Is 15 Weeks Enough to Build Muscle PostMenopausal? Science Unpacked

If you're in menopause and you're wondering whether your muscles are still capable of responding, I have a study for you. Actual postmenopausal women, actual resistance training, and MRI scans to see what changed inside their muscles. You're in perimenopause, menopause, or postmenopause, and you're not slowing down. You're just getting started. But the old rules don't apply anymore. The workouts that worked before—they're working against you now. The advice you've been given incomplete at best. I'm Deborah Atkinson, and I'm the founder of Flipping Fifty, the pioneer in fitness for women in midlife. For more than forty years, I've been in the trenches with women just like you, and for the last twelve, right here on this podcast, and and the founder of Flipping Fifty, the stronger way app and membership. Welcome to Flipping 50 the Stronger Way, where science meets strength, where you'll find the tools, research, and real talk to build the body and the life you want in your second half. Each week, you'll get evidence-based exercise and nutrition strategies, conversations with leading experts, and honest answers to the questions your doctor didn't get answers to in medical school and doesn't have time to answer in an appointment. This is your show. Let's get stronger. Hey everyone, thank you for joining me. If you're just tuning in for the first time, we are breaking down science in this particular solo episode. And in other episodes, you will find interviews with physicians, practitioners, even some of our Flipping 50 community members and inspiring adults aging the way we all want to and sharing How they did it so you can too. This one is for you if you're in menopause or beyond and you wonder whether your muscles are really still capable of responding, or maybe you're hitting one of those dark days or moments when you're wondering why yours aren't. This is for you. First of all, on this study, the headline is really encouraging. After 15 weeks, the women in this study who trained increased their measured muscle volume. Wow. By about four percent. Now let's talk fifteen weeks. Put that into perspective. That's October first, and your first week of January you're already there. So it's a quarter, just a little over of a quarter or twelve weeks' time. You know when you say fifteen, I think it gets to be what is that? What does that look or feel like? So there it is on the calendar, and there's another finding that makes this worth discussing. One characteristic of muscle changed while another did not. So we'll unpack that. That's why. I want to talk you through what researchers actually tested, what they found, and what I would do with this information if I were deciding how to exercise this week. Hey, it's Debra Atkinson. You, of course, are listening to Flipping 50 the Stronger Way, and I'm helping you in this episode make science of what the actual research says. So sometimes taking a study at face value, which is what anyone would do who honestly has not had a graduate degree and a course that explains to them, here's good science, here's just science, here's what the layperson doesn't understand. And my hope is that you're actually getting that graduate degree without getting the graduate degree. I want you to understand how you sort through when somebody says, well, science says, and how you even take a Study and go look yourself. Is it peer-reviewed? Is that really what they meant? And was there a large pool of people studied? We're going to unpack this today. In this one, we're going to talk about building muscle after menopause without promising what 15 weeks can magically solve. But your dumbbells are absolutely useful, yet they are not fairy godmothers. So this paper appeared in the journal Maturitis in 2026. Really new if you're listening in real. Sophia Thorell and colleagues reported a secondary analysis of a randomized control. And by the way, randomized control trial, the RTCs, that's what you're looking for. We want to make sure that things were randomized, not too predictable. That's always good. So it means they examined muscle outcomes using data from an existing trial. 65 postmenopausal women with hot flashes and low physical activity. They were randomized to supervised resistance training 3 times a week for 15 weeks. Now, I'm going to divert from that for a moment because that, for somebody in my community, you may be distracted by that. So the study looked at 3 times per week, and I'm a huge advocate for starting with the minimum, which is twice weekly resistance training for total body. So all the major muscle groups get taxed. Twice weekly minimum. It doesn't make 3 or 4 or more better because we have to ensure that you're recovering. So if you're getting caught up in, well, they said 3, so I need to be doing 3 if I'm going to get results, don't go there yet. And be sure that if you don't at home right now, as we are approaching the holidays, have your own smart scale or a bioimpedance scale. Ask for one, buy yourself one. It's the best health investment you're going to get because you are truly measuring not weight, but you're measuring what is that weight made up of. That's the important part. So