PULS3

Guide

Strength training through perimenopause and menopause

Lift weights on two or more days a week through perimenopause and after menopause, and keep going through the rough weeks. In reviews of trials in postmenopausal women, exercise training increased muscle mass, and resistance training seemed to improve everyday physical function, with no serious adverse events reported. Most of those women were past menopause, with average ages around 59 to 62, so treat the results as promising rather than proven for women in their 40s.

This guide covers what the trials found and who was in them, what a sensible week looks like, how to adjust on a bad-sleep or symptom day, and when to see your GP.

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Last checked: 6 October 2026

Why strength matters through the change

If what you want is to feel strong again, and like yourself, lifting is where the research points.

Muscle

Muscle changes even when the scale does not. A long-running study that followed women through the transition (Greendale, JCI Insight, 2019) found that at the start of the menopause transition, the rate of fat gain doubled and lean mass declined, while the pace of weight gain did not change. Your weight can look steady while the mix underneath it shifts. If your middle is where you notice it, see what training can and can't do for menopause belly.

Training moves it back. A review of 101 trials in 5,697 postmenopausal women (Khalafi, Frontiers in Endocrinology, 2023) found exercise training increased muscle mass and fat-free mass. Resistance and combined training had the greater effect on muscle; aerobic and combined training had the greater effect on fat mass.

Strength for everyday life

A review of 12 trials with 452 postmenopausal women, each lasting up to 16 weeks (Sá, Menopause, 2023), found resistance training "seems to promote an improvement in functional capacity" compared with no exercise. No serious adverse events were reported. The authors rate the certainty of this evidence very low to low, so treat it as promising rather than proven.

Bone

A review of 8 trials (Jones, Menopause, 2026) found small but significant effects of high-intensity, impact and strength training on bone density at the hip and lower spine in postmenopausal women. It did not detect an effect in premenopausal women, but only 2 small trials looked at them, so the question is open rather than answered "no". Heavy, loaded work is the kind that was studied.

Sleep

Here the results conflict. A review of 12 trials in 1,493 perimenopausal women (Zhao, Explore, 2023) found exercise improved sleep, though many of those trials used yoga, walking or Qigong rather than weights. A review of 9 trials in 1,579 women with hot flushes or night sweats (Corrêa, Maturitas, 2025) found exercise did not significantly improve sleep quality or insomnia. Move because it is good for you; do not expect it to fix nights broken by sweats.

Who was in these studies

Almost none of the strength trials enrolled women aged 35 to 55. Most studied women past menopause, with average ages around 59 to 62. The results are the best evidence there is, but they were not tested in women in their early 40s.

What a sensible week looks like

Australia's Physical Activity and Sedentary Behaviour Guidelines for adults aged 18 to 64 ask for muscle-strengthening activities on 2 or more days per week, moderate to vigorous activity for 30 minutes or more on most days, and activities for mobility, balance and coordination on 3 or more days per week. A week that fits that might look like this:

Pick a weight you could lift a couple more times when you stop. Add weight slowly, only when the last set feels steady. Two sessions you keep doing for months will do more than four you drop after a fortnight.

Food is part of it. Protein works with lifting, not instead of it: in trials of women 55 and over (Kuo, Nutrients, 2022), whey protein helped arm strength and leg lean mass only when it was paired with resistance training. A simple habit is some protein at each meal.

On a rough night or a symptom day

Some weeks the night sweats win, your joints ache, or you are just flat. That is not a failed week. Keep the session if you can and keep your weights where they were last time, rather than adding more. Cut a set or two if you need to. Leave new personal bests for a day you slept.

If you skip, skip one session, not the habit. The trials above ran for weeks and months; one missed day is not what decides the result.

Wind down at your usual time after a broken night, and keep your usual bedtime rather than going to bed early to catch up.

When to see your GP

For neutral reading, Jean Hailes for Women's Health, the Australasian Menopause Society and healthdirect.gov.au all cover menopause and exercise.

How PULS3 helps

PULS3 is an iPhone coach that plans your training, food and sleep together, and adapts the plan around how you are. Tell it you are in perimenopause or past menopause, and each day's plan is built for that.

