Muscle Mass and Strength Gains After Menopause How Much How Fast?

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I'm Debra Atkinson and you're listening to Flipping 50. I started this podcast over a decade ago to answer questions about fitness in menopause and beyond before you know to ask them. The goal: to help accelerate your results with the science and the practical application of proven protocols while living your best life. There's no more powerful health influencer in the world than a midlife woman.

It's not just you, but it's the 3 generations that you influence.

My unique 40-year career, including being a university senior lecturer in kinesiology, an industry subject matter expert and international speaker, to founder of the first and the only exclusively made-for-menopause-and-beyond fitness membership in the world. Every week I interview experts behind the science of optimal hormone-balancing fitness and longevity and share answers to our community's questions so you can have the vitality and the energy you you want, need, and deserve.

If you've ever doubted your ability to make muscle mass and strength gains after menopause, this episode is for you. Even if you're trying everything and it seems to be failing, this is for you. If you and I ever think we'll be seeking a retirement community, the very first thing on our must-have lists is a gym, not one with bands and tubing and pink dumbbells and a cute 22-year-old redhead doing chair aerobics. If I see you in the hallway, by the way, girlfriend, I'm going to be pulling you into the gym with leg press, row, and pull-up bars. Psst, okay, at 61, I need you to know this. I didn't lose muscle mass during 10 weeks of time. Away from heavy lifting and HIIT workouts, but I did gain 2 pounds in the first 8 weeks after beginning to increase my mechanical stress again. And I don't wanna say too much yet, but watch the show notes for a supplement that I just learned about at exactly the right time for me. Some of you know that in June of 2025, I did stem cell therapy, so stem cells, an optional therapy, and most of us are going to decide to do it maybe before we do some other procedure. Or in my case, I wasn't about to do another procedure, but I was feeling that I wasn't 100% me. My knee wasn't functioning the way I wanted it to, a little, a little puffy, a little inflamed, probably holding on to a little bit of fluid, fluid, and none of that is good. So I was able to do all the things I wanted to do. It's just I wasn't getting the signs and the symptoms afterward. I was getting a little too much feedback, and I wanted to fix that, knowing if I keep doing what I'm doing, it's probably not going to get better. So I had the procedure, but then after the procedure, you have to take it easy. Now, that's a little awkward. I will have to admit that you kind of have to wonder, or at least I do, 10 weeks out now had I taken a break from all of it, would it feel better anyway? And is that the reason it's feeling better, or is it the stem cell therapy? And it's yet to be determined. It's really like 3 to 6 months. It will still do a lot of healing in that period of time. So I'm just not there yet, but I will keep you posted. So I realized I wasn't just supposed to take it easy for a couple of days. I was supposed to have no mechanical stress for the first couple of months, it is really truly good for me that I did not read the fine print or I probably would have put it off the closer I got. So I knew it needed to be light, but I didn't know it needed to be none. So that hadn't sunken in. Even long walks I didn't do for the first 4 weeks. Seriously. So it was a big deal when I went for my first like 45-minute walk. I was like, I'm back. I mean, no HIIT, no high-intensity sprinting, no heavy load, but it felt so good. And honestly, it's good to be a beginner again. So I will share with you what I did and what I took and how I did have a concern. I had a greater concern for what would happen far off in my future in a couple of decades and how I might be much more limited with mobility if I'm getting this kind of feedback now, which is true for a lot of people who maybe have been very active and especially liked higher impact exercise. But that for another story. Today, keep that in your back pocket if you're struggling with muscle mass gains and you're ready to say, I'm doing all the things, meeting the protein, doing the resistance training, but not making gains. You might be interested in that little share that I'm going to make. But right now I'm going to break down a study that talks about why BS is what we're all going to call if anybody ever says, I'm too old, it's too late. A 2024 study published in the International Journal of Sports Nutrition and Exercise Metabolism about muscle mass and strength gains in older adults will blow all of your it's too late thoughts away. I'm breaking it all down for you today, and the only ones listening to this podcast who will be left thinking, oh, but that won't work for me, are those looking for excuses. So if that's you, just know it. Just know it. And truly, don't keep making yourself feel guilty. If you're not going to do it, you're not going to do it. Nothing I say is going to sway you otherwise. But my hope is that it just might. So in this study, 17, yes, one-seventh, this is a small study, but 17 healthy older adults between 65 to 75 years and 12 healthy older adults above 85. They were enrolled in a 12-week resistance training program. Before, during, and after the exercise training program, muscle mass, strength, and functional capacity were assessed, like how well they move and get up from chairs, how quickly. That kind of thing. After a 5-minute warm-up, there was a— there was one warm-up and then 4 regular sets on both leg press and leg extension machines. So they did 4 