How to prep your muscles for menopause: Why it’s crucial for women to build body strength now

Loss of muscle mass, or sarcopenia, is a natural part of ageing. Recent research shows that women lose more muscle mass as they transition into the menopause years.
Much of your body is made up of skeletal muscle, known as muscle mass. These are voluntary muscles, meaning one can control how they move and work. For example, if you reach for something high on a shelf, you are using the muscles in your shoulder, neck and arms.
Involuntary muscles are those which work without one thinking about it, such as the cardiac muscle which helps to pump blood throughout the body.
Muscle mass is a vital part of overall health. It’s the key to mobility, balance and strength – the tenets of physical function.
Muscles also have a role to play in metabolism – having more muscle burns calories faster. It also aids the body’s response to recovery from trauma and illness.
A 2009 study in the ePlasty Journal found that a 10 per cent loss of muscle can have negative effects on health, such as weakening the immune system’s response to common disease-causing bacteria and viruses. 
Low muscle mass also leads to cardiovascular risks, breathing problems, weight problems and even a higher risk of falls and fractures due to weakness.
Sarcopenia is mostly caused by the natural ageing process from physical inactivity or injury, causing immobility, obesity and chronic diseases.
Adults lose between 3 per cent and 8 per cent of muscle mass after the age of 30, a 2004 study about sarcopenia found. From age 50, this rate of decline accelerates by 5 per cent to 10 per cent and speeds up after the age of 60.
The loss of muscle mass can affect one’s balance, speed, ability to perform daily tasks, difficulty in climbing stairs and losing stamina. This inactivity leads to further muscle loss.
For women, losing muscle mass from middle age is dangerous. Research shows that hormonal changes, especially in oestrogen deficiency, alter certain signals in the skeletal muscle. This, in turn, leads to further loss of muscle and cell death in the body.
Dr Low Yen Ling, senior director of International Nutrition Science and Global Research and Innovation at healthcare company Abbott, said: “At the onset of menopause, from the ages of 45 to 55 years, a woman’s muscle mass, bone mass and collagen start to decline rapidly – a decade or so earlier than they do for men.”
As women transition through menopause, the hormone fluctuation of estradiol (a type of oestrogen) affects the muscles, exposing her body to sarcopenia.
Estradiol is the most potent of oestrogen hormones as it regulates the female menstrual cycle. It also helps to promote muscle regeneration, stimulating muscle cells for growth, repair after exercise and overall function.
In menopause, the body is also prone to inflammation, and accumulation of fat mass due to inactivity can also further muscle loss.
Most people tend to dismiss muscle loss as part and parcel of getting older. Research studies published in the Annals of Medicine point to this loss as more problematic.
For example, those with low muscle mass take longer to recover from surgery, have longer hospital stays and poorer physical function. It is also the underlying cause for almost 20 per cent of heart failure patients.
Women tend to have a higher fat mass needed for reproductive health, and have lower muscle mass and strength compared with men. This increases our risk of functional decline.
Dr Low added: “Because muscles are intrinsically responsible for body movement and are an important metabolic organ, research indicates that muscle mass is a better predictor of health than the usual Body Mass Index or BMI.”
Citing the Strengthening Health in Elderly study by Changi General Hospital, SingHealth Polyclinics and Abbott, of over 800 Singaporeans above age 65, Dr Low said: “Four in five elderly Singaporeans have low muscle mass and are at risk of malnutrition. Even for those with normal nutritional status, one in five have low muscle mass.”
Nearly 25 per cent of women in the study had low muscle mass compared with 15.5 per cent of men.
Dr Low’s advice is to watch for symptoms of muscle loss like decrease in energy levels, fatigue and even a drop in strength and speed. “Because age-related muscle loss can be invisible to the eye, be mindful of the signs and prioritise good nutrition and physical activity.”
Start this before you hit menopause, to build muscle mass, increase muscle strength and reduce the risk of osteoporosis. You can use dumbbells, barbells, weight machines, or even resistance bands.
The benefits may seem physical but a 2020 study in the Women’s Midlife Health journal showed that having leaner body mass may also help women with menopausal symptoms such as hot flushes, night sweats, irritability, and even weight gain.
The study also found that lower lean body mass increased oxidative stress and lowered antioxidant levels in the body, leading to more symptoms like inflammation.
There is no best time to start, according to fitness experts. Evy Bellina, co-founder of Omni Strength and a personal trainer with over 10 years of experience, said: “Regardless of where you are on the perimenopause or menopause timeline, start building strength and your muscle mass with weight training and sound nutrition. This way, you can remain strong in spite of expected natural decline due to ageing.”
Bellina’s three must-dos for women are:  
Nutrient-rich foods are key. Dr Low recommends a balanced diet including colourful vegetables and fruit, wholegrains, proteins, and healthy fats like nuts and good oils like olive and avocado.
Eat more protein too. Aim for between 25-30g of protein at every meal. Good sources like lean meat, eggs, beans and dairy products will help enrich your diet.
Don’t forget supplements and vitamins. “Omega-3 is a key supplement to help with managing inflammation, and lends a protective quality to muscle and joints, so you can have longevity with physical activity,” said Bellina.
Other vitamins and minerals like calcium, vitamin D and vitamin K are fundamental for bone health.  
Finally, sleep. Poor sleep quality influences muscle strength and affects muscle mass reduction – both in youths and older adults. A 2019 study in the Journal of Clinical Medicine found that the lack of good quality sleep increases the risk of sarcopenia in women more than men. 
Due to the blue light and electro-magnetic fields (EMF) emitted from our mobile phones and tablets, experts recommend putting them away at least 45-60mins before bed to help with sleep quality.
Experts recommend between seven and nine hours of sleep nightly for all sorts of recovery. The body gets a chance to replenish the energy expended.
What’s more, if you have a training programme with intensive exercise, it is recommended to have a minimum of 48 hours of rest for each muscle group.
CNA Women is a section on CNA Lifestyle that seeks to inform, empower and inspire the modern woman. If you have women-related news, issues and ideas to share with us, email CNAWomen [at] mediacorp.com.sg.