Do postmenopausal women have to lift heavy weights?

I sent this as an email recently and am following up with a blog post introducing another study and wondering about what we still don’t know. (Hint: A lot) It’s no surprise that my bias leans towards heavy lifting. I talk about it often, I train that way, and I believe in its long-term benefits, especially for women navigating midlife and hormonal transitions. I’m also clear with how I define strength, and what I mean when I say “heavy.” Strength isn’t just about moving a barbell. It’s about adaptation. It’s about the ability to produce force, absorb force and build tissue resilience. “Heavy” depends on the person. What matters is that the load you’re using is challenging your system enough to create a response (neurological and structural).

With my bias clearly noted, a new study published in Medicine & Science in Sports & Exercise (Svensen et al., 2025) is making the rounds with some claiming it ‘refutes the idea’ that women lose substantial lean mass during the menopause transition, and ‘pushes back’ on the claim that women must lift heavy to build strength after menopause.

I’ve had a few brief conversations with some women in my DMs about this paper, along with one other circulating. They expressed frustration over conflicting messaging seen on social media lately. So, I want to break it down because the data tells a more nuanced story.

What Did the Svensen Study Actually Test? 

The study:

A novel low-impact resistance exercise program increases strength and balance in females irrespective of menopause status

Methods:

• Sample: 72 enrolled, 70 completed, ages 40–60 

• Classification: PRE, PERI, and POST-menopausal based on follicle-stimulating hormone (FSH) and menstrual history.

• Activity level: Self-reported as “moderately active” using IPAQ (600–3,000 MET.min/week), but activity is notoriously inflated.   

• Randomization: Assigned to a training group (EXC, n=45) or control group (CON, n=25) 

• Duration: 12 weeks 

• Training:

  • 4x/week, at home, virtually supervised (Pvolve platform)

  • "Progressive in nature" increasing in time (~2.7 to 3.3 hrs/week), reps, and weight using 0.5-5 kg and resistance bands.

  • No training to failure. Participants were told to reduce load if reps couldn’t be completed

  • Focused on hip strength, balance, and flexibility 

Control group was instructed to meet the public health standard of 150 minutes of moderate-intensity exercise/week.

The Study’s Purpose:

To determine whether menopause status (PRE, PERI, POST) affects a woman’s ability to adapt to a low-load resistance training program. Authors hypothesis: Women in PERI and POST groups (with lower sex hormones) would show reduced or delayed adaptations compared to PRE.

What Did They Find?

• Hip abduction and flexion strength increased by ~19–20% across all menopause groups. The caveat here is hip abduction: 19% ± 48% shows a HUGE amount of inter-individual variability. Whereas, hip flexion 20% ± 17% is better. That 17% is a much tighter range around the average, so the flexion increase was more consistent across participants. 

• Shoulder strength increased slightly over the 12 weeks in both EXC and CON. However, the authors suggest the gains weren’t due to training, but more likely from testing familiarization and/or normal human variability. 

• Balance: Posterolateral Reach improved in EXC group regardless of menopause status, with no change in CON group. Posteromedial Reach improved significantly in the EXC group, and slightly in CON, with no effect of menopause status. Anterior reach improved only in EXC-POST and declined in EXC-PERI. There was no change in EXC-PRE or CON group.  

• Flexibility (sit and reach test) improved significantly across all menopause status in EXC, but not in CON group. 

• Lean mass (via DXA) increased ~2%. The two caveats here are that only “a subset of participants” completed the whole-body DXA scan. Out of 70 women, only 41 (EXC N=24, CON N=17) were assessed for changes in lean mass. Secondly, the ultrasound data didn’t support widespread muscle growth. Only vastus intermedius showed measurable thickness increase (12%), and only in cross-sectional view not longitudinal which would have reflected actual structural remodeling. There is also no mentioned of how many underwent ultrasound.  

• No change in the other two muscles assessed: rectus femoris or medial deltoid. (medial is their language. I use lateral.) 

• No statistically significant difference in overall training response between PRE, PERI, and POST in the EXC group. While a few individual outcomes varied, they found that all groups adapted similarly to this low-load resistance training program.   

Something else worth expanding on: statistical significance doesn’t always translate to real-world change. A result might be statistically significant on paper, without being physiologically or clinically impactful. This is why we have to be careful not to over-interpret small ~2% "statistically significant” findings as if they reflect major physiological adaptations.

A little more on what the data can’t tell us:

1. If that 2% increase in lean mass was actual muscle growth.

   DXA separates the body into three components: bone, fat, lean tissue. The lean tissue measurement here includes water, glycogen, and connective tissue, basically everything that isn’t fat or bone. The authors admit: “It is difficult to determine where this increase resided.” That means they couldn’t tell if the increase was actual contractile tissue growth or something else. 

2. Whether low-load is just as good as high-load. It didn’t test high-load training. Because there was no high-load comparison, it can’t “push back” against high-load approaches or say whether this low-load model is equally effective. 

3. Whether menopause causes muscle loss. This study didn’t follow women over time or measure changes in lean mass as they transitioned between stages. It included those already classified as PRE, PERI, or POST. So how can it “refute” the claim that menopause causes muscles loss? It literally wasn’t designed to test that. It was designed to test whether women in different menopause stages could respond to a specific low-load program.

