Muscle equals metabolism. This is the long and the short of it. And I love that people are talking about this more and more. I was recently interviewed by The Output, Peloton’s blog, to talk about all things menopause and exercise.
Menopause is more than just hot flashes and sleepless nights—it’s a fundamental shift in how your body works. Many women in their 40s and 50s feel frustrated, like their bodies are betraying them. Weight creeps on despite eating well. Joints feel stiffer. Energy dips. The workouts that used to work… don’t anymore.
But here’s what I want you to know: how you move during this phase can dramatically influence how you feel now—and decades down the road. Exercise during midlife isn’t about punishment or “fighting aging.” It’s about supporting your body through a natural transition so you can stay strong, capable, and confident.
And no, it’s not about working harder. It’s about working smarter. Muscle is king.
What’s Actually Happening in Your Body
During perimenopause and post-menopause, your body experiences significant hormonal shifts—particularly declining estrogen levels. Estrogen isn’t just about reproduction; it plays a protective role in muscle health, bone density, joint stability, metabolism, and even mood regulation.
When estrogen declines, here’s what can happen:
Muscle loss accelerates. Without intervention, you can lose 3-8% of muscle mass per decade after age 30, and that rate speeds up after menopause. This is obviously a large range and varies widely, just to point out what might be less than obvious. Suddenly, everyday movements like carrying groceries, getting up from the floor, or climbing stairs feel harder. A study published in Menopause, the journal of the Menopause Society, earlier this year might offer an easier way to predict women who might be at a greatest risk for sarcopenia: creatine to cystine C ratio, which is valuable because currently the only real way to test is MRI.
Bone density decreases. Bone density naturally declines with age, but the drop in estrogen during and after menopause accelerates bone breakdown, increasing the risk of osteoporosis and fractures. Estrogen normally helps balance bone remodeling, so when levels fall, bone resorption outpaces bone formation. Bones are living tissue that require mechanical stress to stay strong. Weight-bearing and resistance exercises provide the stimulus bones need to maintain density and structural integrity, helping reduce fracture risk over time.
Metabolism shifts. Metabolism is the set of chemical processes your body uses to turn food into energy so you can breathe, move, think, and stay alive. Even when you’re resting, your body is constantly burning calories to support basic functions like circulation, digestion, and temperature control—this is called your resting metabolism. Muscle tissue burns more energy than fat, so when muscle mass declines with age or hormonal changes, your body needs fewer calories to function. That means the same amount of food can more easily be stored as fat, especially when metabolism slows and energy needs decrease.
As hormones change with age—especially during menopause—metabolism slows and the body becomes less efficient at burning calories at rest. Declining estrogen shifts how and where fat is stored, with a greater tendency for fat to accumulate around the abdomen rather than the hips and thighs. At the same time, loss of muscle mass reduces resting energy expenditure. As a result, weight gain can occur even when diet and activity habits remain the same, making weight management feel more difficult and frustrating.
Joints stiffen. As we age—and especially as estrogen declines during perimenopause and menopause—the tissues that support our joints begin to change. Ligaments, tendons, fascia, and joint capsules are made largely of collagen and water, and estrogen helps regulate both collagen turnover and tissue hydration. When estrogen levels drop, these connective tissues become less elastic and less well-hydrated, reducing their ability to stretch, recoil, and glide smoothly over one another.
The result is joints that feel stiffer, tighter, and more uncomfortable, particularly after periods of rest like sleeping or sitting—hence that familiar morning stiffness. This isn’t simply “wear and tear” or inevitable aging; it’s a hormonally driven change in tissue quality. The good news is that regular movement, strength training, and loading joints through full ranges of motion can help maintain connective tissue health and improve how joints feel and move.
Mood and sleep suffer. Hormonal fluctuations can disrupt sleep quality and contribute to anxiety, irritability, or brain fog. When you’re exhausted and stressed, everything feels harder.
The frustration is real—and valid. But here’s the good news: exercise directly addresses every single one of these challenges.
Why Exercise Matters More Than Ever in Midlife
Exercise during menopause isn’t about aesthetics or fitting into a smaller size. It’s about preserving function, maintaining independence, and protecting your quality of life for the long haul.