let's come back to my little divergence here. So the resistance training was done 3 times a week for 15 weeks with these 65 postmenopausal women, or they were assigned to a control group that maintains its usual low activity. Not a hard task for them. 44 had MRI scans at the beginning and at the end. And usually what happens in a study is if there were 65, 44 had those tests, something happened, there was fallout. You know, midlife, life, it lifes you. So not probably fallout from the study. Strength testing in the training group used an 8-repetition maximum test. And that means, just to spell out the obvious for some of you and for others, just to give clarification. A 10-rep max is a far safer thing than a test that often is used with, say, strenuous or elite athletes. And yet sometimes we wouldn't even do it there because we don't want them to be injured either. But a 1-rep max test has always been a gold standard. We err on the conservative side with a 3-rep max test, and then we will project via calculations what would a 1-rep max test be. And if we wanted then people to start exercising at a certain percentage of that to increase that 1-rep max test. It's a whole thing, can you tell? But we also will sometimes use 8-rep max tests or 10-rep max tests because they are much safer. You already probably are capable of doing 10-rep max. You know, if you were good and warmed up, what weight should I pick up that I can only lift 10 times? So in this case, they tested with 8. 8 repetitions to fatigue, can't lift anymore, in order to err on the conservative side. The training group increased muscle volume by approximately 4%, which is significant, while the control group did not show a change. No surprise there. Strength improved across the muscles tested in the training group. Fat infiltration within muscle did not change. Interesting, right? So if we were looking at a cross-section, and you see these so often now on social media, but basically it's like going to the meat counter and looking at a ribeye versus a sirloin versus prime rib and looking at how much fat is within it. That's an important distinction. So we're going to come back to this. Fat infiltration within the muscle slice did not change. Those are the results. Now let's talk about what they mean to us. Muscle volume Strength and fat within muscle are different measurements. So I don't want us treating them as interchangeable because then we start expecting one number to answer every question. And that is really a key distinction when you hear about any research. We can't assume that, say, research on creatine answers all the questions that we want answered about it. We can't say the same about consuming protein or fasting before exercise. A study generally answers one very narrow question, even though multiple things are tested. So keep this in mind as we keep going. Imagine that you want to know whether a program is helping you. You might look at the weight that you can lift, and you might look at a scan. You might look at whether getting out of a low chair is easier, and those Those questions are related, but they're asking about different things, right? So weight alone is absolute strength. Getting out of that chair is power. We talk a lot about protein and lifting here, but the little things matter too. 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The strength test detected improved performance in the training group. The fat math, or the muscle fat measurement— the fat math, I guess that's a good term, but I don't know where that came from— the muscle fat measurement did not detect a change. So an unchanged result on that third measure doesn't cancel out the other two results, but it is interesting and makes you wonder, would that have taken another 3 months? Or, how long does it take for that in particular to change? Or was it the protocol, for instance? That's a useful reminder when you decide whether your own effort is working. Before you judge a program, ask, what was it designed to improve? And what you're using to measure your progress. And I will vouch for this right now. Never in the history of Flipping 50 and our programs and membership and coaching have I ever declared, that I am a weight-loss coach. People join our programs, nowhere on the page seeing anything about a promise of weight loss. And yet, many weeks or fewer into a program, I will hear women say, and actually tick off, you know, I'm feeling better, my clothes are fitting better, I'm sleeping better, I have so much more energy, and I was sure I would have lost weight, but I got on the scale and I didn't lose any weight. And so my immediate response is, you know, I didn't promise any weight loss. The other piece of that is that I'm often— I heard them celebrate and celebrate and celebrate and celebrate and then give it all back to the scale and let the scale have the power because the scale just dictated they're now in a bad mood, no longer celebrating. Just a rhetorical question since this is a one-way street, but have you ever done the same? There is some reason that we put so much weight into literally the number on the scale. We've given it a rating that if that number is good, then I am going to be happier. And so I want you to ask