regular sets on 2 leg exercises. They had 3 upper body exercises. Those were chest press, latissimus dorsi pulldown, or what's called lat pulldown if you're at the gym, and a horizontal row. So that might be, if you're at home, a bent-over row. Is essentially the same as a horizontal row. If you're at a gym, might be sitting down on the rowing machine, not the like a boat rowing machine, but the seated row machine. So there you have it. Hopefully you're all in the same spot. And I'm going to call out this— why would they do that? I often do this as well for programming for myself or older adults to counter our postures from every day, what we call repetitive postures. We're rounding forward around keyboards, we're, we're working life out front. So I will do 2 pulling exercises or 2 exercises for the back to every 1 chest exercise. If I'm in a hurry, I will sometimes not do chest, but I will do the back, and it helps to offset daily postures, daily things that you're doing. So just thinking about why would they do that, that's probably one of the reasons. We need to stand up straighter, and as we age, that becomes more and more true. So every exercise session ended with about 5-minute stretching. So 5-minute warm-up, 5-minute stretching at the end, and in between there was a warm-up set, a very light set, and then 4 regular sets on leg press and leg extension, and then those 3 upper exercises, they were performed with just 2 sets of each exercise. And why is that okay? Well, again, because they did 2 sets of 2 exercises for the back, that's essentially 4 sets for the back and just 2 for the front. And again, because of the balance from the front to back, it makes sense if we design exercise programs that are exactly— if you do 2 to the front, you got to do 2 to the back, and if you push 2, you got to pull 2, or you got to do the quads, then you got to do the hamstrings— if you absolutely do that and someone is starting a program imbalanced, we will amplify the imbalance. So I hope that makes sense. This program was really perfectly structured in order to help balance the upper body. Now, the lower body I'm not so convinced on because they did not do anything for hamstrings, but a little more difficult with older adults. So keep that in mind as well. During the first 6 weeks of the training, so it was 12 total, the workload was increased. They took a one rep max. Now, I promise you, they didn't actually do a one rep max test, that means we'd say to you, okay, let's pick up a weight that you can only do one time. It's that heavy. That is like injury waiting to happen. We never do that. What generally happens with researchers in a study like this is we might do a 10-rep max with somebody, find the weight they can lift 10 times, and then we predict based on calculations what would their one-rep max be. And then we say, okay, let's have them do 60 to 80% of that. We defined that. So they did a specific percentage of that, and it equated to somewhere between 8 and 15 repetitions was what they were doing the entire study. And as they got stronger, they recalculated that halfway through so that they continued after they'd gained strength to still have that same percentage of stress on their body. So If we just kept you at the same weight and you gained strength, that wouldn't work, right? So same here too. All the participants completed at least 29 out of the 36 sessions. So if you're doing math, it was 12 weeks long, they did 3 sessions a week. Okay, so they completed the majority of them if they got to be included in the study. So All participants, the results, all participants increased quadricep strength, top of the thigh, and the increase ranged from somewhere between 1% to 18% in the group labeled older, the 65 to 75 group, and increased, listen to this, 6 to 21% in the older 85+ group. Yes. So the increase in strength ranged from 1 to 18% in the 65 to 75-year-old group and from 6 to 21% increase in the 85 and older group. So one, one rep max leg extension increased by how much, you ask? I'm so glad you asked. From 38 %, plus or minus 20%. That's a big distinction. In the older group, 65 to 75, and 46%, plus or minus 14%, in the older 85+ group. And this is just absolutely crazy. So increases were across the board bigger and larger in the oldest of old group. So similar improvements were observed for the leg press, the lat pulldown, the chest press, the horizontal row, and the grip strength in the older 65 to 75 and the 85+ group. So in functional tests, we talk about how well you're going to move around. The tests that are often used are the timed up and go, where you'd be sitting in a chair and then we say, okay, go. And they have to kind of go round, generally around a cone. So they actually have to maneuver, turn around and come back. And, um, that's called timed up and go or TUG. Significantly improved for the 85 and older group. Their increased strength and their power directly improved their ability to get up from a chair. It wasn't something they practiced. It was just pre and post. When you increase your strength, generally your gait speed increases. And by the way, gait speed is related to longevity. So this really matters. The times also improved for the group that was 65 to 75, but to a smaller extent. So as you might guess, the younger set were more mobile and active in daily activities probably already compared to the 85+ group prior to the study. The percentage increases for the 85+ was about 13% compared to 8% in the 65 to 75-year-old group. So in all cases, though, the actual loads were higher in 65 to 75-year-old group. The percentage of increase in strength or function testing were greatest in the older group. If you have more to gain and you've been more sedentary for years, that is you. You can actually gain it and be pretty impressed by yourself. Improvements