Menopausal Weight Gain: Why Muscle Mass Matters.

I’ve been working out for most of my life, much of it completely unaware of how under-fueled I was. 

The messages many women receive about food, exercise, and body composition are remarkably consistent: be skinny, be smaller, eat less, don’t get bulky. The rise of weight loss drugs have only reinforced this. I call this the “shrink yourself” approach to health. 

Meanwhile, men are often given a very different message: build muscle, lift heavier, eat enough protein, recover well, get stronger. 

Women are taught to shrink themselves. Men are taught to build themselves. 

As I enter what I lovely call “perimenopause prep” era, I’ve become increasingly interested in a different question: 

What if the goal isn’t to get smaller? What if the goal is to get stronger? 

I’ve written previously about blood sugar regulation, joint health, and inflammation in menopause. But underneath all of those topics is something even more foundational: muscle. 

Muscle influences metabolism, blood sugar control, strength, balance, bone health, independence, and healthy aging. It is one of the most important tissues we have, yet many women don’t think about it until they start noticing changes in midlife. 

I had a strategy call with a 65 year old women this week who said: 

“Kate, I’ve been the same weight for 25 years, until recently! My mid-section is soft and my legs don’t look the same and nothing about my food has changed in decades, what’s happening?”

It’s a question I hear all the time. 

It’s a change in body composition. The same body weight looks different. The mid-section feels softer, the legs less toned, strength declines, energy changes. This happens because muscle is metabolically active tissue. As muscle mass declines, your body burns fewer calories at rest and becomes less efficient at managing blood sugar and storing nutrients. 

The reality is that women begin losing muscle mass as they age, and that process accelerates during perimenopause and menopause due to declining estrogen levels. This age-related loss of muscle mass and strength is called sarcopenia. 

What is Sarcopenia?

Sarcopenia is the gradual loss of muscle mass, strength, and function. 

Muscle is not just about strength, it’s deeply connected to your overall health.

• Muscle supports your joints → less pain, better mobility

• Muscle regulates metabolism → helps maintain weight and energy

• Muscle improves blood sugar control → stabilizes energy and cravings

• Muscle supports longevity → strength is strongly linked to aging well

This isn’t a theory! Researchers have documented measurable changes in muscle mass, strength, body composition, and fat distribution throughout the menopausal transition. An excerpt from the Frontiers Journal a paper called Sarcopenia and Menopause: The Role of Estradiol: 

"It is to note that the menopausal transition (staged as pre-menopause, perimenopause, menopause, and post-menopause) (9) is associated not only with a decline in estradiol levels (10), but also with an increased visceral adiposity and decreased bone density, muscle mass, and muscle strength (7) (Figure 1). All these factors significantly contribute to the development of a condition termed “sarcopenic obesity” (11) characterized by a sarcopenic clinical condition and an excessive body weight. Sarcopenic obesity has direct consequences on the health of menopausal and post-menopausal women (12).

Figure 1. Reduction of estradiol concentrations, morphological changes, and cellular modifications affecting sarcopenia in women aging. Note. E2 = estradiol. Reprinted from Sarcopenia and Menopause: The Role of Estradiol, by A. Geraci, R. Calvani, E. Ferri, E. Marzetti, B. Arosio, and M. Cesari, 2021, Frontiers in Endocrinology, 12, Article 682012 (https://doi.org/10.3389/fendo.2021.682012)

Regardless of Hormone replacement therapy (HRT), diet and lifestyle interventions continue to be the cornerstone of maintaining muscle health throughout the aging process. 

The literature shows women in menopause have a reduction in protein intake and energy expenditure (i.e. we are eating less protein and having less physical activity). You know that phrase “if you don’t use it, you lose it!” It so deeply applies here. 

The Workout Piece - building muscle mass

Here’s what surprised me most in the research - women often begin losing strength before they notice significant muscle loss. That means the first sign of sarcopenia isn’t what you see in the mirror, it’s what you experience in your body. 

