Muscle, metabolism, and menopause

by Benjamin Bikman, PhD

Menopause is a natural milestone that marks a transition in a woman’s life, typically occurring between the ages of 45 and 55. It is defined by the absence of a menstrual period for 1 year and also a significant decline in hormone production—most notably, estradiol, the most potent form of estrogen. 

While menopause is often discussed in terms of hot flashes, mood changes, and bone health, its effects extend further. Two of the most underappreciated yet impactful consequences of menopause is its influence on: Skeletal muscle health and metabolism. 

Skeletal muscle health and estradiol

Protein synthesis and protein breakdown

Estradiol is a reproductive hormone and key regulator of muscle health: 

Before menopause: Estradiol supports muscle health by enhancing protein synthesis and suppressing protein breakdown. 

During menopause: This balance is disrupted, leading to an overall decline in health lean mass due to both reduced muscle protein synthesis and increased muscle protein breakdown. The loss of estradiol during this transition accelerates muscle loss, impairs insulin sensitivity, and increases the risk of metabolic disease.

Muscle insulin resistance

Changes during menopause also contribute to muscle insulin resistance. Estradiol enhances insulin-sensitivity, and without this hormonal support, insulin signaling deteriorates, blood glucose rises, and metabolic flexibility is impaired. 

Critically, insulin also plays a direct role in muscle protein maintenance. When insulin resistance develops, this effect is weakened, accelerating muscle loss.

Hormonal shifts and metabolic strain

This dual hit—low estradiol and high insulin—creates a metabolic environment that favors muscle degradation over preservation. The result is not only a loss of strength and function but also a decline in overall metabolic health, as skeletal muscle is central to how your body manages blood glucose and burns calories.

Anabolic resistance and muscle maintenance

Maintaining healthy lean mass becomes even more challenging with the development of anabolic resistance. Anabolic resistance is when your body doesn’t build muscle as easily as it used to, and it is made worse by the hormonal shifts of menopause.  

As a result, even with enough protein in your diet and regular physical activity, you may struggle to maintain muscle mass and strength.

Fueling resilience: Nutrients that protect your muscle and metabolism

Fortunately, targeted solutions can help counteract these effects: 

Optimizing protein intake

One of the most effective strategies is optimizing protein intake—both in quantity and quality. High-quality proteins, such as those from dairy, eggs, and meats, are rich in essential amino acids, particularly leucine, which promotes muscle protein synthesis. Additionally, make sure you are eating enough protein and evenly spread out your protein intake throughout the day. 

Protein blends, leucine, and creatine

Emerging science also supports the use of protein blends or supplementation with leucine to support muscle protein synthesis in older adults.

Creatine is another promising strategy. While best known for its role in boosting energy during high-intensity exercise, creatine also influences gene expression. Studies have shown that creatine increases the expression of genes involved in muscle growth and cellular energy production. 

This makes creatine a valuable tool for preserving muscle mass and function during the menopausal transition, especially when combined with resistance training.

STRONGHOLD

A particularly effective supplement that addresses these muscle-preserving needs is STRONGHOLD, which combines (among others) three well-researched ingredients: leucine, HMB (β-hydroxy β-methylbutyrate), and creatine. 

We’ve already described some of the benefits of leucine and creatine earlier. HMB, a compound related to leucine, helps to reduce muscle protein breakdown—especially important with the hormonal shifts occurring during menopause. In fact, HMB has been shown to be significantly more effective than leucine alone at preventing muscle loss in older adults. 

Together, these ingredients make Stronghold a comprehensive tool for combating anabolic resistance, preserving lean mass, and supporting metabolic health during and after the menopausal transition.

Move forward with strength and confidence

Menopause is a hormonal and metabolic inflection point. Understanding the muscle-specific consequences of estradiol decline provides a foundation for targeted strategies that preserve strength, function, and metabolic resilience. 

By addressing anabolic resistance and supporting muscle health through nutrition, exercise, and supplementation, women can navigate menopause with greater vitality and reduced risk of chronic disease.

About the author: Dr. Benjamin Bikman is the director of the Unicity Scientific Advisory Board. He earned his doctorate in bio-energetics and specialized metabolic disorders as a postdoctoral fellow of the Duke-National University of Singapore. As a professor and scientist at Brigham Young University, Dr. Bikman’s focus is understanding chronic, modern-day diseases with an emphasis on the origins and consequences of metabolic disorders, including diabetes and obesity. He frequently publishes his research in peer-reviewed journals and presents at international science meetings.

References

1. Sartori, R., et al. (2021). Mechanisms of muscle atrophy and hypertrophy: implications in health and disease. Nature Communications, 12(1), 330. 

2. Smith, J. A. B., et al. (2023). Exercise metabolism and adaptation in skeletal muscle. Nature Reviews Molecular Cell Biology, 24(9), 607. 

3. Hargreaves, M., et al. (2020). Skeletal muscle energy metabolism during exercise. Nature Metabolism, 2(9), 817. 

4. Tessier, A.-J., et al. (2025). Optimal dietary patterns for healthy aging. Nature Medicine, 31(5), 1644. 

5. Kazak, L., et al. (2020). Creatine metabolism: energy homeostasis, immunity and cancer biology. Nature Reviews Endocrinology, 16(8), 421.