It’s important to note that with most research, the results are reported as group averages. This study is no different. That means that individual variation can be buried in the data. Some in this study might have seen huge improvements, with others seeing none. But when we average them together, the results look like “moderate gains.” So, while these group-level findings are helpful for general trends, they don’t guarantee a specific outcome for you.

Some other interesting things to note:

The authors acknowledge their program produced smaller gains than seen in other studies showing 30–50% increases in squat strength from free-weight training. But then pivot by adding that “hip flexion and abduction generate less force,” than compound lifts and weren’t measured in those other studies, “so the comparison is difficult.” That’s fair. They are contextualizing their findings. I get it. But it's also a strategic deflection. It doesn’t change the fact that the modest outcomes in this study are more likely due to the low-load, non-fatiguing design, not just movement choice. I find this subtle sidestep really interesting. It blurs the bigger picture which (again) is that this study wasn’t designed to produce that kind of adaptation = high-level strength gains and hypertrophy.

The original study planned for 56 participants, but after adding DXA halfway through, they had to recalculate their stats and recruit 22 more women specifically for this purpose. This is why the EXC group was larger than the CON group. This is pretty common in research as studies evolve in real time, so not a big deal. But again, not everyone in the final cohort of 70 was assessed via DXA or ultrasound. Only a subset was measured, and the paper doesn’t clearly state if those selected did both DXA and ultrasound, or how they were selected. This limits how confidently we can interpret or generalize the ~2% lean mass gain findings.

So, what can we take away from this study?

1. Women in all stages of menopause can adapt to low-load training.

2. Hormonal decline didn’t block adaptation to this low-load training program.

3. Low-loads are a valid option for improving balance and flexibility.

4. It’s a good entry point = tolerable, accessible, and adherence was high. 

But remember: the strength gains were modest, likely neural reflecting the early phases of motor learning and coordination. They were not indicative of structural adaptation.

So, circling back to the claim that this study ‘refutes the idea’ that women lose substantial lean mass during the menopause transition, and ‘pushes back’ on the claim that women must lift heavy to build strength after menopause....We simply cannot use this data to say that. This study did not track women across the menopause transition, so it cannot speak to how much lean mass is lost during that time. And it did not compare low-load to high-load training, so it cannot tell us whether heavier lifting is unnecessary or less effective.

This study doesn't just challenge how others are interpreting the data, it’s also a good reminder that we should be more critical of how the authors frame their findings.

All we can say is that this data showed that these women (group average) can adapt to a low-load program regardless of menopause status. But that doesn’t mean that’s all they will ever need, especially for long-term strength, connective tissue adaptation, or change in body composition (with the obvious caveat that deficits play). The “you don’t need to lift heavy” narrative goes off the rails when it ignores what decades of research tells us: adaptation requires challenge. I also think that this kind of messaging sells women short. While it encourages accessibility and consistency, which are important, it downplays what women are capable of and risks capping their progress at entry-level training by ignoring the nuance that different goals require different inputs.

We know that estrogen decline affects muscle, and tissue quality, which the authors acknowledge in their discussion. And it’s well established in the mechanistic literature and animal models (both of which I love) that estrogen plays a role in muscle protein synthesis, tissue remodeling and collagen turnover. Some human studies have also shown that estrogen can influence muscle quality and connective tissue function, particularly in postmenopause. But when it comes to strength capacity, the picture is less clear.

In this Svensen study, they didn’t see major differences between menopause groups either at baseline or in response to training. That doesn’t mean hormones are irrelevant. It likely means these women were relatively active, had similar body composition, and either hadn’t crossed the threshold where hormonal differences become more pronounced or the study’s methods weren’t sensitive enough to detect them.

That same pattern, suggesting that estrogen decline may not directly impair strength, also appears in Isenmann et al. (2023), where they tested a traditional moderate-load resistance training program for 10 weeks and found that postmenopausal women gained strength similarly to premenopausal women. They did not show the same improvements in muscle mass or fat-free mass. Figure 2 on that paper shows significant increases in lean muscle mass and decrease in fat mass in premenopausal women, while postmenopausal groups remained flat. Yet when you look at the strength outcomes (Figure 4), all groups showed meaningful gains in 1RM squat, bench press and grip strength. This data supports the idea that estrogen decline blunts hypertrophy and body composition, but not strength gains, at least in the short term.

Do either of these studies settle or prove anything? Nope. In fact, these two papers (for me) raised more questions, which is the whole point of research, and why I added more to this post (and might even come back to revamp it at a later time). We need more research, more nuance and a more honest look at how research is interpreted. Not just by influencers selling a narrative, but by researchers framing their own conclusions. Because how those findings are communicated directly shapes what people believe they need to do.

So, what does this mean for you?

In short, do whatever kind of activity you enjoy and can stick with! Low-load training is a solid starting point, especially for building confidence and consistency.  But as your strength, muscle mass or performance goals change, you will likely need to increase the challenge to keep progressing.....adaptation requires a stimulus that your biology responds to.

PMID: 39480197

PMID: 37803287