By Dr Andie Siggers
🎧 We’ve also recorded a podcast on this. If you’d rather listen, you can find our conversation about strength training as midlife medicine here. Listen to the podcast
There was a time when strength training simply wasn’t part of the female vocabulary. We were encouraged to exercise, of course. Jog. Swim. Do aerobics in brightly coloured leotards. Burn calories. Stay slim. But lifting weights? That was a man’s world. Intimidating, testosterone-fuelled and often deeply unwelcoming.
Yet increasingly, the science is telling us something profound: strength training may be one of the most important things women can do to protect their future health. Not to become smaller. Not even necessarily to become stronger, although that is a wonderful side effect. But because it is becoming increasingly clear that strength training is metabolic medicine.
Our bodies change long before menopause arrives
For decades, oestrogen quietly works behind the scenes, influencing almost every system in the body. We often think of it purely as a reproductive hormone, but it is so much more than that. Oestrogen has receptors throughout the body, including within our muscles and even on mitochondria – the tiny energy-producing batteries inside our cells. One of oestrogen’s many jobs is to help our bodies use fat efficiently as a fuel source and maintain metabolic flexibility.
As we enter perimenopause and oestrogen levels become more erratic, that relationship begins to change. Women often describe a sudden shift: “I haven’t changed anything, but my body has.” The scales creep upwards. Energy dips. Recovery takes longer. Sleep fragments. This isn’t a failure of willpower. It’s biology.
The good news is that strength training activates many of the same metabolic pathways that oestrogen previously supported, helping preserve mitochondrial function and metabolic health as oestrogen fluctuates. Building and maintaining muscle improves insulin sensitivity and sends a powerful signal to the body that it still needs to remain metabolically active. In simple terms, we are reminding our bodies that they still need to be robust. We are telling our muscles, bones and metabolism that retirement is not an option.
Muscle is an organ of longevity
We perhaps underestimate how extraordinary muscle tissue really is. It isn’t simply there to help us carry shopping or open stubborn jars. Muscle is now recognised as an endocrine organ, producing signalling molecules called myokines that communicate with the brain, bones, immune system and metabolism.
The more muscle we preserve as we age, the more physiological reserve we maintain, because ageing, in many ways, is simply the gradual loss of resilience. Strong muscles mean fewer falls, better balance, greater independence and better glucose control. It means being able to get off the floor when you’re 80. It means carrying grandchildren. It means remaining capable.
Bones are listening too
Women lose bone density rapidly during the menopausal transition, with declining oestrogen accelerating the process. But bones are living tissue. They constantly remodel themselves according to the demands we place upon them. Walking is wonderful. Yoga is wonderful. But bones respond particularly well to load, and when we lift weights, our skeleton receives a message: this structure is needed, keep it strong.
Resistance training has consistently been shown to improve or preserve bone mineral density, particularly in the hips and spine. We don’t wait until osteoporosis arrives; we invest decades earlier, because prevention is always easier than repair.
The cortisol conversation
Social media has become slightly obsessed with cortisol. Everything, apparently, is ‘raising your cortisol’. But cortisol itself isn’t the enemy. We need it. It helps us wake up, mobilise energy and respond to challenges. The problem is chronic overload.
Many women in midlife are carrying extraordinary invisible burdens: careers, ageing parents, teenagers, relationships, administrative labour and poor sleep. We live in a state of constant low-grade alertness. Add endless high-intensity exercise and under-fuelling into that mix and, sometimes, the body simply receives one message over and over again: survival.
Well-designed strength training can offer a different message. Done consistently, alongside adequate protein, sleep and recovery, it improves our resilience to stress rather than simply adding another stressor. This is one reason why many women discover that swapping endless cardio for two or three purposeful strength sessions a week can be transformative. Less punishment, more protection.
Finding somewhere you belong
All of which sounds wonderfully scientific. But the biggest barrier isn’t knowledge, it’s confidence. How do you walk into a room that historically wasn’t designed for you? How do you start something that feels intimidating at 48, 52 or 63?
For me, the answer was finding the right place. I feel enormously fortunate to have found E-motion in Poole. It was only after attending for quite some time that I realised something surprising: there are no mirrors. No vanity training. No endless rows of people scrutinising themselves. Instead there are people of every age, every shape, every ability — people to aspire to, and people who gently encourage those of us who are still learning, constantly saying, just have a go, scale it if you need to.
I’m still, frankly, rubbish compared with many there. But oddly, I never don’t want to go, and that tells me something. It has become less about exercise and more about investment. It feels like preventative medicine. It feels like protection.
There is Alzheimer’s disease in my family and, after careful thought, I decided to undertake genetic testing. I discovered I carry a double variant of a BDNF polymorphism associated with reduced activity-dependent production of brain-derived neurotrophic factor – one of the chemicals exercise helps stimulate. For me, exercise is no longer optional. It is one of the tools I have available to reduce future risk. Not a guarantee, but an opportunity.
And perhaps that’s what strength training really is: a quiet accumulation of opportunity. Each session a small deposit into a future version of ourselves — stronger bones, healthier muscles, more resilient brains, a more metabolically flexible body, a better chance of independence.
I was genuinely surprised recently to discover that gyms are subject to VAT. It feels counterintuitive when we increasingly recognise exercise as a cornerstone of future health protection. We exempt many aspects of healthcare because they reduce future burden on society, so perhaps it’s time we began having a broader conversation about where structured exercise fits into that picture too. I don’t think of myself as particularly political. But perhaps prevention should be.
So thank you to E-motion in Poole, and to the brilliant coaches there — especially Josh. Thank you for creating a space where women can discover that strength is not about intimidation. It’s about insurance: the sort that quietly protects the rest of your life.
🎧 We go deeper into all of this in the accompanying Mosaic podcast. Listen now
References
- Oestrogen receptors are present within mitochondria and influence mitochondrial function, fatty acid utilisation and energy metabolism.
- Resistance training improves bone mineral density in postmenopausal women, particularly at the lumbar spine and hip, with higher-intensity training (≥70% 1RM) and three sessions weekly appearing especially beneficial.
- Resistance training also improves menopausal symptoms, physical function and metabolic health in postmenopausal women.