your options and create a plan that works for you.

Just like the England women’s rugby team showed us, strength comes in many forms including physical, mental and emotional. With the right tools and support, you can stay strong, resilient, and ready for whatever this stage of life brings.

Joanna Vlies