Do Hormonal Changes Affect Exercise In Menopause?

By: Dr. Anna Camille MorenoHolly L. Thacker, MD • Posted on October 23, 2019

Do Hormonal Changes Affect Exercise In Menopause? Do Hormonal Changes Affect Exercise In Menopause?

Hormones and Muscle Building

Estrogen and progesterone play important roles in muscle building. Estrogen in particular turns down the anabolic capacity of the muscle, which is also referred to as the “growing phase.” Progesterone, on the contrary, turns up the catabolism or the breakdown of muscle tissue. This creates a more difficult time for our bodies to access branched-chain amino acids such as leucine, isoleucine, and valine which are all essential for maximizing muscle building.

When estrogen and progesterone levels are high (high-hormone phase), it’s harder for females to make and maintain muscle. Aerobic capacity, breathing rates, blood sugar levels and strength are also negatively impacted. High protein intake is key before exercise and must be replaced within 30 minutes of exercise.

When estrogen and progesterone levels are low (low-hormone phase), which starts on the first day of menstrual bleeding, females could make greater strength gains, feel less muscle soreness and recover faster according to one study that involved 20 active premenopausal females.

How does menopause affect body composition and exercise?

As estrogen (estradiol in particular) levels start to decline in peri-menopause, and then later in menopause, there’s a tendency for postmenopausal women to face the following body changes:

  1. Accumulate fat in the belly. This could increase your risk of metabolic medical conditions including fatty liver and heart disease.
  2. Feel fatigued and hungry all the time. This is because lack of estrogen decreases insulin sensitivity so it requires more insulin to pull sugar out of your bloodstream and into your cells after eating.
  3. Retain more water which leads to bloating. Keep in mind that other significant contributors to bloating are sugar substitutes and sugar alcohols such as xylitol, mannitol and sorbitol.
  4. Become sensitive to carbohydrates. You will have more blood sugar swings and less need for overall carbohydrates.
  5. Can’t handle heat well. You will feel less sweaty and feel more thirsty because your blood vessels become less compliant. Your body tries to get rid of heat by sending more blood to the skin.
  6. Use protein less effectively because the rate of protein synthesis and muscle break down go up. The type and quality of protein you eat are essential for building lean muscle mass.
  7. Lose lean muscle. The speed and strength of muscle contractions tend to decrease with age.

How can a postmenopausal woman achieve optimal training performance?

More and more women continue to stay active in their 40s, 50s and beyond. Below are recommendations to help with those specific changes that occur in midlife:

  • Increase intake of foods lower in the glycemic index (more veggies and fruit, less grains, breads and pastas)
  • Rely on watery fruits, veggies, protein drinks, tea, and mineral waters as means of hydrating throughout the day
  • Use cool towels or cool-water immersion to get a bit of skin constriction. Consume cool foods and fluids
  • Aim for a lower carb intake (40-50 grams per hour) and increase your calorie intake with mixed macronutrient foods that contain balanced amounts of fat, protein, and carbs
  • Take 15 grams of whey isolate or 9 grams of BCAAs 30 minutes before exercise and 25 grams of mixed whey isolate and casein within 30 minutes post-exercise
  • In general, do not take soy protein because it doesn’t contain enough leucine for postmenopausal women to promote muscle synthesis - if your goal is muscle building
    • focus on power training
    • focus on hydration

Menopause doesn’t have to mean slowing down or stopping exercise. If you need to go over your training goals, please check with your personal trainer, physical therapist or exercise physiologist to see which exercise regimen works for you!

Be Strong. Be Healthy. Be in Charge!

-Anna Camille Moreno, DO and Holly L. Thacker, MD

Anna Camille Moreno, DO is a Family Medicine Doctor at Duke Women's Health Associates. Dr. Moreno is dedicated to an interdisciplinary women’s health practice focusing on the care of midlife women as it relates to menopause, perimenopause, hormone therapy, and their associated medical problems. Dr. Moreno is a graduate of the Specialized Women's Health Fellowship Program at Cleveland Clinic.

Holly L. Thacker, MD, FACP is nationally known for her leadership in women’s health. She is the founder of the Cleveland Clinic Women’s Health Fellowship and is currently the Professor and Director of the Center for Specialized Women’s Health at Cleveland Clinic and Lerner College of Medicine at Case Western Reserve University. Her special interests are menopause and related medical problems including osteoporosis, hormone therapy, breast cancer risk assessment, menstrual disorders, female sexual dysfunction and interdisciplinary women’s health. Dr. Thacker is the Executive Director of Speaking of Women’s Health and the author of The Cleveland Clinic Guide to Menopause.


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