Many middle-aged women don’t necessarily “have it easy.” They’re experiencing mental and physical health changes, such as depression and menopause. They’re inaccurately portrayed in the media. They may feel “invisible.” That’s only the beginning of the list.
The good news is, many of their concerns can be addressed. Today, doctors want to focus on a major example — declining bone density and muscle mass from menopause — and how middle-aged women can address it to improve their quality of life.
Their No. 1 tip? More strength training.
Why Middle-Aged Women Need More Strength Training
As mentioned, middle-aged women are experiencing changes in their bodies, particularly due to perimenopause and menopause. That may require them to change their habits, including those related to exercise.
“We’re becoming more aware of what actually happens in perimenopause: the metabolic shifts, the muscle loss, the bone changes, the mood fluctuations,” said Dr. Alexandra Dubinskaya, a urogynecologist, pelvic reconstructive surgeon and menopause and sexual health expert.
Strength-building exercises help all of those things. They increase bone mineral density, improve muscle mass, support metabolic health, decrease fall risk, improve mood and more.
“Strength training is one of the most important and most underutilized ways that women can protect their health and independence as they age,” said Dr. Clarinda Hougen, a primary care sports medicine specialist at Cedars-Sinai Orthopaedics in Los Angeles and a team physician for Angel City Football Club.
Bone health concerns, in particular, are more common for this group than you may realize, thanks to hormonal changes. As many as 1 in 3 women over 50 experience an osteoporosis fracture, and women can lose up to 20% of bone density in the five to seven years after menopause.
“Resistance training is one of the most effective non-pharmacologic tools we have to slow this process,” Dubinskaya added.
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At-home exercises can be beneficial for building up strength. It’s important to start with a program that will keep you consistent.
Strength Exercises and Training Tips For Middle-Aged Women
If you’re a middle-aged woman who’s not super familiar with strength training, fear not: Experts share some beginner-friendly tips and exercises you can do right now (some even from the comfort of your home).
Get an evaluation from your primary care provider.
Before making any health changes or starting a new exercise routine, check in with your healthcare provider.
“Let your practitioner know your goals of starting a resistance program, and make sure that cardiac concerns, such as high blood pressure, are not a roadblock for you to start,” said Yvonne Di Edwardo, a physical therapist at Atlantic Health.
While you’re there, she also suggested getting your bone density and balance evaluated.
Start with at-home exercises.
Exercise doesn’t have to be a lengthy, expensive, scary thing — a couple of days a week at home will do.
“You do not need a gym membership,” Hougen said. “Start with body weight exercises, like squats, step-ups, modified pushups and planks.”
She encouraged focusing on your form to ensure you avoid injury. Checking with a personal trainer can help.
“As you get stronger, you can add light weights with dumbbells or kettlebells,” Hougen added. “Resistance bands are also handy for a variety of exercises.”
Di Edwardo shared some great starter exercises that use resistance bands:
- Sit to stand from a chair without using your hands. For an extra challenge, add a resistance band above your knees and put light pressure into the bands as you stand up.
- Supine march (basically, “march” while lying on your back) with resistance bands above your knees.
- Do gentle rows with resistance bands while standing or sitting. Pull the bands back to your chest with good posture.
- Side-step with a resistance band above your knees, using a countertop or wall to assist with your balance if necessary.
Don’t forget about warming up beforehand. “It is always a good idea to warm up — even for a short walk or a small amount of time on a recumbent or upright bike is a good way to warm muscles,” she added.
Incorporate pelvic floor exercises.
You may also experience urinary incontinence or the weakening of pelvic floor muscles during menopause. Resistance training can help.
“In pelvic floor training, the use of resistance training, either bands or light weights, with appropriate integration of our pelvic floor muscles and breathing technique, can make challenges such as running, lifting and stair-climbing less stressful on our pelvic floor and aid in maintaining our bladder control,” Di Edwardo explained.
Exercises that strengthen the pelvic floor include kegels, bridge pose, squats, pelvic tilts and “bird dog.” A pelvic floor therapist can work through those with you.
Pay attention to warning signs.
When attending to your pelvic floor, Dubinskaya encouraged patients to “lift smarter” by paying attention to warning signs.
Examples include lower back tension, pelvic heaviness, a feeling of fullness or “something stuck” in the vagina, symptoms that worsen at the end of the day and new urinary leakage during lifting.
Make it a fun, social activity.
Let’s be real: Exercise isn’t always enjoyable. Even fitness pros don’t always want to work out. To stick to a routine, you may want to grab a couple of friends or attend a class.
“For some individuals, the social component to exercising is an added perk, and it helps in compliance and routine,” Di Edwardo said.
She recommended a water aerobics class to work your muscles and aid in muscle-building, or checking out a community-based activity focused on light resistance challenges.
Nourish and hydrate.
The way you feed your body matters, too. In this case, protein is particularly important. “Make sure you are eating an adequate amount of lean protein to support muscle growth and repair,” Hougen said.
Lean protein food sources include chicken, turkey, beef, pork and others.
Don’t forget about adequate hydration, either. “Muscles that are underhydrated can cause us to cramp or not recover quickly,” Di Edwardo explained.
Don’t go too hard or too fast.
Going slow with exercise changes is key — especially for women who have connective disorders, such as Ehlers-Danlos. According to Dubinskaya, aggressive heavy lifting in particular can cause symptoms to flare up earlier and progress faster.
“Weightlifting is good, but more is not always better,” she said.
Di Edwardo agreed. “As with all resistance training, know your limits,” she said. “Allow your muscles to take a break when needed.”
The “golden rule” here, perhaps, is to push yourself, but not too hard.
“Midlife health is not about extremes,” Dubinskaya said. “It’s about longevity. The goal isn’t to lift the heaviest weight in the room, but to still be lifting safely 20 years from now.”