were seen in, this is really important. Lean mass, strength, and functional activities. And this is really big because what this study, even though it was small, showed is counter to previous thoughts that there's maybe a decline in adaptive response with increasing age, particularly in gaining lean mass. We have always known, and I say always for as long as I've been in this career, and that's 41 years right now, rapidly getting closer to 42. We've always known you can increase strength at any age. We could take people who are wheelchair-bound and give them hand weights to do bicep curls and other things with their upper body, and they can gain strength pretty significantly. However, what we didn't know or have documented was gaining lean muscle mass, and now we do. Now we have that evidence. So we've always observed in previous studies gains in muscle mass were reduced with increasing age. No longer is that true. So we just raised the ceiling, y'all. Specifically, recent insights clearly show, apart from greater exercise intensity, also greater exercise volumes. That means you do 3 sets instead of 1 set. And 3 versus 1 or 2 training days a week leads to greater improvements in skeletal muscle mass and strength in the older population. So while that might or might not be true for women in menopause, because we're juggling this fine line between adrenal fatigue, juggling cortisol issues, that just adding another day— yes, while it increases the volume of exercise we do— may or may not work because we're still in this period of hormonal upheaval, if you will. But it's not just hormones, it's life. Life's throwing us a lot of things all at once. And in addition, we're in this sandpile with hormones changing, and that just becomes a lot. So we have to not just look at what do your muscle need, what does your bone need, what is brain health, but what does your endocrine system need in order to fully recover? Because if we throw cortisol and your adrenals under the bus, we throw thyroid under the bus, we throw metabolism under the bus, and then you won't sleep well, and then you won't get testosterone and growth hormone and estrogen levels to optimize. Cortisol is really almost like the master control switch. You'll hear more about that in upcoming podcasts. We've done so many episodes with interviews with new guests coming on this fall. You're going to want to hang in there and listen, but I'm teasing all the good stuff. Hey, this is Debra Atkinson, and there's one thing that you can't do in the gym at your age, and that's get all the protein that you need. You've got to do that in the kitchen. To make it easy for myself to not only get the protein but the fiber, fruits and veggies that I want daily, I started drinking drinking a smoothie a day over 30 years ago when I realized all the junk, the sugar, and the extras that you don't want hiding in most protein powders or pre-made shakes. I finally caved in after years of saying I'd never, ever, ever sell supplements. Look, stop skipping, skimping, and sabotaging yourself in the morning and after workouts by always being prepared Protein plus fiber kill cravings and boost satiety and build muscles and a strong future. Use code PODCAST for 10% off your first order at flipping50.com today. So let's define muscle mass and strength gains after menopause. Exercise intensity with resistance training is based on decreasing the repetitions to rep or to muscular fatigue. And that means basically if we say, you know, fatigue at 5 or 8, you're having to lift a heavier weight than if we say fatigue at 15. Exercise volume is based on the number of sets. So 3 or 4 being greater than 1 or 2 sets. Or 1 or 2 training days a week, right? So think about different ways that you can add volume. And volume is a calculation. So we can literally say, you know, if you— for any given workout, we take you did X number of sets and you did X number of repetitions. Or we can say you did X number of sets, you did X number of the weight. This is the weight that you lifted. And, um, do the multiplication that way so that over the course of the week we can look at all of it. We could look at what's the volume of sets that you did this week, and what's the volume of sets that was for upper body or lower body if we wanted to dig into that. But there are a lot of ways to calculate, but I want you to make it clear that volume is not just add another half hour or add another day because that may interfere with your adequate recovery that is required for you to really get the benefit. So considerations for exercise volume in menopause. As a side note, for women post-menopause, increasing the number of days per week to reach greater exercise volume can be problematic because of the need for balance with those recovery days. And by balance, don't mistaken that we mean one workout day, one recovery day, then let's work out again. Balance actually means whatever you need. I mean, that's probably the best way to say it. It's all about you, girlfriend. The words we've been waiting to hear our whole lives, right? But what we really mean usually is this. So you do a workout, you need 48 hours minimum, and you always did when you were 20 and when you were 30. But when you're 40, 50, 60 and over, you may need 3 days, 72 hours may feel better. And I've had women say, I don't feel recovered yet. Is it okay to wait another day? And the answer is yes, dear, it's good. Know yourself, listen to yourself, because so many times in our lives we haven't been willing to do that. But that doesn't mean don't move that day. Recovery can be active. And so you can still facilitate fitness without pushing really hard and causing more breakdown. Science does indeed suggest greater volume for older adults, older being defined as the more years over peak muscle mass, right? So that is a very loose term