menopause and muscle atrophy (sarcopenia)

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 help you support healthy muscle as you age.

Move it! Exercise is the number one thing you can do to help maintain your muscle tone and strength. 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.

How often matters too. In an 18-month study of 162 women age 65 and older, those who exercised at least twice a week held on to more bone and muscle than the women who exercised less often.

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. 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.

If you are taking a GLP-1 medication, protein gets harder to eat and matters even more, because you are losing weight quickly while your appetite is down. We walk through it in GLP-1s and muscle loss in menopause: what to eat to protect it.

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.

Know your vitamin D level. Low vitamin D is very common, and in a study that followed 686 adults for more than two years, people with low levels had less muscle mass and weaker legs. But a supplement is not a muscle builder. A 2014 review of 30 trials found vitamin D gave a small boost to muscle strength, mostly in people who started out low, and no change in muscle mass. So the useful step is to ask your healthcare provider to test your level before you take anything.

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 been 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 support and maintain your muscle strength.