that question of yourself very specifically. I've got very intelligent and articulate women who've been training clients, and this is something we revisit often. And it's not the intellect in them that doesn't understand it. They understand it completely. But what we can't control is our emotional response to something that we've been conditioned for decades. And it takes time and conditioning to revisit that. And sometimes identifying that it's not going to go away forever, or maybe completely. And you will always need to catch yourself and come back with the logic and the intellect and the, but other things are working, as a measure of success. Divergence. Let's get back. Useful for deciding whether your own effort is working, right? When you, or before you judge a program, something you've been doing, habits that you've changed, ask, what was it designed to improve? And did you make a good choice in, here's what I want to change, and choosing the action that will get you that change? We often go wrong and there's a gap between the activities that we're choosing and the things that we truly want. For me, the encouraging part here is that these were women already experiencing menopause symptoms. So hot flashes are significant. We don't have to pretend that every woman begins a strength training program with perfect sleep, with boundless enthusiasm and energy. We can acknowledge symptoms and still investigate what training can do. So what this paper does not do, and this is important, it wasn't a promise that every woman will gain 4% muscle mass. It doesn't ensure that you will. An average from a research group is not a personal guarantee. So number one, it's an average. Probably no one in that study gained exactly 4%. That's an important distinction too, right? Somebody gained more, somebody gained less. The MRI sample was smaller than the original trial. I let you know this was a secondary analysis. The participants had low activity levels, so I would be careful about expecting the same response in a woman who's already trained Consistently for years. That's you. You say, come to me, you're not getting results, but you want to begin one of our stronger programs, which is 12 weeks, not 15 weeks long, but close enough for comparison's sake. Are you going to gain 4% lean muscle? No. I mean, I would almost guarantee that. And the reason is because when you are starting as a virgin exerciser, you have the most to gain. It's most exciting. I'm envious of anybody who is doing a first-time start, who is doing a first-time triathlon, a first-time marathon, because there is nothing like it. Nothing. And you can't go back. There will be a next one, but it's different. And the closer you are to the end goal that you have, the slower those results will come, the more hard-earned they will have to be. When you're a beginner, it's a really exciting time. You're going to make progress almost no matter what you do. And I say almost because I've seen a lot of things. Okay. So the MRI sample was smaller than the original trial. We only had 44 do the final, 65 started, and it was a secondary analysis. So it— this study also doesn't settle the question of 2 versus 3 lifting days. 3 days was the schedule studied. Researchers did not compare those women with a group lifting twice weekly, and this particular paper Cannot tell us whether a hormone therapy prescription would change your response. I have thoughts about that. It wasn't a randomized comparison of hormone therapy, so in this case didn't really matter. I don't want to slip an answer to a hormone question into a study that wasn't designed to answer it. However, other studies have shown resistance training is equally effective. There is no significant difference whether you are on HRT or you are not. on HRT or a non-user. Finally, the researchers didn't establish longer life or fewer fractures from these 15 weeks. Now, would I project that if you continued to lift weights that you would have not only a longer life, but you would have a stronger life, better, higher quality of living, and fewer risk of fractures? Let's just say that and not assume we're going to have any at all. Those are different outcomes that require different evidence. However, so we can be enthusiastic about the muscle findings without upgrading to where we project or think that they're going. Hypotheses are fine as long as you and I realize that's what they are. My practical interpretation is that this is a real reason to take a structured strength plan seriously. So it laid it out. Here's how you participate. Here's what we're studying. They're going to hypothesize. That this is the outcome. And if they're measuring something specifically, that's the expectation they have is it will change it. We want to look at what is the study that you're doing? What are the changes that have been proven in the programs that you're doing before you get involved in them? And what is the amount of risk in it? I think is a legitimate question that you want to be asking as well. So I would want the plan adapted to your limitations. To your ability to recover rather than borrowing the study schedule as a prescription for every woman. What happens quite frequently is we have women who will