that makes us older. If peak muscle mass occurs at about 25 to 30, then we're older than that, right? And if you're 75 or 85, you're older than that. And so As we age, if you are right now are X years old, you know, X plus 10 or X plus 20, we're probably going to need a little more recovery or to be more careful of it. And by that, recovery is not just time. Let's make this clear. It's also what else happens. Are you stressed the day between, or are you like, you're going to work? So you think, well, I'm not exercising. So I took a day off. It's not quite the same as, you know, if you were an Olympic athlete and you could lie on the couch and eat bonbons and have somebody feed you grapes, that's really recovering. And few of us get that. Even Olympic athletes don't get that. They're real people too, most of the time. But it does matter. You want to think about how much do you need. But the more years between peak muscle mass and your current age, the greater anabolic resistance you have. For women in metabolic menopause, the reduction in estrogen, which has previously served as your stimulus for muscle and for bone, and corresponding increase in cortisol, which is a catabolic hormone— mean it, it breaks down— contributing to muscle breakdown and fat storage. This combination makes anabolic resistance a greater factor in the need for exercise prescription with volume in it that respects your recovery needs. So you can't have one without the other. However, when beginning resistance training, my recommendation is start with 1 or 2 sets, 2 days a week if you've been inactive. You've been active, then begin with 3 sets, 2 days, and yes, still 2 days a week. I'm all for that because until you're started and doing something consistently, you have have no business going all out and grabbing all the volume. That's, that's greedy, right? And more so, it's more likely to make you want to drop out. Let yourself be successful. Don't put the bar so high that you can't play, and then you convince yourself that you can't get it all, so it doesn't matter. 2 and 3— the difference between 2 times and 3 times a week right now is insignificant. And even for older adults, we're seeing there are a lot of studies that come out for adults post-menopause that are just twice, twice weekly strength training, and they're still getting good results. So again, start there, establish a habit. If you say, I'm feeling great, not sore, not achy, I feel like I could do so much more, then try that third time. Then once you have a habit, make it easy to do the next thing. Make yourself want it, not impose it. It's a very different way to come at it. So by the way, that's not to suggest injury risk increases with weight training. I don't want to imply that it would. However, dropout rate does increase with frequency. The, the more times we tell you you should do it, we get to 5 or 6, not very many people last through programs. That do that. Those people are more obsessed, right? And, and all respect to those of you that is that. However, very few of us that have a lot of a full life and meaningful things that we're doing in it have that kind of time to dedicate or want to. We, we have these, all these things that we want to do. I'm all for a minimum viable physical activity, MVP, a new way to think about it. That is the least amount of physical exercise that you have to do so that you have the most amount of energy left to go play in your life or work if you love your work and it's still giving you purpose. The beginning phases of exercise should last longer for a woman starting in her 60s or 70s than if you're a woman starting exercise in your 20s or 30s. Our muscle, our ligaments, tendons collectively are not as resilient at 60 and over as they were at 20. And, and we could say the same at 50, since most early improvements when we start an exercise program are due to a neural adaptation, turning on the Wi-Fi between your brain and the muscles, getting the pattern of movement right, especially if it's new for you. We can't accelerate that neural connection by going heavier, but we could accelerate injury if we haven't laid the foundation strong enough yet. So you're in this for life. There's time. The adaptation— adaptive, I'm sorry— response to resistance training is preserved even in males and females over 85. I want that to sink in. There are no non-responders, no matter how old you are, males and females, midlife, older life, you'll respond. So there were no additional changes made to diet, no increase in protein, lifestyle, additional activity outside of resistance training sessions for the study that we opened with. That was just adding strength training, period, end of story. So imagine what might have happened if they'd focused on increasing their protein a little bit more, or imagine if they took creatine. And I say that tongue-in-cheek because, by the way, if you're not consuming a good, high micronutrient-dense diet and consuming adequate protein, don't go for the extras. Let's just stick with the basics. Things we know we need. So one has to wonder, given we know there are two ways to stimulate muscle protein synthesis, resistance training and eating protein, what more could have been seen with a subset group who also increased their protein beyond existing daily intake? Or even a third group who did no resistance exercise but only increased their protein intake to a certain level beyond previous intake. 