The onset of perimenopause varies greatly between women, but typically occurs between the ages of 45-55. This period of time is marked by large fluctuations, and eventual decline, in sex-hormones; particularly estrogen and progresterone.
The common symptoms of perimenopause are well known: changes in energy levels, mood, sleep patterns, memory and temperature regulation. However up to 70% of women also report musculoskeletal aches and pain as symptoms of perimenopause.
Exercise, especially targeted resistance exercise, is a powerful tool to help navigate the changes that come alongside perimenopause and aging.
Understanding Perimenopause and its Musculoskeletal Effects
Estrogen receptors are found in bone, muscle, ligaments and tendons. As such, hormonal fluctuations can affect the tissues that support movement. As we get older, and transition through perimenopause, many women notice changes such as:
- A decline in muscle strength and endurance
- Joint stiffness and new or recurring tendon pain
- Changes in body composition
- Loss of bone density (osteopenia or osteoporosis)
- Balance disturbances or decreased mobility
- Pelvic floor weakness, leading to leakage or heaviness
Why Strength Training is Essential during Perimenopause
Strength training refers to exercises that challenge the muscles through resistance – whether using body weight, bands, free weights, or machines. For women in perimenopause or menopause, it’s one of the most powerful ways to protect against age-related musculoskeletal decline, and to promote long-term physical health.
The ACSM recommends strength training at least 2 days per week, and 30 minutes of moderate intensity aerobic exercise most days of the week.
The benefits of exercise include:
- Preserving muscle mass: Strength training helps counter age-related muscle loss, which in turn promotes physical function.
- Protecting bone density: Mechanical loading from progressive resistance training stimulates bone formation and helps maintain bone density.
- Improving balance and joint stability: Targeted lower-body exercises reduce fall risk and joint pain.
- Enhancing mood and energy: Exercise helps regulate stress hormones, improves sleep, and boosts mood.
- Supporting long-term independence: Strength underpins movement, mobility, and confidence; all of which matter for quality of life.
A Transition Worth Training For
Perimenopause is a powerful reminder that women’s bodies are adaptable and resilient. Our physios at Restore Function Physiotherapy, have a special interests in womens and musculoskeletal health. With physiotherapy support as needed, and a commitment to consistent, strength training, women can enter perimenopause, and the years beyond, strong, balanced, and confident.
References
Currier et al. 2026. American College of Sports Medicine Position Stand. Resistance Training Prescription for Muscle Function, Hypertrophy, and Physical Performance in Healthy Adults: An Overview of Reviews. Medicine & Science in Sports & Exercise 58(4):p 851-872.
Greendale et al. Changes in body composition and weight during the menopause transition. JCI Insight. 2019 Mar 7;4(5):e124865.
Sims, T. 2013. Changes in physical activity and body composition in postmenopausal women over time. Medicine and Science in Sports and Exercise 45(8):1486-92.