Menopause, Muscle and Metabolism: Why Strength Training and Nutrition Matter After 40

Menopause does not automatically mean piling on weight. What it does tend to change, fairly reliably, is what your body is made of: a bit more fat, particularly around the middle, and a bit less muscle, during the years either side of your final period. Bone loss speeds up too.

The good news is that the two levers most within your control, strength training and decent nutrition, work just as well after menopause as before it. They won't fix hot flushes, and they are not a replacement for HRT if you need it. But for muscle, bone, and long-term capability, they are the foundation.

I am not a woman going through menopause, so I won't pretend to know what it feels like. But menopause comes up in my sessions at Lightwater Leisure Centre almost every week. Many of the women I coach from Lightwater, Bagshot, Windlesham, and the villages around them are somewhere in perimenopause or beyond, and the same questions keep coming up: why is my shape changing, should I be eating differently, and is it safe to lift? This is the answer I give them, and what the evidence actually says.

What is actually changing?

The best long-term data comes from the Study of Women's Health Across the Nation (SWAN), which tracked body composition in women through the transition using DXA scans. Two things happened at the start of the menopause transition: the rate of fat gain doubled, and lean mass started to fall. Both trends carried on until about two years after the final period, then levelled off.

Here is the part most people miss: total weight did not speed up. It had been creeping up steadily before the transition and simply carried on at the same rate. Fat went up, muscle went down, and the scales barely noticed the swap.

That fits with what the British Dietetic Association says: most midlife weight gain is down to ageing and lifestyle rather than menopause itself, but menopause does change where fat is stored, shifting it towards the middle.

There is also a bit of honest uncertainty worth knowing about. A 2026 review from the University of Nottingham looked at how much of that muscle loss is genuinely caused by falling oestrogen, and concluded the evidence is still limited. The link is biologically plausible, but a fair chunk of the decline may simply be the same ageing everyone goes through, men included, over the same decade.

For practical purposes, it doesn't matter much which is to blame. Either way, the answer is the same: give your muscles a reason to stay.

Why muscle matters

NICE, in its menopause guideline, specifically tells clinicians to explain the importance of maintaining muscle mass and strength through physical activity. That is a short sentence carrying a lot of weight.

Muscle is what gets you up off the floor, up the stairs at Brookwood, and through a weekend of carrying grandchildren or suitcases. It is also the main place your body stores and uses the glucose from your meals, which is why losing it tends to go hand in hand with creeping blood sugar and a thickening waist. And muscle pulling on bone is one of the main signals that tells bone to stay strong.

The really encouraging bit is how well women respond to training at this stage of life. A 2026 meta-analysis in the Journal of Science and Medicine in Sport pooled 126 studies and just over 4,000 women. Strength gains and improvements in body composition were essentially the same before and after menopause. Menopause did not blunt the response to training.

On bone, the LIFTMOR trial is worth knowing about. Postmenopausal women with low bone mass did two 30-minute sessions a week for eight months, lifting heavy (five sets of five at over 85% of their maximum) plus some impact work. Their bone density and physical function improved, with no injuries reported. The caveat matters, though: these were screened women, average age 65, closely supervised the whole way through. It shows what is possible with good coaching, not that anyone should start deadlifting heavy on their own next week.

"Won't strength training boost my metabolism?"

A little. Muscle burns more energy than fat at rest, but less than the internet suggests: roughly 13 kcal per kilogram per day. Add 2kg of muscle and you are burning around 25 extra calories a day, about the same as a small biscuit.

That is not a reason to skip it. The real return is everything else muscle does: strength, glucose control, bone, balance, and independence. Just don't expect lifting to undo a diet that has drifted.

Nutrition without the nonsense

The basics haven't changed because you have reached menopause. They have just become harder to get away with ignoring.

The pattern I recommend: Mediterranean-style eating

When women I coach ask what they should actually be eating, I steer them towards a Mediterranean-style pattern rather than any menopause-branded diet. Lots of vegetables, fruit, beans, lentils, and wholegrains. Olive oil as the main fat. Fish a couple of times a week, oily fish at least once. Nuts and seeds, yoghurt and some cheese, poultry and eggs, with red meat and processed food pushed to the edges.

It is not a fad and it is not a rule book. It is a sensible way of eating that most people can keep up, and it happens to cover most of what matters at this stage.

The European Menopause and Andropause Society (EMAS) reviewed the evidence in a 2020 position statement. Sticking closely to a Mediterranean pattern over the long term was linked with lower cardiovascular risk, better maintenance of bone, and less cognitive decline, and in the shorter term with improvements in blood pressure, cholesterol, blood sugar, and mood. The honest caveat is that much of this comes from observational studies, so it shows strong associations rather than proof. But heart disease risk rises after menopause, and few eating patterns have a better track record.

