Ask most women how they want to age, and you’ll likely hear something like, “I just want to stay healthy and independent for as long as possible.”
That desire often stems from wanting to feel confident, capable, and good in their bodies—even as those bodies change with age.
Nothing will put a damper on your ability to age strong than having weak bones. Bone density can literally make or break your quality of life postmenopause. So a key element of aging strong is having a strong bones in your skeleton.
But when it comes to supporting women through perimenopause and postmenopause, the guidance many receive is to maintain bone density is … lacking. Most doctors don’t offer much proactive advice, and when they do, it’s often vague or incomplete.
Part of the problem? The research on perimenopause is still catching up. But it also reflects deeper cultural beliefs about what women’s bodies should look like and what we assume they’re capable of as they age.
There are a few reasons that bone fractures from falls are more common in postmenopausal women than any other population. Let’s talk about them and why they are important.
The Missing Link: Bone Health, Hormones, and Strength
As women age, they begin to lose bone mineral density (BMD) right around the time when perimenopause starts. This is attributed to overall hormonal changes, but particularly the decrease in estrogen—which plays an important role in how our bodies maintain strength and density. When estrogen levels drop, bones become more porous and fragile. This raises the risk of osteoporosis and fractures from everyday falls. So something as normal as tripping and falling can result in a more severe fracture than when the bones are stronger and healthier.
While both men and women experience changes to their hormones which affect bone density later in life, unlike men, who typically lose testosterone gradually over time, women experience a sharper hormonal shift. Once menopause hits (defined by 12 consecutive months without a period), that drop accelerates. Without intentional intervention, bones can weaken rapidly.
Why the Knowledge Gap for Women Over 40?
I recently asked a group of women what advice they’d received from their primary care practitioners when they started perimenopause. A few were told to focus on strength training but the majority said they were given no health recommendations whatsoever or were simply told to make sure they were getting enough calcium.
This tracks with what medical professionals are taught regarding a proactive approach to women staying strong and healthy as they age.
Amanda Aune, MSc, MPH, BSN, RN, shared that nurse practitioners are taught in medical school to suggest the following to postmenopausal women as preventative for osteoporosis:
- Adequate intake of calcium (1200mg/day for postmenopausal women)
- Adequate intake of vitamin D
- Weight bearing and resistance exercise
- Fall prevention
- Avoiding tobacco
- Moderating alcohol intake
But, as you can see from list above, she says that this advice lacks clarity and definition. What qualifies as “resistance training”? What does “fall prevention” really entail?
According to Aune, clinicians are also required to give information the different medications that can prevent bone loss and reduce the risk of fractures and notes that “the meds are what most people are looking for.”
How Strength Training Supports Bone Density
Which brings me to the other main reason that women are at a higher risk for bone fractures from falls—women aren’t encouraged to do activities that build bone as they age. At least not in the same way men are.
Multiple studies have shown that one of the key things you can do to increase bone density is physical activity—but the most effective types of bone building activities are strength training (lifting weights) and impact training (jumping).
The reason that strength training and impact training are so effective for increasing bone density is that in order to grow, your bones need stress and force. When you put a certain amount of stress on your bones, your body responds by generating bone-forming cells to create more bone tissue. Like creating its own insurance policy against future, similar types of stress.
From a biomechanical perspective, when you’re lifting heavy (for you) weights, your muscles pull on your bones, creating tension (aka stress), that stimulates your body to make your bones stronger and more dense.
The key is that the load on your bones has to be heavy enough to create the right amount of mechanical tension to stimulates bone growth. If the weights you’re using aren’t causing enough stress on your muscles and bones, it’s not going to be an effective method for increasing BMD.
How Women Have Been Conditioned to Stay Weak
And the problem is that, when it comes to strength training, women are typically encouraged to use smaller hand weights, light and pink and feminine, as opposed to heavier weights or barbells.
Although it’s now more common for women to lift heavier weights or do high intensity exercise like Crossfit, in general, women are more likely to do cardio workouts or gentler bodyweight movement like pilates or yoga. The reason these types of workouts are typically more popular with women is that they are geared more towards getting smaller rather than getting stronger.