say, well, I'm going to do strength training 3 times a week, and those very same women are not actually recovering. So their consecutive weeks or workouts, meaning the second one and the third one, actually are not as strong and not as vital, not as fresh, not as able to lift as heavy or to do as many reps depending on the weight load. And so if that's true, Twice weekly might be more effective, would be my argument. If you are then working at your capacity during those two and fully recovered at those two, and I am also not projecting that that is true above board for everyone. But I do think why would we not start with two? Find out where is our capacity for work and for recovery, and if we 6, 12 weeks down the road, say, I want to add a third time a week and see how I do because I can already say I'm fully recovered. My energy is great. I'm sleeping really well. My body composition has optimized, at least from when I started. I'm getting every signal that I've got good results doing this. I want to see if I can go to great results doing something else. Your feedback, if you're open, maybe yes, Yes. And maybe no. And I think that is the value of you are the N of 1. Let's start with a framework, then put it to the test with another framework and see what happens. And that— then you will decide, right now, in this moment of time I'm in, with the hormones I've got now, with the bandwidth of other life stressors, this is the best exercise for me because it's working. And you're measuring skeletal muscle mass, body composition, energy, sleep, Digestion, elimination, mood, cognitive function, which are all related to also being in your sweet spots for exercise. And a lot of other things run those circuits as well. So it can be hard, but if you've not changed anything else and it's the exercise that's been your variable, now we know it's an easier decision to make. What I would suggest, if you are starting, I would want you to know what exercises you're doing, what resistance You're using, meaning what kind of weight, and how you'll decide when to progress. And I would want the plan adapted to your limitations and to your recovery. Your limitation might be: I have an old injury at my knee, and I don't want that to start shouting again. Or it might be that you have osteoarthritis, and at a certain point, you know you've got to listen very closely so that you work the muscles, but you don't. Tax or stress the joints. All of those matter. I would want the plan adapted to you based on that rather than borrowing just the study schedule and say the days— they probably said Monday, Wednesday, and Friday— this is what we're doing. But I'm guessing, you know, you've got to manipulate, or you can, even based on your life schedule, not just even recovery. You would write down the weight you're lifting, the repetitions you do, how the exercise Felt to you after, and both immediate and the next day. You don't need an MRI appointment to start keeping a useful record, and you do need something better than, you know, I think this felt hard last month, but I also think I misplaced my glasses, right? I mean, we need something more definitive. Choose a few repeatable measures. Perhaps it's the same exercise with the same range of motion and the same technique. Perhaps it's practical tasks you care about. Keep the conditions consistent enough that your comparison means something. And I would also ask whether you have guidance. Now, there is no proof. In fact, there are plenty of studies have been done to show supervision doesn't matter as long as you're doing it and you're doing it consistently. You can do it at home, you can do it alone in the basement, upstairs in the attic, I don't care. Or you can go to a gym doing it on your own. You can do it in a group, you can do it with a partner or with a trainer. There is no difference in results based on supervision. And I will tell you right now, there is one thing that I'm a little concerned about, and it's, you know, is supervision a bad thing? And I don't think so, but I think anyone giving you a scare tactic suggesting that you have osteoporosis, therefore you are fragile, is wrong. It's not true because we know it. Postmenopausal women doing or with osteoporosis have been in studies with high-impact In fact, in high-intensity loads with no injury rate and great participation rate. In fact, adherence levels were probably as high, if not higher, than other studies involving women with osteoporosis. We know you're not fragile as long as you don't have a history of fracture before. That puts you at high risk. And/or if you have a health history, maybe long-term use of steroidal drugs, like prednisone, you probably are more prone to a fracture. And I would say clinical supervision on machine weights would probably be the safest for you. However, for the rest of the population, that is not true. So do the exercise where you are most comfortable doing it. If you're uncomfortable or apprehensive about participating without having supervision of a trainer, get some eyes on You first. Go through sessions with a proficient and guided trainer. And I would say, take your phone along, tape those sessions. They're yours. You're paying for them. Videotape those sessions of them