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menopause and muscle atrophy (sarcopenia)

By | Fact Checked |

Have you noticed that the muscles in your arms aren’t as toned as they used to be? Is there a little more jiggle in your inner thighs and less muscle? Do you feel like you’ve lost muscle strength? You can thank your changing hormones for these and other changes in your muscular landscape. It’s known as muscle atrophy (sarcopenia), and yes, you can do something about it.

What is muscle atrophy?

Muscle atrophy (aka, sarcopenia) is progressive muscle degeneration, or the loss of muscle tone and function. It occurs in both men and women as they age. Basically, sarcopenia is caused by an imbalance between signals given to promote the growth of muscle cells and those devoted to their breakdown. Several hormones have a role, including growth hormones, which interact with enzymes that destroy protein to help maintain healthy muscles. With age, however, normal growth signals are less effective, which can result in muscle loss.

Read about menopause and changes in body shape

How is muscle atrophy associated with menopause?

Loss of muscle tone and function in perimenopause and menopause is the result of several factors. One is the decline in hormones, with estradiol playing a major role. 

Estradiol has a positive impact on special cells called muscle satellite cells that are essential for muscle function. Experts have found that the decline in estradiol results in reduced proliferation of these muscle cells, as well as protection against inflammatory stress damage on muscles. These factors contribute to the risk of sarcopenia in women in perimenopause, menopause, and postmenopause.  

Another study also found that women who experience hot flashes and other vasomotor symptoms are less likely to develop sarcopenia than those who don’t have those symptoms. The authors noted that this finding is important for several reasons, one of which is that “Considering that vasomotor symptoms are some of the major reasons that middle-aged women visit hospitals, health care providers should consider that menopausal women without vasomotor symptoms also need to be screened carefully given the high risk of sarcopenia observed in this study.”

How to manage muscle atrophy in menopause

It’s very important to maintain muscle tone and function as we get older, as sarcopenia is associated with poor quality of life, physical disability, and even death. That said, here are some tips to fight sarcopenia.

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Move it! Exercise is the number one thing you can do to reverse sarcopenia. Research suggests that a combination of balance training, aerobic exercise, and resistance (strength) training is the optimal approach. Of the three, resistance training appears to be the most beneficial because it boosts the activity of growth hormone activity and also activates the muscle satellite cells. 

In a study involving women age 65 and older, the authors found that engaging in at least two to four exercise sessions every week appears to be necessary to prevent and even reverse sarcopenia. 

Increase protein intake. Protein is critical for building, repairing, and maintaining muscle. If you don’t get enough amino acids, muscle atrophy occurs because muscle fibers break down. For individuals with sarcopenia, daily protein intake should be 1.2 to 1.5 g/kg. Here is an example for you: a 120-lb (54 kg) woman needs 64.8 g (1.2 x 54) to 81 g (1.5 x 54) of protein daily. The best protein foods to include in your diet regularly include grass-fed beef, lentils, beans (black, pinto, kidney, etc), natto, organic chicken, wild-caught fish, kefir, yogurt, and free-range eggs. 

Read about menopause and inflammation

Reduce pro-inflammatory foods. Inflammation is an enemy of healthy muscles. Significantly reduce your intake of pro-inflammatory foods, which include simple carbohydrates, added sugars, and processed foods, especially those containing trans fats and high fructose corn syrup. Read labels carefully!

Boost anti-inflammatory food intake. These include berries, melons, dark leafy greens, cruciferous veggies, and other fruits and vegetables, whole grains, cold water fish, healthy fats (avocados, olive oil, nuts), herbal teas, beans, nuts, and seeds. 

Take omega-3 fatty acids. Results of a clinical trial have shown that taking omega-3 supplements “stimulate muscle protein synthesis in older adults and may be useful for the prevention and treatment of sarcopenia.”  

Supplement with vitamin D. Low or deficient levels of vitamin D are very common, and this can be especially worrisome for women with sarcopenia. Taking a vitamin D supplement can boost muscle function and muscle mass. Ask your healthcare provider to test your vitamin D level before you take a supplement.

When to call your doctor

Consult with your healthcare provider if your loss of muscle tone, mass, and strength affect your daily activities. Sarcopenia has associated with type 2 diabetes, obesity, and high blood pressure, so be sure to talk to your doctor if you have these conditions. 

Bottom line

Muscle atrophy (sarcopenia) can have a significant impact on your daily life if you don’t take steps right now to improve or even reverse it.

  • Geraci A et al. Sarcopenia and menopause: the role of estradiol. Frontiers in Endocrinology 2021 May 19

  • Kemmler W, von Stengel S. Exercise frequency, health risk factors, and diseases of the elderly. Archives of Physical and Medical Rehabilitation 2013 Nov; 94(11):2046-53.

  • Monostra M. Sarcopenia more prevalent among menopausal women without vasomotor symptoms. Menopause 2021 Nov 11

  • Price A. Sarcopenia: 10 keys to keep your muscle mass up as you age. Dr. Axe 2016 Feb 22

  • Scott D et al. A prospective study of the associations between 25-hydroxy-vitamin D, sarcopenia progression and physical activity in older adults. Clinical Endocrinology (Oxford) 2010 Nov; 73(5):581-87.

  • Smith GI et al. Dietary omega-3 fatty acid supplementation increases the rate of muscle protein synthesis in older adults: a randomized controlled trial. American Journal of Clinical Nutrition 2011 Feb; 93(2):402-12.

  • Thorpe M. How to fight sarcopenia (muscle loss due to aging). Healthline 2017 May 25

Andrea is a Registered Holistic Nutritionist (RHN) & Menopause Expert. Andrea is in menopause & has been researching for the last 5 years science-based ingredients and methods to help women manage their symptoms. She’s the Founder of NaturallySavvy.com—a multiple award-winning website. Andrea co-authored the book “Unjunk Your Junk Food” published by Simon and Schuster, as well as “Label Lessons: Your Guide to a Healthy Shopping Cart,” and “Label Lessons: Unjunk Your Kid’s Lunch Box.” Andrea co-hosts the Morphus for Menopause podcast and appears as a Healthy Living Expert on TV across North America. Andrea has more than 20 years of experience in the health & wellness space and is a multiple award-winning Influencer.