In a diet culture world which prioritizes smaller-bodied women, exercise that burns calories and tones your core will always be assigned a higher value.
Unfortunately, aiming for being smaller and thinner – and the mechanisms that many women use to get there – are not likely to result in increased bone density.
I spoke with Laurel Beversdorf, CSCS (certified strength and conditioning specialist) and ERYT 500, about the diet-culture influenced mindset that has kept many women, now in their 40s, 50s, and 60s, from doing heavier lifting or higher intensity workouts. She notes that much of the aversion to lifting heavier weights comes from a fear of getting bigger instead of smaller. And yet, having more muscle going into menopause is actually protective.
“Why are you so afraid of having muscle on your body given the health benefits of having muscle on your body?,” Beversdorf asks women who avoid lifting weights. “It’s better metabolically. It’s better for you musculoskeletally, and as you approach menopause your body will actually start to lose muscle a little bit faster, so why not bank some muscle to take you through that period of life when you might be less responsive to muscle growth.”
She continues with a question that gets at the overarching patriarchal ideology that makes women sometimes work against their own best interests because of unhelpful, often harmful beliefs about body shape and size.
“What is it about the societal narratives that you’ve internalized that make you feel like you need to stay in a body that doesn’t have muscle? And who does that benefit? Does that truly benefit you or is it in service of another agenda or system of control that as a woman you remain without visible muscle or thin or small. What are the other ways that women are made to feel, be, and act small and why and who does that serve?”
The LIFTMOR Study: Real Proof That Heavy Lifting Works
It was Beversdorf who first introduced me to the LIFTMOR study, a groundbreaking “randomized controlled trial that investigates the effects of high-intensity resistance and impact training (HiRIT) on bone mineral density and physical function in postmenopausal women with osteopenia and osteoporosis.”
The study followed postmenopausal women in two groups: one group did HiRIT twice weekly under supervision and the other did low intensity strength training twice weekly on their own at home. The study followed them for 8 months. What the LIFTMOR study found is that the HiRIT group increased their BMD significantly at the femoral neck (hip joint) and lumbar spine (lower back), as well as improving their overall functional performance, when compared to the other (lower intensity) group.
Additionally, the HiRIT program was “well tolerated” and there were no injuries or vertebral fractures due to lifting heavy weights or jumping.
Beversdorf, who works with women in the perimenopause and postmenopause age ranges, notices that older women often surprise themselves with what they’re capable of because strength wasn’t always something they focused on when they were younger.
“Because they’re women and have been raised in a society where they’ve been ushered towards activities that are feminine in nature, they’re capable of reaching levels of strength in 50s and 60s that they never experienced or enjoyed in their 20s—because in their 20s they were encouraged to do things that were gentler, slower, lower intensity, so they were never really working on their strength until now. And so they have all of this room to blow their previous levels of strength out of the water.”
“Their expectations are low,” she continues. “Older women have very low expectations for what they’re able to achieve with strength, which is honestly sometimes good because then they get to be blown away and pleasantly surprised by how little it takes for them to be much much stronger than they were.”
Expert Tips for Getting Started
Beversdorf and Aune both recommend starting with a professional if possible—especially if you have osteopenia, osteoporosis, or are brand new to lifting. Working with a coach helps ensure proper form, safety, and progression.
Aune also adds that it’s important to emphasize that people who haven’t lifted or worked out in a while, or have other health concerns, or those who have a disability or disease which prevents them from engaging in the type of training shown to be effective in the LIFTMOR study can and should be encouraged to do the lower weight or body weight exercise because “it does help some, maybe just not to the same degree. If we say, ‘oh that doesn’t work or does nothing,’ we are potentially sending an ableist or discouraging message.”
So even if you’re starting (or sticking) with bodyweight or lighter weights, you’re still doing something good for your bones and your muscles.
It’s Time to Change the Narrative Around How to Stay Strong Over 40
With increased data from studies like the LIFTMOR study, our advice to women is shifting and fleshing out into something more specific.
