Strength training through perimenopause and menopause.

What changes during menopause

Perimenopause is the transition towards menopause. Natural menopause is usually identified after 12 consecutive months without a period, when there is no other cause; hormonal contraception can make identification more complicated. It most often occurs between 45 and 55, although it can happen earlier. Symptoms and experiences vary considerably. [1, 2]

Changing hormones interact with ageing, activity, nutrition, sleep and health. The long-running Study of Women’s Health Across the Nation found that the menopause transition was associated with faster fat gain and a decline in lean mass. Those changes were not fully reflected by changes in overall weight. This was observational research: it helps explain patterns across a population, but does not predict what will happen to every woman. [3]

That is one reason a useful training goal is to become stronger and more capable, rather than judge every week by the bathroom scales. Weight loss can be a valid personal goal, but you can benefit from exercise without making it your main aim.

Your muscles can still become stronger

Muscle strength supports everyday tasks: climbing stairs, carrying shopping, lifting luggage and getting up from a chair. Resistance training gives your muscles a challenge they can adapt to. That challenge might come from a machine, dumbbell, resistance band or your own body weight.

One of the largest recent reviews, published in 2026, combined 126 studies involving 4,019 women. It found improved strength in both premenopausal and postmenopausal participants, alongside improvements in measures of muscle or lean tissue and fat mass. There was no statistically significant difference in strength gains between the two menopause groups. That does not prove everyone responds identically, but it challenges the idea that menopause removes your ability to benefit. [4]

A separate 2024 review specifically examining healthy postmenopausal women also supported improvements in physical fitness, including strength. Findings for body composition and bone density were less consistent. [5]

The practical message is encouraging: your starting point does not have to be your finishing point. Progress means gradually increasing what you can do with good control. It does not require exhausting yourself at every session or starting with heavy barbells.

Bone health needs attention before a fracture happens

Falling oestrogen contributes to bone loss around menopause. Osteoporosis makes bones more vulnerable to fractures, so maintaining bone health matters even when you feel well. Nutrition, medication when appropriate, and suitable exercise all have roles. NICE recommends discussing bone health and the importance of maintaining muscle mass and strength through physical activity. [1, 6, 13]

A 2025 review of 17 randomised trials involving 690 postmenopausal women found benefits of resistance training for bone mineral density at several skeletal sites. Results varied substantially between studies, particularly at the spine and femoral neck, so the findings do not establish one ideal programme for everyone. [6]

A newer 2026 review of eight trials also reported small improvements in spine and femoral-neck bone density in postmenopausal participants when high-intensity, impact and strength interventions were pooled. The researchers highlighted limitations in the studies. A change in bone density is also not the same as proof that a particular programme prevents fractures. [7]

The LIFTMOR trial provides an example of what carefully supervised training can achieve: 101 selected postmenopausal women with low bone mass took part in an eight-month trial comparing supervised high-intensity resistance and impact training with a lower-intensity home programme. Bone-density and physical-function outcomes favoured the supervised programme. This was a screened research population, not a recommendation to copy heavy lifts or jumps independently. [8]

UK osteoporosis guidance supports resistance exercise, appropriate impact activity, and strength and balance work. The right starting point depends on fracture history, symptoms and stability. Known osteoporosis or a previous low-trauma fracture calls for suitable professional guidance before progressing the programme. Bone health is a long-term investment; an eight-week course cannot promise to reverse osteoporosis. [9]

Strength training also supports cardiovascular health

Your heart and blood vessels benefit from an active lifestyle. Walking, cycling, swimming and other aerobic activities remain valuable alongside resistance exercise. [12]

A 2026 systematic review of 60 studies in postmenopausal women found that resistance training improved several cardiovascular measures, including blood pressure. The findings support including resistance exercise in a broader heart-health plan; individual risk and medical treatment still need attention. [10]

The sensible approach is to combine strength work with enjoyable aerobic activity and appropriate medical care. You do not need to choose between being strong and being cardiovascularly fit.

Sleep and wellbeing may improve but symptoms need individual care

Poor sleep can make exercise feel much harder. It can also make a rigid, all-or-nothing programme difficult to maintain.

A 2025 review of 31 randomised trials found that several exercise approaches improved reported sleep quality in peri- and postmenopausal women. Evidence certainty differed between exercise types and was low to moderate for the approaches showing benefit. This supports exercise as one possible part of a sleep-support plan, without guaranteeing that lifting weights will resolve insomnia. [11]

Hot flushes need a separate distinction. The Menopause Society’s 2023 nonhormone treatment statement did not recommend exercise specifically as a treatment for vasomotor symptoms because the supporting evidence was insufficient or inconsistent. That does not cancel its benefits for strength or general health. Persistent or disruptive symptoms deserve a discussion with your GP or menopause clinician. HRT and other treatments are individual medical decisions. [1, 14]

Coaching can adapt to how you are feeling: a shorter session, a lighter load or extra rest may help you keep a routine during a difficult week. You should not have to prove your commitment by pushing through concerning symptoms.

