The Role of Estrogen in Muscle Strength and Sarcopenia Prevention in Perimenopause

Written and edited by Sarah Bonza MD, MPH, FAAFP, Dip-ABLM, NBC-HWC

Understanding Perimenopause: An Overview

I work with women who are experiencing symptoms of perimenopause. Many of them are surprised to learn that they will continue to grow weaker if they do not work to maintain their protein intake and strength training during perimenopause and menopause. Perimenopause is a transitional phase that women experience leading up to menopause. During this time, hormone levels, including estrogen, start to fluctuate and decline. Progesterone make a gradual decrease until ovulation stops. Decreasing levels of estrogen and progesterone have broad implications for health and longevity. Muscle strength is one area that is impacted.

Woman exercise workout in gym fitness breaking relax holding apple fruit after training sport with dumbbell and protein shake bottle healthy lifestyle bodybuilding. stock phot

The Role of Estrogen in Muscle Strength During Perimenopause

Estrogen plays a crucial role in maintaining muscle and bone strength. It is known as an “antiresorptive” agent, which means it inhibits bone resorption and decreases the frequency of bone remodeling cycles. Estrogen also has a direct effect on muscle tissue. When estrogen levels decline during perimenopause, it can lead to a reduction in muscle mass and strength. This can contribute to the development of sarcopenia, a condition characterized by age-related loss of muscle mass and strength.(Messier et al., 2011)(Pierrynowski, 2010)

Sarcopenia: Definition and Risk Factors

Sarcopenia is a condition characterized by the loss of muscle mass, strength, and function that occurs with aging. It is a multifactorial condition influenced by various factors, including hormonal changes, inadequate protein intake, sedentary lifestyle, and chronic illnesses.

The impact of sarcopenia on women’s health during perimenopause cannot be understated. As estrogen levels decline, the risk of developing sarcopenia increases, leading to decreased muscle mass and strength. This not only affects the overall physical strength and performance of women but also has implications for their metabolic health and risk of chronic conditions such as diabetes and cardiovascular diseases (Enns & Tiidus, 2010).

Infographic of pathology of mechanisms of muscle loss in women

Understanding the broader implications of sarcopenia on women’s health can empower them to take proactive steps in mitigating its effects. By incorporating targeted lifestyle interventions and being mindful of their nutritional needs, women can work towards maintaining their muscle strength and overall well-being during perimenopause. This will help prevent hip fracture and injuries in the future.

Strategies for Sarcopenia Prevention and Management

In light of the role of estrogen in muscle strength and the development of sarcopenia, it is crucial for women in perimenopause to focus on strategies that can help prevent and manage this condition. This includes prioritizing strength training exercises, ensuring adequate protein intake, and seeking guidance from healthcare professionals for hormonal treatment.

Woman enjoying a plant-based breakfast after a home workout. iStock

The Importance of Protein Intake for Perimenopausal Women

Protein intake plays a significant role in preventing and managing sarcopenia in perimenopausal women. During perimenopause, it is important for women to increase their protein intake to support muscle health. Women should aim to eat 2.0g grams protein per kilogram body weight while maintaining an exercise routine. (To calculate your kilograms, divide your weight in pounds by 2.2). Research has shown that higher protein intake is associated with greater muscle mass and strength in women during perimenopause(Silva & Spritzer, 2017). Including plant-based protein-rich foods such as legumes, and nuts in their diet can help maintain muscle mass and support their overall physical function.

By adopting a holistic approach that encompasses nutrition, exercise, and healthcare support, women in perimenopause can proactively address the challenges associated with muscle strength decline and sarcopenia. Empowering women with the knowledge and tools to prioritize their musculoskeletal health can contribute to enhanced overall well-being and quality of life during this transitional phase.

Counting Macros: A Guide for Perimenopausal Health

Counting macros, or tracking macronutrients such as proteins, fats, and carbohydrates, can be a useful tool for perimenopausal women. It allows them to ensure they are meeting their protein needs, which is crucial for maintaining muscle mass and preventing sarcopenia. Additionally, tracking and counting macros can help women in perimenopause optimize their overall nutrient intake and maintain a healthy weight. By tracking and counting macros, women can gain insight into their dietary habits and make informed decisions about their food choices to support their overall health and well-being during perimenopause.

In the Bonza Health 14 day b-well program, we offer training on counting macros and provide recipes and meal plans that are specifically tailored for perimenopausal women. Through proper nutrition and strength training, perimenopausal women can reduce the risk of sarcopenia and maintain muscle strength. By focusing on adequate protein intake and utilizing tools such as counting macros, perimenopausal women can take proactive steps to prevent sarcopenia and optimize their muscle health during this stage of life.

Strength Training: A Key Component in Combating Sarcopenia

Portrait of mature woman with dumbbells doing exercise in the morning stock photo

In addition to adequate protein intake, engaging in regular strength training exercises is essential for preserving muscle strength and function. Resistance exercises, such as lifting weights or using resistance bands, can effectively stimulate muscle growth and counteract the effects of sarcopenia. Women should aim to incorporate strength training into their regular exercise routine, and they may benefit from working with a fitness professional to develop a personalized strength training program

Physical activity is a cornerstone in the prevention and management of sarcopenia in perimenopausal women. Incorporating regular strength training exercises into their routine is essential for preserving and building muscle strength. Resistance training, such as lifting weights or using resistance bands, can help counteract the muscle loss and weakness associated with perimenopause and sarcopenia. Additionally, engaging in weight-bearing activities like walking, dancing, or hiking can further support bone health and muscular strength.

Conclusion

As women navigate the changes and challenges of perimenopause, understanding the role of estrogen in muscle strength and the implications of sarcopenia on their health is crucial. By prioritizing proper nutrition, regular physical activity, and seeking guidance from healthcare professionals, women can take proactive steps to support their musculoskeletal health and overall well-being during this transitional phase. Empowering women with the knowledge and resources to address the impact of hormonal changes on muscle strength can enable them to embrace this phase of life with strength and resilience.

References

1. Enns, D L., & Tiidus, P M. (2010, January 1). The Influence of Estrogen on Skeletal Muscle. https://doi.org/10.2165/11319760-000000000-00000
2. Messier, V., Rabasa‐Lhoret, R., Barbat‐Artigas, S., Elisha, B., Karelis, A D., & Aubertin‐Leheudre, M. (2011, April 1). Menopause and sarcopenia: A potential role for sex hormones. Maturitas, 68(4), 331–336. https://doi.org/10.1016/j.maturitas.2011.01.014
3. Pierrynowski, M. (2010, January 1). The Influence of Estrogen on Skeletal Muscle: Sex Matters. Yearbook of Sports Medicine, 2010, 88–89. https://doi.org/10.1016/s0162-0908(10)79674-4
4. Silva, T R., & Spritzer, P M. (2017, May 1). Skeletal muscle mass is associated with higher dietary protein intake and lower body fat in postmenopausal women: a cross-sectional study. Menopause, 24(5), 502–509. https://doi.org/10.1097/gme.0000000000000793