cueing you in proper movement. You don't have to pay for just that half hour or that hour. Pay for also the documentation of that hour. It's yours. That, I think, is something still missing from many personal training sessions that should be a given, especially if you're paying upwards of $100, $120, or $150 per session. You want to make sure that that individual is focused on you, and I guarantee if you turn a camera on, they will be and they will stop texting. That's an important distinction. Okay. The question has much more utility than asking whether menopause has made all effort pointless. The questions we want to ask is, what is it that you want to change? What are you willing to do? And will you stay the course and follow a plan in order to go from A to B with the ability to measure progress? In closing, I also want to give you one more asset that I've mentioned. You can make it very simple if you have a an activity, a task, something you do at home right now you don't feel comfortable with. You need to get up on a chair or a counter, or you need to— you're cleaning your own house, you're doing something you don't feel comfortable, you feel shaky doing. Measuring how steady, stable you are in that task may be the way you're measuring your success. But you also may want to do some more guided and practical exams, things that you can do at home. I have a battery of assessments. There are at At least 10 there, many of which you can do with no equipment. To look at your stability, your mobility— stability being balance, your mobility is flexibility— and your power getting up from a chair. So a chair you have in your kitchen or dining room will suffice. And a timer, a way that you can look at a clock with a seconds hand and do your own counting. Many of these things you could do alone. With a partner, they'll go faster, but it's optional. Testing in certain ways, making sure that you test today, you test again in 4 weeks or 8 or 12. Keep yourself accountable because then you'll keep the eye on the ball. I would highly recommend it. We'll put that in the show notes. It is important that you have some kind of guidance if you're not proficient at writing your own exercise program. When you get started doing the basics and the variables at first, it's all you need. But then even that, you want to change the order you do those basics in. That's an easy given. I've given it to you. If you start with a squat, a chest press, and a row, you know, in a few weeks, let's do the row and then the chest press and then the squat in a different order. That can make a difference as well. But we also need to know when will you increase the weight? And if you start with 15 to 20 repetitions, increasing the weight should come at a point where doing more than 20 is possible with the weight that you have. You want to then increase the weight. You may find you have to come down to, I can only do 15 now, or I can only do 14. I can barely make it. Great. That's where you want to start. And when you get stronger, you'll climb back up within that. And when you reach 20, it's time to increase the weight again. That's another stage of progression. But you also want to probably expand from 3 exercises to 4, to 5, and to 6. You want to expand and make sure you're putting those exercises together in a way that makes the most sense. Major muscles compound exercises to smaller muscles or isolated as time and your energy permit. Those things are very important. So it's encouraging evidence in this study. It gives you a reason to act while leaving room for an individual plan. And if you'd like starting point for deciding where to work, the fitness scorecard we now call the Strong Aging Index. All the numbers that you will find from doing your own tests at home, with many of them no sweat and in seconds, will tell you where do you stand according to other women in the same age group you're at. And by the way, you want to be off the charts to the right because the average individual is not exercising the minimum amount even for good metabolic health. You and I can change history here by making that different. So if you're not subscribing on one of the podcast platforms like Apple or Spotify, iTunes, iHeartRadio, please do that so you don't miss podcasts, either a solo like this breaking down science or an interview with one of the hormonal menopause longevity experts that we frequently have on. And you can go to show notes at flipping50.com/podcast where you will find all of the individual shows and show notes that read many of them like a blog. And you'll find any links that we've put in the show, like the Thank you so much for joining me. And if this has been valuable, please share it with a friend. The information shared on Flipping 50 the Stronger Way is for educational and informational purposes only and not intended as a substitute for medical advice, diagnosis, or treatment. Always consult your physician or qualified healthcare provider before beginning any exercise program, making changes to your diet, or adjusting any medications or supplements. Individual results may vary. Deborah Atkinson and Flipping 50 are not responsible for any injury or adverse outcomes resulting from information presented on this podcast.