46% of older adults don't get the lowest of low dietary protein recommendations. Yeah, so that is for a 160-pound adult. The low recommendations provided might be 60 grams a day. Only 40%— 46% of older adults get that. Yikes. Consider for active adults with anabolic resistance and desire to increase muscle, the recommendation would be a minimum of 100 grams a day to hit metabolic health benefits. That's a metabolic health, that's not fitness really. So that's just support for blood sugar and insulin and your heart function. For optimal fitness and strength in a thriving life with energy, reduced disease 160 grams of protein is more in alignment for a 160-pound person. And that, of course, is a huge leap for anybody who's not been eating more than 40 to 60 grams of protein per day. To increase protein and complement your resistance training, I don't suggest starting at the recommendation for 160, but if you were that 160-pound person, what I found successful for clients is something like this 5-step very small process. Number 1 is track your intake in a no-judgment zone so you know what you have been taking in. Number 2, start paying attention to your caloric recommendations based on age, weight, height, body fat, and your activity level. And you can find that at caloriecalculator.net. We can put that in the show notes for you. But just get curious, what am I doing? Take that first. And now You've got that data, compare it to your own activity level and your stats and say, wow, is there a gap there between recommended and what I've been doing? Step 3 is objectively consider if there's a gap there. And again, don't judge, but just look at how could I close that gap? That's step 4. Decide if you want to test the possibility that protein could enhance energy and lean muscle gain or fat loss. Either or both, really. Step 5 is set some short-term goals at meals. So for instance, at breakfast, let's say you've only been getting about 15 grams of protein. You had 2 eggs and maybe a slice of toast. You could do better, friend. We want you to get about double that. But how could you start with even one more egg? Or you could find Another way to add a little protein, maybe through a shake, maybe through Greek yogurt, or I like goat or sheep myself. I don't do dairy, but we're just looking to keep it easy for you. What would that look like for you? I don't like to see a strong protein start as the basis of change, right? So not a whole lot of it. It often sets off a positive domino effect, or I'm sorry, it does if we get more protein in. Just don't start super high, but it— that small change sets off a strong domino effect because you gain energy that you didn't expect to gain. You, you gain some things, you win just from these small things if you start doing it. So it's very easy that once you start feeling better and more energetic, you suddenly get more motivated to do more strength training Research does say that if breakfast is high in protein, then at the concurrent meal, the next one, we tend to make another good choice. We will be more conscious in that choice, so we'll be healthier at every meal after that as well. But it's not just that. We set ourselves up for good blood sugar the whole day with that breakfast, or Not so good. Could also be true. So muscle mass and strength gains after menopause are dependent on really your relative strength training power. It decreased significantly after the age of 50 years, and it was negatively and strongly associated with mobility limitations. That means, my friends, you can't just think strength training. Is it? But we have to maintain our mobility. So getting in the regular stretching, no more skimping on the warm-ups and the cool-downs, getting yourself more loose, lean, and keeping your range of motion, or getting it back, because that, once it's lost, is more difficult to get back. So start looking specifically at 3 areas that I like to see older adults, right? And older than peak muscle mass, that'd be you and me. Ankles, hips, and upper back. We tend to lose it there. And if we lose mobility there, we will pay for it in other areas. So if you're not already exercising, start. Find a place to begin. One place might be the 10-Day Hot Numb Other Challenge. We in fact start you in the green room getting ready for the challenge with mobility exercises, and we keep those around for the first few days as well. But you will, I promise, feel better even before you start the challenge. So if you're in need of a start, a restart, or a reset, this is a perfect place to begin. It's not an 'and,' by the way. It's not something you add to what you're already doing. 'I'm going to do this too.' It's a 'what I'm doing isn't working or I'm going to get started and I need a kickstart. That's the perfect place. It's not for somebody who says, well, I'm going to add this to what I'm already doing and layer it in. You're not going to see the results from it, so you may not need it. If you're getting great results, don't fix it if it's not broken. But starting this, park whatever you're doing, come in and reset. If you're tired all the time, you're achy, you're you're not seeing results from the exercise you're doing that you've earned results for. So I hope that was helpful. I'd love to hear your thoughts, how this resonated with you, but realize that this is great news. It is really amazing that we've got a study that is saying to us, okay, and as recently as 2024, 85 and older, still not too old. We got lots of good years left. So let's do this, friends. Thank you so much for listening.

To listen and access a decade of episodes and the show notes, visit flipping50.com where you'll be able to find all of our prior episodes. And I made it easy for you to make the most of your listening time by selecting 5 specific areas most commonly high priorities for our community and giving you top 10 lists if you let me know you'd love them. If you know a midlife woman or a soon-to-be one who wants to optimize her midlife energy and time with the right exercise and lifestyle changes and a mindset shift about just what is possible, share this podcast with her, and I thank you. There is no more powerful health influencer in the world than you, midlife Life on it.