Content warning: This article mentions dieting and body shaming. 

In late 2024, my mother was diagnosed with Type Two diabetes, a largely asymptomatic medical condition where cells are not able to properly respond to insulin. Insulin is a hormone in the body that regulates blood sugar, and if your body cannot use insulin properly, it results in unstable high blood pressure and a predisposition to diabetes. 

If not managed over time, prediabetes can lead to cardiovascular problems, kidney disease, and even early cognitive decline. Type Two diabetes can be caused by a variety of complex, intertwining factors, from genetic to environmental factors, and even menopausal status. 

Over the past two years, my mother has prioritized a diet involving high-fibre and nutrient-dense foods, as well as physical activity through daily walks around the neighbourhood. But research suggests that strength training helps manage insulin resistance, lowers the risk of diabetes, and protects against the age-related decline in health. 

While aging naturally causes muscle loss and strength, muscle mass begins to progressively decline starting at age 30, putting people at a greater risk of age-related bone and muscle illnesses. So, why should more women lift weights, and why don’t they already? 

Use it or lose it: Skeletal muscle as the body’s biological buffer 

Beyond its association with body aesthetics and athletic performance, skeletal muscles do more than just walk you to class. For example, they regulate metabolism — a collection of chemical reactions in your body essential for sustaining growth and cell repair — by using and storing glucose, your body’s most abundant fuel source.

The reason skeletal muscles are metabolically active is that, even during inactivity, such as when you are asleep, they continue to burn calories. Through a series of complex biochemical reactions, sugar molecules are converted into adenosine triphosphate (ATP), another molecule that powers nearly every life-sustaining process. While glucose is an essential life source, excessive glucose buildup in the blood over prolonged periods of time can damage the delicate walls of blood vessels, leading to restricted blood flow and pressure on the heart. 

Muscles act as absorption and storage powerhouses for glucose. When certain exercises increase muscle mass, myofibers — the fibres making up skeletal muscles — become more sensitive to insulin. This sensitivity helps glucose enter cells and bind to the sugar. As your muscles become more sensitive to insulin, it makes them more metabolically active.

But the opposite can also take place. As a result of injury, age-related decline, disease, or lifestyle factors, a reduction in muscle mass can compromise your body’s ability to store and use glucose, leading to insulin resistance — the foundation for Type Two diabetes. 

Estrogen: The overlooked hormone in women’s muscular and metabolic health

Estrogen is a hormone typically associated with reproductive health in women; however, its influence in the body extends far beyond fertility, pregnancy, or menstrual cycles. 

While every body is different, most women will experience perimenopause in their late 40s, a transitional period defined by decreasing estrogen levels and sparse menstrual cycles. Perimenopause is followed by menopause, which officially begins when the menstrual cycle doesn’t appear for more than 12 months. 

On top of this, perimenopausal and menopausal symptoms can include mood changes, joint pain, headaches, and inconsistent sleep, to name a few. A 2021 review of clinical data in the American Journal of Pathology outlines how estrogen plays a protective role against metabolic syndrome (MetS) — a collection of individual conditions that significantly raise the risk of weight gain, heart disease, diabetes, and stroke. 

Scientists have found that men are more vulnerable to developing MetS than pre-menopausal women. However, menopausal women are at a far greater risk of developing insulin intolerance and MetS after they have experienced estrogen drop. The connection between estrogen and insulin resistance underscores estrogen’s protective qualities, which include maintaining bone, muscle, brain, and cardiac health.

As women go through menopause, one of the concerns that comes with a rapid dip in estrogen is the inability to maintain and build muscle mass efficiently. Age-related loss of muscle mass is closely related to estrogen function. Estrogen plays an important role in promoting muscle protein synthesis (MPS), the key process that makes myofibres stronger and bigger after strength training. 

A reduction in MPS often induces microtears in muscle tissue, which leads to increased muscle growth and strength over time. Therefore, the habit of strength training early on in one’s life makes our muscles stronger so that when menopause hits, our muscles are more resistant to natural age-related decline.

A 2013 review in the Journal of Applied Physiology states that hormonal therapies, where postmenopausal women take additional estrogen through pills, patches, or gels, can significantly improve the debilitating symptoms of menopause by maintaining the strength and mass of skeletal muscle. 

Your muscles are a powerhouse — not only because of their physical strength, but also due to their role as a built-in biological buffer against age-related declines in strength and overall health. For women, starting strength training early to make muscles stronger and more resistant to decline can create a world of difference by the time the estrogen-decline of menopause is felt. 

Going against historical and mainstream messaging for women

Still, for those who identify as a woman or were socialized as one, many cultural norms and stereotypes of ‘what women are supposed to look like’ have systemically discouraged women from resistance and strength training. They were taught that lifting weights and building muscle would make them look ‘manly’ or ‘unfeminine.’ 

While awareness about the connections between muscle mass, estrogen, and metabolic health is expanding, the scientific community often overlooks how social perceptions and psychological factors can shape women’s participation in rigorous, weekly strength training. 

Historically, patriarchal ideas often emphasized grace and thinness when circulating exercise and health recommendations. The 1960s and ’70s saw a boom in a fitness culture designed for male-dominated preferences. For example, commercial gym equipment did not accommodate women’s physical profiles, and women were often advised by the media and health gurus to focus on yoga, jogging, stretching, and mild resistance-band exercises. Since then, accessibility, acceptance, and attitudes involving women’s strength training have evolved, but many women, like my mother, have grown up impacted by the myths surrounding what exercise looks like for women. 

Just last week, I told my mother she should start lifting weights in addition to speedy walks. In response, she said that lifting weights “like a bodybuilder” will affect the regularity of her period. While it is true that excessive and intense exercise can cause missed or delayed periods, there isn’t a causal connection between exercise and irregular periods. 

This myth, and many others, are based on largely overblown facts that discourage women from strength training. While social factors continue to shape how honestly we speak about women’s health, having earnest conversations with the women in our lives can help trigger small changes felt across a lifetime.