Three Types of Strength Training For Menopause
Learn which one is for you.
Facing menopause? Here are the three main types of strength training that may benefit you:
Hypertrophy training
Strength and power training
Isometric training
In this article, we elaborate on each of them before concluding with the most optimal type for you.
1. Hypertrophy Training: To Address Muscle Mass Decline
Hypertrophy training focuses on increasing muscle size, which is important because declining estrogen levels starting from perimenopause can accelerate muscle loss.
For context, a study in 2021 showed that compared to women in early perimenopause, those in late perimenopause had 10% less muscle mass in their arms and legs.
At a broader level, muscle mass in men and women has been shown to decrease by
3 to 8% per decade after the age of 30
5 to 10% after the age of 50
In other words, menopausal women experience a significantly faster decline in muscle mass compared to men of the same age.
Such reduced muscle mass has been shown to correlate with a 2.1-fold higher risk of falling and a 2.7-fold higher risk of bone fracture than women with preserved muscle mass, making it a concern for lifelong mobility.
Hypertrophy training helps.
However, be cautious when applying training guidelines intended for the general population.
Multiple studies have shown that while general strength training improves strength across all menopausal stages, achieving muscle growth in perimenopausal and postmenopausal women may require higher training volumes and intensities than recommended for younger women.
Specifically, a 2023 study found that postmenopausal women did not gain as much muscle mass with moderate-intensity strength training as premenopausal women.
The takeaway here is that menopausal women have to aim for higher volume and intensities of more than 50% 1-RM to induce hypertrophy gains compared to their younger peers.
2. Strength and Power Training: To Address Functional Decline
Researchers have shown that postmenopausal women have significantly lower strength and power production when compared to premenopausal women.
Strength refers to the ability of your muscles to produce force, either slowly or quickly, and power refers to the ability to exert force quickly, i.e. a combination of strength (force) and speed (velocity).
Women going through menopause experience a dip in both strength and power due to interactions between hormonal changes, particularly estrogen reduction, neuromuscular alterations, and lifestyle factors.
This decline not only leads to a lower quality of life.
According to a paper published this year, it also reflects a sustained elevation in mortality risk, i.e. risk of death.
Specifically, researchers found that, in middle-aged and older adults:
Women in the lowest muscle strength group had 1.7x higher hazard ratio than the highest group
Women in the lowest muscle power group had 6.9x higher hazard ratio than the highest group.
For context, another group of researchers previously compared individuals’ VO2 max, a measure of cardiorespiratory fitness, between men and women in the elite category (top 2.5th percentile) and the lowest 25th percentile, and the difference was a 5x increase in risk of all-cause mortality.
The elevated hazard ratio highlights the importance of power training.
Other studies linking power to function support this, suggesting that muscle power is a more critical determinant in older adults than muscle strength.
Additionally, power training has also been found to be more effective than strength training in reducing bone loss in postmenopausal women, which is vital since the prevalence of osteoporosis increases dramatically with age.
In Singapore:
Approximately 8% midlife women have osteoporosis
Among women over 60 years, approximately 25% are at high risk of developing osteoporosis
Osteoporosis prevalence increases dramatically to 58% in those over 80 years of age
This progressive increase reflects the cumulative bone loss that occurs with advancing age, particularly after menopause.
How, then, should you train for power (and strength)?
For beginners, it is recommended to start with strength-focused training before progressing to power-focused exercises; the latter requires a foundation of strength before adding the speed component that characterises power training.
Strength training typically involves slower, controlled movements with weights, resistance bands, or body weight. Traditional strength training protocols often include:
1 to 5 repetitions per set
Movement performed at a slower, controlled pace
Resistance at 80-100% of one-repetition maximum
Power training incorporates the element of speed while still using resistance. This type of training involves:
Strength foundation adequate for power development
Focus on explosive movements rather than just lifting the weight
Both low resistance, high-velocity training and high resistance, ballistic movement training
3. Isometric Training: To Address Blood Pressure and Tendon Health
Heart disease is the number one killer of women, both locally and in many countries abroad.
Menopause correlates with hypertension, with possible underlying factors including age, metabolic syndrome, and arterial stiffness changes.
A specific type of strength training is beneficial.
Researchers found that isometric exercises are the most effective mode of reducing blood pressure compared to typical dynamic strength training, aerobic exercise, and high-intensity interval training, making them a better option for addressing hypertension.
A 2019 study also found that a 6-week isometric handgrip program lowered systolic blood pressure by 12% and diastolic blood pressure by 16.27% in hypertensive postmenopausal women when combined with antihypertensive drugs, and this was more effective than just using antihypertensive drugs alone.
Additionally, there is also a chance that the benefits of isometric exercises go beyond blood pressure.
Due to hormonal shifts, postmenopausal women experience notable changes in their tendons’ composition, mechanical properties, and susceptibility to injury.
There is evidence that menopause decreases collagen type I synthesis which is critical for tendon strength. Due to collagen degradation and stiffness, menopausal women face elevated risks of Achilles tendinopathy, gluteal tendinopathy, and rotator cuff tears.
Researchers also found that before menopause, the risk of developing tendon pathology in women is lower than in men, but in older women, the incidence of tendinopathy and tendon rupture is similar to that of men.
A way to address tendon health is through the combination of plyometric training, a form of power training, and isometric training.
The extensibility of tendon structures during ballistic contractions is enhanced after plyometric training, and the stiffness of tendon structures increases after isometric training.
In other words, both plyometric and isometric training improve tendon health, but via different mechanisms and through unique effects.
While research directly examining isometric exercise specifically for menopausal women’s tendon health is limited, available evidence suggests potential benefits based on the known effects of isometric training and the tendon changes associated with menopause.
Hence, it can be helpful to consider isometrics for women facing menopause.
How to Choose the Most Optimal Type of Strength Training for You
The process of optimal strength training is similar to regular health screening: assessment, intervention, and reassessment.
Applicable assessments in this case include, but are not limited to, DEXA Scan, blood pressure measurements, and strength assessments. These assessments inform the training program of what to do and what not to do.
For example, although isometric exercises have long-term blood pressure benefits, individualised prescription is needed in high-risk populations due to acute spikes in blood pressure during the exercises.
Another example is that strength assessments help you determine if strength or power training is more appropriate, based on your test performance.
Remember this point from above?
Power is more important, but you need a strength foundation.
Hence, the type of strength training you need varies, even though menopause is a common phase that women worldwide experience.
A personalised program can range from prioritising strength training volume for muscle mass gains to incorporating isometric-plyometric contrast sets for concurrent benefits in strength, power, and isometric strength.
To choose the most optimal type of strength training, consider menopause strength training in the same way you approach health screening: assessment, intervention, and reassessment.
If you have further questions about strength training for menopause, feel free to reach out.
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