It reads your workouts and sleep from Apple Health, and your sleep from Oura if you wear one, so the plan knows when you trained and how you slept. PULS3 is coaching, not medical care: it does not diagnose or prescribe, hormone therapy included, and it tells you when something is one for your GP.

Want the bigger picture of how the team works together? See PULS3 for you.

Feel strong again, on the good weeks and the rough ones.

Download on the App Store

Free for everyone until 31 October 2026. From 1 November, every plan starts with a 7-day free trial. Nothing to pay until then, and nothing renews unless you choose to subscribe.

Questions

How many days a week should I do strength training during menopause?

Australia's physical activity guidelines for adults aged 18 to 64 ask for muscle-strengthening activities on 2 or more days per week. Two sessions you can keep doing on busy and rough weeks is a good place to start.

What is the best exercise during menopause?

Doing both lifting and cardio. In a review of 101 trials in 5,697 postmenopausal women (Khalafi, Frontiers in Endocrinology, 2023), resistance and combined training had greater effects on muscle mass, and aerobic and combined training had greater effects on fat mass.

Does strength training help hot flushes?

Do not count on it. A review of 21 trials (Liu, Climacteric, 2022) found no significant change in how often hot flushes happened with exercise, and that was the high-certainty finding. One small comparison of 18 women per group suggested resistance training may cut hot flush frequency more than aerobic exercise, but the authors rate that evidence very low to low certainty. Lift for strength, and talk to your GP about hot flushes.

Is strength training different in perimenopause?

Most strength trials enrolled women past menopause, so the evidence for perimenopause is thinner. For bone, a review found small but significant effects of strength and impact training in postmenopausal women and none detected in premenopausal women, but only 2 small trials looked at women before menopause. In a separate trial of women with regular cycles (D'Souza, Medicine & Science in Sports & Exercise, 2026), resistance training built muscle and strength whatever the cycle phase.

Do I need more protein when I lift?

Protein works with lifting, not instead of it. In trials of women 55 and over (Kuo, Nutrients, 2022), whey protein helped arm strength and leg lean mass only when it was paired with resistance training. In a cohort of adults aged 40 to 75 (Chen, Clinical Nutrition, 2023), women who ate the most protein had a 35% to 50% lower risk of sarcopenia than those who ate the least. That is an association, not a dose to copy.

Is it safe to start lifting if I never have?

In a review of 12 trials of resistance training in postmenopausal women (Sá, Menopause, 2023), no serious adverse events were reported. Start light and learn the movements. If you have a bone, joint or heart condition, talk to your GP before you start.

Can you get muscle tone back after menopause?

Yes, muscle still responds to training after menopause. In a review of 101 trials in 5,697 postmenopausal women (Khalafi, Frontiers in Endocrinology, 2023), exercise training increased muscle mass and fat-free mass, and resistance and combined training had the greater effect on muscle. Protein helps when you lift: in trials of women 55 and over (Kuo, Nutrients, 2022), whey protein helped leg lean mass only when paired with resistance training.

Does lifting weights help with menopause symptoms?

For some symptoms, and the evidence is mixed. A review of 12 trials (Sá, Menopause, 2023) found resistance training seems to improve everyday physical function, though the authors rate the certainty very low to low. A review of 21 trials (Liu, Climacteric, 2022) found exercise did not significantly change how often hot flushes happened. For sleep, one review found exercise helped perimenopausal women (Zhao, Explore, 2023), and another found no clear benefit in women with hot flushes or night sweats (Corrêa, Maturitas, 2025). Lift for strength and everyday function, and talk to your GP about symptoms that get in the way.

How many times a week should a 45-year-old woman lift weights?

Australia's physical activity guidelines for adults aged 18 to 64 ask for muscle-strengthening activities on 2 or more days per week. Two whole-body sessions you can keep up is a good start. Most strength trials enrolled women older than 45, so the guideline is a better guide here than any one trial.

What should I avoid doing during perimenopause?

A few practical things to avoid:

Sources

PULS3 provides coaching guidance, not medical advice, diagnosis, or treatment. Talk to your GP about your own health.