One muscle group researchers pay particular attention to is the quadriceps, the large muscles on the front of your thighs. These muscles help you climb stairs, get up from a chair, walk confidently and smoothly, maintain balance, and stay independent as you age. People notice things feel harder in their body before they notice changes in their physical body. Have you noticed it’s harder to:

• Get up off the floor without using your hands

• Carrying 2 loads of groceries 

• Hiking 

• Lifting your suitcase 

• Playing with grandkids 

• Open jars

These are not simply signs of getting older - ugh I hate that throw away phrase! These are signs your body is losing strength, power, and muscle function. Let that be your cue! 

Right now, my focus is simple:

• Strength training consistently and simply 

• Prioritizing recovery

• Supporting my joints through intentional movement

The goal is maintaining strength, power, and function. It’s not perfect. It’s not complicated. It’s consistent. Imagine if more women started describing themselves as strong, powerful, and capable?! 

Strength training provides the signal to keep and build muscle.Nutrition provides the materials to support that process.

The Nutrition Piece and muscle mass

One of the biggest mistakes I see in clinical practice is that women continue to eat, diet, and workout in the same way they did in their twenties and thirties expecting that vacation meals and inactivity will come off and stay off after a few days of “crash dieting”. 

At the exact stage of life where muscle becomes the most important, women eat less protein, diet more aggressively, and become less physically active. 

Women who consume less protein than the RDA (0.8 g/kg/day) tend to have

• Higher body fat

• Worse body composition

• Lower physical function 

Increasing protein is part 1...part 2 is increasing demand on the skeletal system = strength training. The strongest results in clinical studies occur when 

• Protein intake is adequate and consistent 

• Protein is distributed throughout the day 

• Resistance training is performed consistently

Current evidence suggests aiming for at least 20-25g of high quality protein at each meal to support muscle maintenance and health aging (Buckinx & Aubertin-Leheudre, 2022). 

Leucine & Muscle Protein Synthesis

One of the key amino acids for muscle building is leucine. It acts as a trigger for muscle protein synthesis—the process of building new muscle.

Foods rich in leucine include:

• eggs

• dairy (like Greek yogurt)

• meat and fish

• protein powders

There appears to be a threshold effect, meaning you need enough leucine in a meal to actually stimulate muscle building.

A Starting Place 

Perimenopause and Menopause is often framed as a time of loss, declining hormones, shifting metabolism, changing bodies.

But it can also be a time of intentional building.

Muscle is one of the most powerful things you can invest in during this phase of life. It supports your joints, your metabolism, your energy, and your long-term health.

If this feels overwhelming, start here:

Muscle Support Checklist

• Protein at every meal

• Strength train 2–4x/week

• Don’t skip meals

• Include anti-inflammatory foods

• Prioritize recovery and mobility

You don’t need to overhaul everything overnight but you can get started tomorrow. This lifecycle is an opportunity to change the narrative…skinny is out, muscles are in. 

Stay strong, stay powerful, stay capable! 

Kate

Your health, your rules - if you’re ready to feel better, let’s make a plan together. Grab a free call today! Book HERE!

References: 

Buckinx F, Aubertin-Leheudre M. Sarcopenia in Menopausal Women: Current Perspectives. Int J Womens Health. 2022 Jun 23;14:805-819. doi: 10.2147/IJWH.S340537. PMID: 35769543; PMCID: PMC9235827.

Geraci A, Calvani R, Ferri E, Marzetti E, Arosio B and Cesari M (2021) Sarcopenia and Menopause: The Role of Estradiol. Front. Endocrinol. 12:682012. doi: 10.3389/fendo.2021.682012

O'Bryan, S.J., Critchlow, A., Fuchs, C.J., Hiam, D. and Lamon, S. (2026), The contribution of age and sex hormones to female neuromuscular function across the adult lifespan. J Physiol, 604: 829-848. https://doi.org/10.1113/JP287496