# @mackinprof on Instagram

- **Type:** Image
- **Original URL:** https://www.instagram.com/p/DXJmrowDm36
- **Gondola URL:** https://gondola.cc/posts/63892915-mackinprof-instagram
- **Thumbnail:** https://img.gondola.cc/tr:w-,h-,fo-auto/postThumbnails/7231a87b33.jpg
- **Posted:** 2026-04-15T11:07:56.000+00:00
- **Account Owner:** Stuart Phillips (@mackinprof) — https://gondola.cc/mackinprof

## Caption

Stop telling women that menopause destroys their ability to build muscle. It does not. And the data on this is not even close.

Isenmann et al. (2026) just published the largest systematic review and meta-analysis ever conducted on resistance training in females across the lifespan. 126 studies. 4,019 women. Premenopausal and postmenopausal women gained strength at virtually identical rates (SMD 1.50 vs. 1.46, p = 0.520). Lean mass went up, and fat mass came down in both groups. Menopausal status made no difference.

What about hormone therapy as the solution to muscle loss? A meta-analysis of 12 RCTs and 4,474 women found that menopausal hormone therapy added 0.06 kg of lean mass. Sixty grams. Not statistically significant (p = 0.26). That is the weight of a single egg!

The observed differences in lean mass (note that's not muscle) between pre- and postmenopausal women (2.5% to 5.7%) are fully explained by normal age-related loss of 0.4 to 0.7% per year over the 7 to 10 year menopausal transition. There is no residual effect to attribute to estrogen.

I wrote an editorial on this. Women lose muscle as they age for the same reason men do. They age, and they stop training. Blaming estrogen is not just wrong; it is harmful, because it convinces women that the situation is hopeless without hormones. It is not. MHT can help with vasomotor symptoms and sleep, and that may allow women to have better agency to make better decisions - good hypothesis, it deserves to be tested!

Resistance training is the single most effective intervention to maintain and build muscle at any age. That is what the evidence says. That is what we should be telling women.

Stop spreading fear. Start spreading evidence. Women can gain muscle in midlife; the prescription for doing so isn't complicated!

https://www.sciencedirect.com/science/article/pii/S1440244026000964
https://doi.org/10.1249/MSS.0000000000003620
https://onlinelibrary.wiley.com/doi/10.1002/jcsm.70248
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2749051

#menopause #resistancetraining #muscle #womenshealth #evidencebased #strengthtraining #HRT #MHT #science #fitness #postmenopause #aging #mythbusting

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## Tags

mythbusting, aging, postmenopause, science, mht, resistancetraining, strengthtraining, evidencebased, fitness, muscle, hrt, menopause, womenshealth

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