What the Research Shows: Muscle Loss in Perimenopause

Muscle loss in midlife women is often dismissed as “just ageing” but the research shows otherwise.

Sarcopenia — the progressive loss of muscle mass, strength and physical function — accelerates during perimenopause and represents a significant, yet under-recognised, women’s health issue. Crucially, this process is not inevitable.

When muscle loss is identified early and addressed appropriately, strength, mobility and metabolic health can be protected well into later life.

What is sarcopenia?

Sarcopenia is a musculoskeletal condition characterised by a decline in muscle mass, reduced muscle strength and impaired physical performance. While it is commonly associated with older age, evidence shows that the biological processes driving sarcopenia often begin much earlier — particularly during the hormonal transition of perimenopause.

For women, muscle is not simply about movement or appearance. It plays a critical role in:

• Bone density and fracture prevention
• Blood sugar regulation and metabolic health
• Balance, stability and injury prevention
• Long-term independence and resilience with ageing

Loss of muscle therefore has wide-reaching health consequences.

How common is muscle loss in perimenopause?

A systematic review examining sarcopenia in menopausal women reported prevalence rates ranging from 10% to over 40%, depending on population and lifestyle factors.

Higher prevalence was consistently observed in women with:

• Inadequate protein intake
• Low levels of physical activity, particularly resistance training
• Metabolic conditions such as insulin resistance or diabetes

Although some of the research focused on rural populations in India, the underlying risk factors — insufficient protein, reduced strength training and hormonal decline — are globally relevant and apply equally to women in the UK.

The hormonal drivers of muscle loss

Perimenopause is marked by complex hormonal changes that directly influence muscle biology.

Key hormonal declines include:

• Oestrogen
• Testosterone
• Dehydroepiandrosterone (DHEA)
• Growth hormone and insulin-like growth factor-1 (IGF-1)

At the same time, cortisol levels often rise due to stress, sleep disruption and metabolic strain.

This hormonal environment reduces muscle protein synthesis while increasing muscle breakdown. As a result, women may notice reduced strength, slower recovery and declining power — even if body weight remains unchanged and physical activity levels stay the same.

Why muscle loss matters for long-term health

Loss of muscle during perimenopause is not a cosmetic issue. It is strongly associated with long-term health outcomes.

Research links sarcopenia to:

• Increased risk of falls and fractures
• Reduced physical function and independence
• Poorer metabolic health and insulin sensitivity
• Accelerated bone loss
• Reduced quality of life with ageing

Muscle is protective tissue. Preserving it is one of the most effective strategies for healthy ageing in women.

What the research shows works

The evidence for preventing and managing muscle loss in midlife women is consistent and practical.

Protein intake in perimenopause

Adequate protein intake is essential to stimulate muscle protein synthesis. Research supports an intake of approximately 0.8–1.2 g of protein per kilogram of body weight per day, with higher intakes often beneficial for physically active women.

Importantly, protein requirements increase with age — yet many women consume less protein during midlife, not more. This mismatch is a major contributor to muscle loss.

Vitamin D and muscle function

Vitamin D plays a role in muscle strength, balance and neuromuscular function. Supplementation of 800–1000 IU per day is commonly supported, particularly in regions with limited sunlight exposure.

Resistance training is non-negotiable

While aerobic exercise supports cardiovascular health, resistance training is essential for maintaining muscle mass and strength.

Research supports:

• At least 150 minutes per week of aerobic activity
• Plus regular resistance training targeting major muscle groups

Consistency matters more than intensity. Strength training does not need to be extreme to be effective.

Hormonal support where appropriate

Where clinically appropriate, hormone therapy may support muscle preservation during perimenopause. This should always be considered on an individual basis with appropriate medical guidance.

Perimenopause is a critical intervention window

One of the most important findings across the research is timing.

Perimenopause represents a critical window of opportunity to protect muscle before significant loss occurs. Intervening at this stage is far more effective than attempting to rebuild muscle later in life.

The nutritional and movement choices made during perimenopause directly influence strength, mobility and independence for decades to come.

Addressing the nutritional gaps

The research is clear: protecting muscle during perimenopause requires adequate protein, targeted micronutrients and nutritional support that reflects hormonal change.

When developing Her Vital Blend (hyperlink to product page), the aim was to address these requirements directly by filling the most common nutritional gaps that compromise muscle, energy and long-term health in midlife women.

Her Vital Blend provides meaningful protein alongside key vitamins, minerals and botanicals shown to support muscle function, energy metabolism and hormonal resilience. It is designed to complement appropriate movement, resistance training and, where relevant, medical hormone support — not replace them.

This is an evidence-led approach: reduce nutritional shortfalls, support muscle biology and enable women to take effective action during a pivotal stage of life.

The takeaway

Muscle loss in perimenopause is real, measurable and clinically relevant — but it is not inevitable.

The research shows that when women are supported with adequate protein, targeted nutrients and strength-focused movement during perimenopause, muscle mass and function can be preserved well into later life.

Ageing is inevitable.
Loss of strength does not have to be.

Support muscle. Support long-term health.

Discover Her Vital Blend — purposeful, science-backed nutrition designed to support strength and hormonal health during perimenopause and beyond.

→ Discover Her Vital Blend

Author & Medical Disclaimer

Written by Hannah Whitcombe, M.Ost
Hannah specialises in women’s musculoskeletal health, perimenopause nutrition and hormone-related strength changes, with clinical experience supporting women through midlife and beyond.

This article is for educational purposes only and does not replace personalised medical advice. Always consult a qualified healthcare professional before making changes to diet, supplements or medical treatment.

References

This article is informed by systematic reviews and peer-reviewed research accessed via PubMed and Google Scholar, alongside guidance from the NHS and the British Menopause Society.