Logan Steele
Menopause is associated with several physiological changes, including loss of skeletal muscle mass. Research shows that muscle loss is accelerated during perimenopause, with women losing about 10% of their muscle mass during this stage. The loss of muscle mass during menopause is likely due to changes in both muscle function and the size of muscle cells, as well as a decrease in estradiol, a type of estrogen. Estrogen plays an important role in muscle development and aging, and the decline in estrogen that occurs around menopause can contribute to muscle loss. This is known as sarcopenia, which is the age-related decline in skeletal muscle mass and function. The prevalence of sarcopenia was found to be 7% in pre-menopausal women, increasing to 32% in late post-menopausal women.
| Characteristics | Values |
|---|---|
| Loss of muscle mass | 10% during perimenopause |
| Loss of muscle strength | Increased risk of falls and bone fractures |
| Muscle pain | Myalgia |
| Muscle weakness | |
| Muscle wasting | <co: 8,9,11>Caused by estrogen deficiency |
| Muscle deterioration | Caused by loss of sex hormones |
| Muscle protein metabolism | Regulated by estradiol |
| Muscle inflammation | Caused by increased release of pro-inflammatory cytokines |
| Muscle satellite cells | Reduced proliferation |
| Muscle health | Hormone therapy may help |
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What You'll Learn
Estrogen deficiency and muscle loss
Menopause is associated with a loss of skeletal muscle mass. This loss of muscle mass is likely due to changes in both muscle function and the size of muscle cells. Estrogen deficiency, caused by menopause, is understood to alter the microRNA signalling in skeletal muscle, which may activate signalling cascades leading to muscle mass loss. This is supported by studies that show that basal rates of muscle protein synthesis were 20-30% greater in post-menopausal women compared to pre-menopausal women, indicating that estrogen deficiency may improve the rate of protein synthesis.
Estrogen has a significant impact on musculoskeletal function. It directly affects the structure and function of other musculoskeletal tissues such as muscle, tendon, and ligament. Estrogen improves muscle mass and strength and increases the collagen content of connective tissues. Estrogen also regulates metabolism and influences the binding of myosin heavy chain to actin to generate force through phosphorylation of the regulatory light chain.
The loss of estrogen also results in decreased mitochondrial function, increased mitochondrial H2O2 production, decreased levels of antioxidant proteins, and impaired insulin sensitivity. These effects are due to the loss of estrogen, and restoring normal estrogen levels restores cellular redox and glucose homeostasis in skeletal muscle.
The loss of muscle mass during menopause can be mitigated through resistance training, especially at middle age, to aid in maintaining muscle mass and power.
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Hormone therapy and muscle preservation
Menopause is associated with a loss of skeletal muscle mass, which is believed to be caused by a decrease in estradiol, a type of estrogen. This decrease in estrogen is also associated with an increase in insulin resistance, bone loss, fracture risk, and chronic diseases like diabetes and heart disease.
Hormone replacement therapy (HRT) has been shown to have a positive effect on preserving muscle strength and improving skeletal muscle attenuation in early postmenopausal women. In a study, 80 women aged 50-57 were randomly assigned to either HRT, exercise, HRT+exercise, or a control group for 1 year. The results indicated that HRT, either alone or combined with exercise, may play a role in preserving/improving skeletal muscle attenuation and thereby positively affecting muscle performance.
Another study examined the effect of a 10-week resistance training program on 31 premenopausal and postmenopausal women. The postmenopausal women were assigned to a low-intensity or moderate-intensity strength training program, while the premenopausal women all performed the moderate-intensity program. This study did not include perimenopausal women, who are at a particularly vulnerable stage for muscle loss.
While HRT has been shown to have benefits for muscle preservation in postmenopausal women, it is important to note that the mechanism of action is not yet fully understood. Additionally, the effectiveness of HRT may depend on the stage of menopause, as one study found that estradiol administration increased the ratio of nuclear to cytosolic estrogen in early-postmenopausal women, but had an adverse effect on protein breakdown in late-postmenopausal women.
Overall, HRT may be a promising strategy for preserving muscle mass and strength in perimenopausal and postmenopausal women, but more research is needed to fully understand its effects and optimal timing. In the meantime, resistance training, especially at middle age, is recommended to aid in maintaining muscle mass and power.
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Physical activity and muscle health
Menopause is associated with several physiological changes, including loss of skeletal muscle mass. Research shows that adults lose about 3 to 8% of their muscle mass every decade after the age of 30, and this loss accelerates to 5 to 10% after the age of 50. Women, in particular, experience a precipitous loss of muscle mass during the menopause transition. It is estimated that women can lose about 10% of their muscle mass during perimenopause alone. Late perimenopausal and postmenopausal women are more likely to experience sarcopenia, or involuntary muscle loss, than premenopausal or early perimenopausal women.
The loss of muscle mass during menopause is likely due to changes in both muscle function and the size of muscle cells, commonly referred to as fibers. One possible signalling route leading to cell death involves microRNA molecules. These molecules regulate gene expression by inhibiting targeted protein synthesis. To date, several microRNAs have been found to regulate key steps in cell death pathways and may regulate the number of muscle cells. A study conducted by the universities of Minnesota and Jyväskylä revealed that estrogen deficiency alters the microRNA signalling in skeletal muscle, which may activate signalling cascades leading to loss of muscle mass.
