Do HRT effects on exercise results give you an advantage (or hold you back)? I’ve addressed this in podcasts and interviews before but it was asked again. So let’s discuss it. In Cliff notes, yes it makes a difference. And yet there are things to consider about why and how it makes a difference. What it does, doesn’t do, and how no matter what your choice, is possible for you.
Research Reports HRT Effects on Exercise
Hormone Replacement Therapy (HRT) has significant beneficial effects on skeletal muscle mass, strength, and protection from damage in older women.
HRT seems to improve muscle power, regulation of muscle contraction, and muscle composition.
HRT is linked to the reversal of both menopause-related obesity and loss of lean mass, without overall change in body weight.
(HRT also referred to throughout as HT)
The increase in lean body mass (LBM) during HT is likely explained by muscle anabolism, which in turn, prevents disease in the elderly. More benefits of HT are seen in younger postmenopausal females and those who initiate HRT proximal to menopause.
The positive association of bone mass and density with estrogen in older women has been well-established in the scientific literature. Bone mineral loss accelerates following menopause in women and this accelerated bone loss is prevented by HRT. Exercise and HRT may also independently and additively help maintain bone mineral density in aging females.
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What is Exercise for Menopause Optimization?
It can’t just be any exercise whether you’re on HRT or not. An ineffective exercise program designed for men, mice, young women, or “everyone” has a small chance of working for a midlife woman.
Note: for exercise to have the most benefit on body composition and bone density it must have an adequate volume of intensity level.
Volume comes from heavy weight and fewer repetitions rather than increased frequency. Namely, because one of the risk factors of muscle breakdown, or catabolism, is elevated cortisol levels.
While endurance exercise is known to contribute to a rise in cortisol with a negative influence on muscle as adults age and particularly women in menopause, so too can too frequent high-intensity exercise based on individual recovery rate.
In 2015 I wrote about the uniqueness of recovery period needs for individuals. Yes, though elite athletes will recover faster than beginners and a 20-year-old will recover faster than a 60-year-old in general is safe to say, across all like individuals recovery can be very different. In You Still Got It, Girl! – I referred to a study of individuals taken through a significant overreaching period of training. The recovery differences were anywhere from a few days to 180 days. That was like individuals. So, this too is a factor.
Will you recover better if you have support through hormone replacement? Likely yes, as you’ve got estrogen progesterone to help offset stress. And if the insulin and cortisol are in better balance there’s less inflammation and more anabolism.
Anecdotal HRT Effects on EXERCISE Evidence
In 40 years of training thousands of participants, clients and supervising thousands more of staff with nearly two dozen trainers, there is a notable difference since hormone replacement therapy became more mainstream and common. Women on HT are less restricted, one by the lack of sleep and fatigue that often is true for women in menopause transition.
Women on HT tend to have an easier time with hot flashes and night sweats (diet however is also a factor and high-intensity exercise though not low plays a big role in improving these vasomotor issues).
Muscle development – which then is instrumental in reducing insulin resistance and supporting weight management – is better. Bone density changes are easier though this I have less evidence of as private clients are the only reference. So we’re down to hundreds not thousands of private clients who I work with in a capacity where we’d share DEXA scans annually over time.
There is this to note, however. On HRT women may not be as diligent as those who opt not to do so for personal, financial, or genetic reasons. We tend to let the pill, cream, and shot do a little more of the work. Those women who don’t and yet modify their diet, exercise, and lifestyle habits for optimal menopause support CAN and DO make significant more improvements in their musculoskeletal health. The best of both worlds would be ideal.
If you’re not started… it’s time to get going! (link to https://www.flippingfifty.com/cafe on strength training regardless of your choice on HRT.
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