“I think older women would benefit from simply having it put in their mind that they SHOULD do strength training because as we become less physically active we feel less capable and then we have thoughts like, ‘I can’t strength train, that’s too much for me. I should just stick to lighter weights or yoga or pilates because that’s more my pace and more what I can handle,’” says Beversdorf. “But the conundrum there is that they would be able to handle more if they actually challenged their bodies more with exercise.”
Real Women, Real Results
I asked 2 of my own students about the impacts of strength training later in life. Both women are postmenopausal and both led fairly active lives before starting strength training.
Julie, 63: “I’m Stronger, I Hurt Less, and I Can Lift My Grandson”
Julie Corliss has been exercising since she was a teenager, but didn’t start prioritizing strength training until she was diagnosed with osteoporosis at 61. Now, at 63, she does strength training 2-3 days a week, mostly on her own after working with a personal trainer to understand correct form. She says that her work as a medical writer has also informed her understanding about the importance of strength training for overall physical health, particularly as we age.
“I’ve come to appreciate how strength training benefits your metabolism, mainly by helping you burn fat more efficiently and improving how your body responds to insulin, both of which lower the risk of diabetes and other chronic diseases.”
She adds that she’s noticed how strength training has improved her quality of life and reduced physical pain.
“Personally, I’ve also found that building up my core strength has really helped reduce bouts of occasional low back pain. Stronger leg and arm muscles also complement the other exercise I do —for example, I can do challenging yoga poses with more ease and hike uphill for longer periods of time.” And, she says, “I’m comfortable lifting and carrying my 4-month old grandson, who now weighs about 15 pounds.”
Susie, 77: “It’s All About the Overhead Bin”
Susie Strasser has also lived a very active life and part of what motivates her to strength train consistently in her 70’s is to maintain that active life for as long as possible. “It’s the only way I know of to preserve a sense of strength and independence,” she says.
Whenever she and I talk about strength training, she says that it’s all about the overhead compartment, referring to the ability to put your suitcase in the overhead bin on an airplane by yourself. And in some ways, proving to those who might otherwise believe that because she’s an older woman, she is fragile and not capable of taking care of herself.
She adds that strength training has come with some added bonuses that she didn’t entirely anticipate, like pride in her physical ability.
“I like feeling strong and independent at 77, and it feels important to be prepared for those moments – mostly, these days, in the garden and when I’m traveling – when strength is called for. And I can’t deny the sense of satisfaction I got from tying with an 11-year-old in a plank-holding competition that involved another 12 year old, two 8 year olds, and two 40-somethings.”
Their Advice for Other Women
While many women are primed to go into perimenopause and postmenopause at a disadvantage, these two women are working to make the later years of their lives as full and active and strong as they can be, which is powerful.
They’re doing it by incorporating strength training into their regular physical activity and learning to lift heavier because heavy lifting and impact training are the best forms of exercise or movement that you can do to increase your bone density and live a more active, healthy life in the postmenopause phase of your life.
Both women have advice for those who haven’t started strength training yet, but want to feel better as they get older.
“Walking and aerobic exercise are great, but adding strength training can help you function better now and in the future,” Julie says. “You don’t need to spend a lot of time or money — even 10 to 15 minutes a couple times a week doing body weight exercises can make a difference to start.”
Susie brings it back to the idea that strength training isn’t about reinforcing diet culture norms, but opposing it. The purpose of lifting weights isn’t about how you look, but how you feel.
“Start small. Find a way to do it that you enjoy and have confidence in — you don’t have to become a body-builder or join a gym to learn and gain strength enough to make you feel good about maintaining your ability to be independent and your sense of strength.”
The Bottom Line: Age Strong, Not Small
Too often, women are told to focus on staying slim instead of staying strong. But strength is what supports your bones, your confidence, and your independence.
Strength training is more than a workout. It’s a radical act of self-care that says: I deserve to feel powerful in my body—at any age.
Start small. Start where you are. And know this: it’s never too late to get stronger.
Whether you’re 43 or 73, your body is capable of more than you’ve been led to believe.
Pick up the weights. Push back against the narrative. Choose strength. Your future self will thank you. —Naomi
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