Here’s what movement can do:
Preserve muscle and strength. Strength training counteracts age-related muscle loss and helps you maintain the ability to do everyday tasks with ease—from opening jars to lifting grandkids.
Protect your bones. Weight-bearing and resistance exercises stimulate bone formation and slow the progression of bone loss. This is your most powerful tool for reducing fracture risk.
Support metabolic health. Regular movement helps regulate blood sugar, improves insulin sensitivity, and supports a healthy metabolism—all of which become more important as hormones shift.
Boost mood and mental clarity. Exercise releases endorphins, reduces stress hormones, and improves sleep quality. Many women report that consistent movement helps them feel more like themselves again.
Prevent falls and maintain balance. Strengthening your core, hips, and ankles reduces your risk of falls—a leading cause of injury and loss of independence as we age.
In short, a thoughtful movement plan during menopause can transform not just your body, but your energy, mindset, and confidence.
What Does a Smart Midlife Exercise Plan Look Like?
Forget the “no pain, no gain” mentality. A sustainable, effective exercise routine for midlife women includes four key components:
Strength training: 2-3 times per week Focus on major muscle groups—glutes, core, back, shoulders, and legs. This is non-negotiable for preserving muscle mass and bone density. Start with bodyweight movements if you’re new, then progress to resistance bands or weights.
Cardiovascular exercise: 150 minutes per week Aim for moderate-intensity activity like brisk walking, cycling, swimming, or dancing. Break it up however you like—30 minutes five days a week, or three 50-minute sessions. The goal is to keep your heart healthy and support metabolism.
Mobility and flexibility: Daily or near-daily Spend 10-15 minutes stretching, doing yoga, or moving through gentle ranges of motion. This keeps joints healthy, reduces stiffness, and helps you move with ease.
Balance training: 2-3 times per week Include exercises like single-leg stands, stability work, or Pilates-based movements. Balance work protects you from falls and builds confidence in your body’s ability to stabilize.
The key? Consistency beats intensity every time. Short, deliberate sessions several times a week will always outperform sporadic, aggressive workouts that leave you exhausted or injured.
Common Mistakes Women Make (And How to Avoid Them)
Focusing only on cardio. Walking and cycling are great, but they won’t build the muscle or bone strength you need. You have to include resistance training.
Pushing too hard without recovery. Your body doesn’t bounce back as quickly in midlife. Overtraining increases injury risk and leaves you feeling depleted. Rest days are part of the plan—not a sign of weakness.
Ignoring posture and alignment. Core and back muscles often weaken during this phase, which can lead to chronic pain or compensatory movement patterns. Address these foundational issues first.
Comparing yourself to your younger self. Progress in midlife looks different. It’s measured by how you feel, how well you move, and whether you’re maintaining or building strength—not by what you could do at 25.
A well-rounded program tailored to your body is the key to long-term success.
How to Get Started (Without Overwhelm)
If you’re not currently exercising regularly, don’t try to overhaul everything at once. Start here:
Pick two – three day for strength work. Even 20-30 minutes focusing on squats, lunges, pushes, and pulls will make a difference.
Add weight-bearing movement daily. Walk, climb stairs, or do light resistance exercises. Your bones need this stimulus.
Incorporate 10 minutes of stretching or mobility daily. It doesn’t have to be complicated—just gentle, consistent movement.
Listen to your body. If you’re sore, fatigued, or dealing with pain, adjust your intensity or take an extra rest day. Sustainability matters more than intensity.
Get assessed by a professional. A physical therapist can evaluate your movement patterns, identify weak areas, and design a safe, effective program tailored to your unique needs and symptoms.
The Bottom Line
Menopause is a natural life stage—not a problem to fix. But how you navigate it is absolutely within your control. Exercise isn’t optional in midlife; it’s essential. And when approached thoughtfully, movement can preserve your strength, protect your bones, support your mood, and help you feel vibrant and capable—today and into your later years.
At WAVE Physical Therapy + Pilates here in Cincinnati, we help women design personalized movement plans that address their body’s unique needs, symptoms, and goals during this transformative phase. We don’t believe in one-size-fits-all programs or punishing workouts. We believe in building strength, restoring confidence, and helping you move through menopause with clarity and resilience. Want our help, reach out to us: info@anchorcincy.com or 513.832.8009.