Hormonal changes during menopause, particularly the loss of estradiol, are also believed to contribute significantly to the loss of muscle mass. Estradiol has been found to reduce skeletal muscle protein breakdown markers, assessed by fork-head box O3 (FOXO3) de-phosphorylation, and muscle RING-finger protein 1 (MuRF1) content in early post-menopausal women. However, there was an adverse effect of estradiol on protein breakdown in late post-menopausal women.
Physical activity and exercise are important lifestyle components that have been demonstrated to improve cardiometabolic, physical, and psychosocial health. Regular physical activity can result in increased longevity, decreased risk of cardiorespiratory and metabolic diseases, maintenance of energy balance, and improved musculoskeletal, functional, and mental health. Resistance training, in particular, has been recommended for middle-aged women to aid in maintaining muscle mass and power. A study examining the effects of a 10-week resistance training program found that postmenopausal women assigned to a moderate-intensity strength training program experienced gains in strength and muscle mass, as well as fat mass loss.
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Nutrition and muscle loss
Menopause is associated with a natural decline in estrogen, which increases visceral fat mass, decreases bone mass density, and causes muscle mass and strength loss. This loss in muscle mass is called sarcopenia, which is an involuntary loss of muscle mass. The perimenopausal transition is a vulnerable period for the loss of muscle mass, with research showing that one can lose 10% of muscle mass during perimenopause alone. Late perimenopausal and postmenopausal women are more likely to have sarcopenia than premenopausal or early perimenopausal women.
The loss of muscle mass during menopause is likely due to changes in both muscle function and the size of muscle cells, commonly referred to as fibres. Estrogen deficiency alters the microRNA signalling in skeletal muscle, which may activate signalling cascades leading to loss of muscle mass.
To combat muscle loss, the World Health Organization recommends that all adults, including menopausal women, strength train major muscle groups at moderate or greater intensity at least twice a week. Resistance training, in particular, can aid in maintaining muscle mass and power. A study examining the effects of a 10-week resistance training program on 31 premenopausal or postmenopausal women found that postmenopausal women benefited from both low-intensity (50% of 1 repetition max) and moderate-intensity (75% of 1 repetition max) strength training.
Hormone therapy studies exploring lean body and skeletal muscle mass in postmenopausal women have provided mixed results. While some studies have demonstrated that hormone therapy preserves skeletal muscle mass in postmenopausal women, others have shown no effect.
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Muscle pain during menopause
Menopause is associated with several physiological changes, including loss of skeletal muscle mass. Muscle pain during menopause, also known as musculoskeletal pain, is a common yet often overlooked symptom. Studies suggest that over 70% of women will experience menopausal musculoskeletal pain at some point, with symptoms becoming more severe after menopause when reproductive hormone levels are at their lowest.
The connection between menopause and musculoskeletal pain revolves around hormonal fluctuations. Estrogen is the sex hormone responsible for the development and regulation of the female reproductive system and secondary sex characteristics. It also helps regulate the maintenance of bone, muscle health, and control of inflammation. As estrogen levels drop during perimenopause, women may experience discomfort.
Oestrogen affects your cartilage (which is the connective tissue in joints) as well as the replacement of bone. Without the potentially protective effects of oestrogen, you may also notice your muscles feeling sorer or more tired after exercise. Low oestrogen can also make your body less efficient at producing collagen, which is an important component of both the cartilage that acts as a cushion between your joints and the tendons that connect your muscles and bones.
Hormone replacement therapy (HRT) replaces the hormones lost due to menopause. It comes in tablets, or as skin gels or patches, and can help to relieve a range of menopause symptoms including hot flushes, anxiety, and sleep problems. However, despite the links between reproductive hormones and muscle pain, there is limited evidence that HRT can help in this case. In fact, some studies have found that menopausal women on HRT had a lower pain tolerance than those who didn’t use it. More research is needed before scientists can fully understand the complex ways these hormones interact with each other to impact muscle pain.
There are some supplements that may help with muscle pain, depending on your symptoms and their cause. Collagen can help maintain cartilage and tendon health, which could be particularly important if your muscle pain stems from a joint issue. Curcumin, an anti-inflammatory extract of the spice turmeric, has been shown to reduce muscle pain. Fish oil supplements containing omega-3 fatty acids have been shown to reduce muscle soreness after exercise, but only at very high dosages of 6 grams per day.
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Frequently asked questions
Menopause is a natural biological process that occurs when a woman's ovaries stop producing eggs, marking the end of her reproductive years. This typically happens in middle age.
Yes, menopause can cause muscle loss. The decline in estrogen that occurs around menopause can contribute to muscle loss. This is known as sarcopenia, which is the age-related decline in skeletal muscle mass and function.
Symptoms of muscle loss during menopause can include muscle pain, weakness, and general muscle loss. These symptoms could also be a result of the aging process.
There are several treatments for muscle loss during menopause, including hormone therapy, physical activity, proper nutrition, and in some cases, medication.