What an effective weekly routine can look like

The NHS advises adults to strengthen all major muscle groups on at least two days a week and aim for at least 150 minutes of moderate aerobic activity, or 75 minutes of vigorous activity, spread through the week. Reduce long periods of sitting too. These are targets to work towards; starting with a smaller amount is worthwhile. [12]

A practical beginner routine could include two full-body strength sessions on separate days, with walking or another enjoyable aerobic activity between them. An additional session can be considered as your confidence and recovery develop. Balance work becomes especially useful if you feel unsteady or have a falls risk. [9, 12]

For an otherwise healthy beginner, a coached session might include a supported squat or leg press, a hip-hinge movement, a row or pulldown, a chest press and a suitable trunk exercise. These are examples of movement choices, not a prescription for every reader.

Initially, the priority is learning comfortable, controlled movements. The coach can then progress repetitions, resistance or sets as appropriate. Keep a simple record of what you do. A meaningful improvement might be standing up more easily, using a heavier dumbbell with control, or completing the same exercise with greater confidence.

Nutrition supports the work you do in the gym

The British Dietetic Association recommends combining healthy eating with activity and highlights adequate protein, calcium and vitamin D for muscle and bone health. Include a protein source in meals, alongside varied plant foods and suitable sources of calcium. Specific dietary or supplement needs depend on your circumstances. [13]

If fat loss is your goal, the plan should still support training and recovery. There is no need to purchase a menopause supplement bundle to begin strength training. A registered dietitian can help with complex dietary needs; a personal trainer should work within their nutrition competence and refer when needed.

Why the programme should be personal

Women over 40 are not one identical group. A confident runner, someone returning after years away from exercise and a woman managing osteoporosis may need very different starting points.

Research also has gaps. A 2025 review focused specifically on peri- and early postmenopause found only six eligible trials; the evidence was low quality and the studies had a high risk of bias. It could not establish the best exercise method for preventing bone and muscle loss during that transition. That is a reason to avoid claiming that one menopause workout is uniquely proven. [15]

A useful consultation explores your training experience, goals, sleep, symptoms, injuries, medication considerations and preferences. Known osteoporosis, fractures, persistent pain or a long-term medical condition may require advice from your healthcare team and coaching within the trainer’s qualifications. [1, 9, 12]

Urinary leakage, vaginal heaviness or a bulge deserve sensitive assessment by an appropriate clinician or pelvic health physiotherapist. They are not symptoms you must simply tolerate during exercise. NICE recommends supervised pelvic floor muscle training for certain forms of incontinence and prolapse. [16]

Stop exercising and seek assessment for new concerning symptoms such as unexplained fainting or unusual breathlessness. Sudden persistent chest pain, chest pain spreading to your arm, neck or jaw, or chest pain with sweating or shortness of breath requires an emergency call to 999. [17]

How personal training can help you put the evidence into practice

Understanding the research is useful. Having a routine you can follow is what turns that information into action.

As a Level 3 Personal Trainer at PureGym Brighton Central, I offer personalised strength coaching for people who want to become stronger and feel more confident in the gym. We begin with your goals and current ability, choose suitable exercises, practise technique and build a manageable routine. Where a health issue needs specialist input, the next step is an appropriate referral.

You do not need previous gym experience, and weight loss does not have to be your goal. You might want to lift shopping more comfortably, return to an activity you enjoy or finally feel confident using the weights area. Those are useful goals to bring to a consultation.

Personal training provides time to learn, feedback on your movement and a clear way to progress. Regular coaching can make the next step easier to understand, especially when you are learning how much resistance to use, which exercises suit you or when to increase the challenge.

Common questions before you begin

Am I too old to start? Research shows that women after menopause can improve strength. Your starting level, health and needs guide the programme; menopause is not a reason to assume progress is over. [4, 5]

Do I have to lift very heavy weights? You need resistance that provides an appropriate challenge, but the starting load should match your ability. Heavier loading may have a place later, with suitable progression and supervision. Bone-health research should not be interpreted as an instruction for every beginner to lift maximally. [6, 8, 9]

Will this remove belly fat? Training can support improvements in body composition, but no programme can promise where you will lose fat or how much. Strength, function and consistency are worthwhile measures alongside changes in weight or waist size. [3, 4]

Can I train if I use HRT? Tell your trainer about relevant medication and symptoms. HRT decisions belong with your prescriber, while exercise should be tailored to your health and ability. Your trainer should not change your medication. [1]

Start with a conversation about your strength

If you are in Brighton and Hove and want a clear starting point, book a free 15 minute consultation with Steph Scully Fitness. We can discuss what you want to achieve, what currently holds you back and whether personal training is a suitable next step.

One to one personal training is £40 per hour at PureGym Brighton Central. Email stephscullyfitness@gmail.com with Women’s Strength 40+ in the subject line to enquire or arrange your consultation.

This article provides general education based on medical guidance and exercise research. It is written by a personal trainer, has not been independently medically reviewed, and does not replace individual diagnosis, treatment or rehabilitation advice.