The one thing I usually add is more protein than a typical Mediterranean plate carries, especially at breakfast. Which brings us to the numbers:

• Protein: Muscle needs raw material. A sensible target for most women over 40 is around 1.0 to 1.2g per kilogram of body weight a day, nudging higher if you are training regularly or trying to lose fat. Spread it out: 25 to 40g at breakfast and lunch does more than one big dinner. I've covered the numbers in detail in How Much Protein Do You Need After 40? Men and Women Compared. One thing worth repeating from that piece: there is no special "menopause protein requirement". It is the same calculation, taken seriously.

• Calcium: Women's Health Concern, the patient arm of the British Menopause Society, puts the recommendation at 700 to 1,200mg a day depending on your osteoporosis risk. Three portions of dairy, or calcium-fortified alternatives, gets most people there. Tinned fish with bones and green leafy veg help too.

• Vitamin D: The NHS advises everyone in the UK to consider a 10 microgram supplement from October to early March, because the sun is too weak for your skin to make enough. If you are reading this in autumn, now is the time. It costs pennies.

• Fibre: Aim for around 30g a day from wholegrains, beans, lentils, fruit, veg, nuts, and seeds. It helps with fullness, cholesterol, and blood sugar, all of which matter more as oestrogen falls.

• Enough energy: This is the one I see go wrong most. Body shape changes, so the instinct is to eat less and do more cardio. Researchers studying menopause have noted exactly this pattern, and it is the perfect recipe for losing muscle. If fat loss is a goal, a moderate deficit with plenty of protein and strength training beats a crash diet every time. I explain why in Weight Loss After 40: Why Getting Lighter Isn't the Same as Getting Fitter.

Soya and phytoestrogens: helpful for some, not for everyone

Soya contains plant compounds called isoflavones, also called phytoestrogens because they act a little like oestrogen in the body. Women's Health Concern says the evidence on hot flushes is mixed: some women notice an improvement from around two servings of soya a day over two to three months, others notice nothing.

There is an important exception. If you have had breast cancer, Women's Health Concern advises against eating soya at those larger, symptom-targeting amounts. The same caution applies to concentrated phytoestrogen supplements such as soya isoflavone or red clover products, which deliver much higher doses than food. And if you are taking tamoxifen or other hormone-based breast cancer treatment, herbal remedies are a particular risk: black cohosh and St John's wort, for example, can interact with tamoxifen.

This comes up in coaching more often than people might expect. If it applies to you, check with your oncology team or GP before changing your diet or adding anything, and let your trainer know so your nutrition advice takes it into account. The Mediterranean eating approach above works perfectly well without leaning on soya.

What about menopause supplements?

This is sold harder than it works. Women's Health Concern is clear that no specific supplements are recommended for menopause, and that supplements cannot replace HRT or a balanced diet.

Two UK investigations this autumn backed that up. A UCL-led review published in Climacteric found 201 menopause supplements on sale, costing anywhere from £1.50 to £95 a month. Half contained no vitamin D, and fewer than a quarter contained calcium, the two nutrients major menopause societies actually highlight for bone health. A separate Which? investigation of 26 products found none had the right combination of nutrients at sensible doses, and that a basic supermarket multivitamin often did the same job for a fraction of the price.

Some herbal ingredients are not harmless, either. Black cohosh has been linked to liver problems, and as mentioned above, several herbal products interact with medications. If you are considering anything herbal, check with your GP or pharmacist first.

The proper answer is straightforward: eat well, take vitamin D in winter, and spend the money you would have spent on a "menopause blend" on something that actually builds strength.

Training when you don't feel your best

NICE lists joint and muscle pain among the symptoms commonly associated with menopause, alongside the more familiar ones. Add broken sleep, fatigue, and low mood, and it's no wonder plenty of women stop exercising right when it would help most.

The answer is rarely to stop. It is to adjust. A few principles I use:

• Keep the session, change the dose. After a bad night, drop a set, lighten the load, or shorten the session. Turning up and doing 60% keeps the habit alive. Skipping it altogether is how a dodgy week becomes a lost three months.

• Work with the joints, not against them. Achy knees or hands usually mean choosing a different exercise or grip, not avoiding strength training. Women's Health Concern notes that regular exercise can actually help joint and muscle pain rather than worsen it.

• Fit it around your energy. If mornings are wrecked by poor sleep, train later. If hot flushes make a warm gym miserable, go at a cooler time of day, wear layers, and keep water to hand.

