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Postmenopausal Women Need to Prevent Muscle Loss

Menopause is a transition point in a woman’s life that marks the end of her fertility – occurring at an average age of fifty-one. Physiologically, it’s the point in time, “when menstrual cycles permanently cease due to the natural depletion of ovarian oocytes from aging. The diagnosis is typically made retrospectively after the woman has missed menses for 12 consecutive months,” according to

The big question on a postmenopausal women’s mind is whether or not to use hormone replacement therapy (HRT) to reduce the risk to osteoporosis, bone fractures, and cardiovascular disease – myocardial infarction and stroke – which increases after menopause.

According to Katherine Swing, an Ochsner Health System, board certified Obstetrician and Gynecologist and Diplomate of the American Board of Obesity Medicine, “nearly all women are candidates for hormone replacement therapy (HRT), the exception being women with active hormone-sensitive cancers.”

Swing, who specializes in bioidentical hormone replacement therapy, says, “there is ample literature to support the safety, efficacy, and better side effect profiles of bio-identical hormones, such as estradiol, progesterone, and testosterone, over synthetic hormones, such as Premarin and Prempro”

As to the appropriate blend of HRT, Swing notes that, “hormone therapy should always be individualized. The goal is to obtain optimal blood levels for heart and bone protection and to alleviate menopausal symptoms such as hot flashes, moodiness, vaginal dryness, and low sex drive.”

An important issue that I encountered with postmenopausal women entering my hospital-affiliated, comprehensive weight management programs, was the accrual of visceral abdominal fat that surrounds vital organs – sending out inflammatory signals to all parts of the body.

Also documented was an early loss of lean, metabolically active muscle tissue in the first six weeks in the program – despite the female participant being on a structured peripheral heart circuit (alternating upper and lower body resistance exercises) and cardiovascular training three times per week – along with a calorie-restricted, balanced eating plan.

Swing emphasized that, “as we age, our testosterone and estradiol naturally decline, followed by a rise in cortisol. These hormonal shifts lead to an increase in visceral and subcutaneous adipose tissue (fat), as well as, a decline in lean muscle mass.”

Estradiol and testosterone, commented Swing, “both decrease fat and testosterone helps women maintain or gain muscle mass by increasing the production of protein. This is why I offer testosterone, along with estradiol and progesterone, to virtually all of my postmenopausal women who are interested in hormone replacement therapy.”

My lifestyle solution was to perform a DXA Scan body composition assessment for lean tissue and visceral fat changes every six weeks, switch the steady-state cardio sessions to sprint-interval training (SIT), substitute an antagonist muscle circuit (alternating front and back exercises), increase the daily protein intake to one gram per pound of lean muscle, utilize a three amino acid complex that has been shown to stop muscle loss in cancer patients, while adding an alternate day cardio walking program – all under medical supervision.

Soon to be published research, “demonstrated the SIT intervention increased total lean mass, decreased fat mass, and increased aerobic fitness of postmenopausal women, after only 8 hours of actual exercise over 8 weeks.”

From Swing’s perspective, “I also recommend taking Vitamin D3. Guidelines typically recommend 800-1000 IU daily for postmenopausal women, but many women will need to supplement with 5,000 IU daily to obtain an optimal level in their blood. Vitamin D is important for building bones, maintaining muscle, and preventing falls in elderly women.”

As far as diet, the Ochsner physician said, “it’s important for postmenopausal women to eat an adequate amount of protein, at least 1 gram of protein per kilogram of body weight, to maintain or build muscle.

In addition to the DXA scan, my program also charted critical inch measurements – waist, abdomen, and hips – to keep a watchful eye out for a high-risk migratory fat pattern.

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