• Two sessions a week is enough to matter. You don't need to live in the gym. Two well-planned full-body sessions, progressively loaded, covers the essentials.

• Walk on the days in between. Brisk walking is weight-bearing, good for your heart, and gentle enough for days when you are running on empty. A loop of Lightwater Country Park or the heath tracks around Bagshot counts, and the hills give you more for your effort than the flat.

• Don't ignore pelvic floor symptoms. If leaking or heaviness is holding you back, a women's health physiotherapist can help, and it usually means adjusting exercises rather than abandoning them.

A worry I hear a lot from women starting strength training later in life is that they have left it too late, or that lifting will hurt them. The evidence says otherwise on both counts. What tends to hurt people is weakness, not well-coached training.

What the evidence supports, and what it doesn't

Honesty matters most here, because the menopause space is full of promises that cannot be delivered.

• Exercise is not a proven treatment for hot flushes. A Cochrane review found insufficient evidence that exercise reduces hot flushes or night sweats. Some women do report feeling better, but if your main problem is vasomotor symptoms, a training plan is not the fix.

• HRT is the main medical treatment for menopause symptoms. Whether it is right for you is a conversation for your GP or a menopause specialist, not your personal trainer.

• HRT is not a substitute for strength training. NICE notes there is only limited evidence that HRT may improve muscle mass and strength. Muscle and bone still respond to load, and nothing else does that job for you.

So the two are not competitors. HRT, where appropriate, manages symptoms. Strength training and good nutrition protect muscle, bone, blood sugar, and long-term capability. Many women do best with both, and feeling better on HRT can make it far easier to train consistently.

Where to go from here

Menopause changes the conditions, not the rules. Muscle still responds to being challenged. Bone still responds to load. Protein, calcium, vitamin D, and enough food still do their jobs. What changes is that you can no longer coast on them, and the cost of doing nothing rises a little each year.

Most of the women I work with locally aren't after a dramatic transformation. They want to stay strong enough to keep doing what they enjoy, protect their bones, eat in a way that feels normal rather than restrictive, and stop feeling like their body is changing without their permission.

If that sounds like you, that's exactly what I help with at Lightwater Leisure Centre: strength training matched to how you are feeling that week, and Mediterranean-style nutrition coaching that fits around your medical history, including any medication or past treatment we need to work around. If you are in Lightwater, Bagshot, Windlesham, or anywhere across Surrey Heath, you can book a free consultation or email me directly at [email protected].

Rob Ede is a health-first personal trainer and Level 4 nutrition coach at Lightwater Leisure Centre, working with adults over 40 across Lightwater, Bagshot, Windlesham, and the wider Surrey Heath area.

Related reading

• How Much Protein Do You Need After 40? Men and Women Compared: practical daily targets, and why menopause doesn't create a separate equation.

• Why You're Getting Weaker After 50, and Why It's Not Inevitable: the fuller picture on age-related muscle and strength loss.

References

• Greendale GA, et al. (2019). Changes in body composition and weight during the menopause transition. JCI Insight, 4(5):e124865

• Menzies C, et al. (2026). Menopause, female sex hormones, skeletal muscle mass and muscle protein turnover in humans. Journal of Cachexia, Sarcopenia and Muscle, 17(1):e70232

• Isenmann E, et al. (2026). It's never too late: the impact of resistance training on strength and body composition in females across the lifespan. Journal of Science and Medicine in Sport, 29(10):1174-1185

• Watson SL, et al. (2018). High-intensity resistance and impact training improves bone mineral density and physical function in postmenopausal women with osteopenia and osteoporosis: the LIFTMOR trial. Journal of Bone and Mineral Research, 33(2):211-220

• NICE (2015, updated 2024). Menopause: identification and management (NG23)

• Women's Health Concern. Exercise in menopause (fact sheet, reviewed September 2026)

• Women's Health Concern. Nutrition in menopause (fact sheet)

• British Dietetic Association. Eating well for the perimenopause and menopause (food fact sheet)

• Cano A, et al. (2020). The Mediterranean diet and menopausal health: an EMAS position statement. Maturitas

• NHS. Vitamin D

• Daley A, et al. (2014). Exercise for vasomotor menopausal symptoms. Cochrane Database of Systematic Reviews, Issue 11

• UCL News (2026). Calls for better research into menopause supplements (Sullivan et al., Climacteric)

• Which? (2026). Menopause markup: specialist supplements no better than 6p multivitamin

• Elia M (1992). Organ and tissue contribution to metabolic rate. In: Energy Metabolism: Tissue Determinants and Cellular Corollaries. Raven Press.