Some relatives in their 70s came to stay recently. We were planning what to do. We live in the countryside. Beautiful walks. Castles. Monasteries. But in Italy most of these involve walking. And where I live, walking means hills or steps.

One of the women visiting has osteoporosis and degeneration in her hips. Getting in and out of the car is hard. Stairs are difficult. A countryside walk is simply not possible.

It really made me stop.

I love to walk. I love to ski and waterski. I moved to Italy to live this way. And I am very clear that I want to still be doing these things in my 80s and beyond. I have already noticed my joints are stiffer than they were even a few years ago.

Many people think estrogen is just a reproductive hormone that declines in our 50s at menopause.

It isn’t that simple.

Estrogen fluctuates monthly during our cycling years, but it also begins a gradual decline from our mid to late 30s. Many women only notice the impact when they reach perimenopause in their 40s. We tend to talk about hot flushes and sleep disruption. But the quieter changes matter too.

Estrogen plays a protective role across almost every system in a woman’s body. It supports bone strength, muscle repair and maintenance, joint health, heart health, cognitive clarity, metabolic balance and healthy inflammatory responses.

When estrogen declines, muscle loss accelerates. From around our 30s, adults lose roughly 3 to 8 percent of muscle mass per decade. After menopause, the rate increases more rapidly due to hormonal change. Lower estrogen is associated with reduced muscle protein synthesis and faster bone breakdown.

This is why strength and bone health become such an important conversation in midlife. Not because we are fragile, but because we are changing.

And this matters deeply for women who carry responsibility.

Carrying responsibility requires energy. It requires clarity. It requires physical and emotional stamina. Our bodies are not separate from that. They are the foundation underneath it.

The good news is this is not passive decline. We are not powerless.

There are practical things we can do.

Three Key Foundations

Strength training

Strength training is not about aesthetics. It is about function.

Lifting heavy things places controlled stress on muscle and bone. This stimulates muscle protein synthesis and helps maintain lean muscle mass. It also improves bone density by encouraging bone remodelling.

Research consistently shows that strength resistance training can slow age related muscle loss and improve bone mineral density in postmenopausal women. It also improves balance, joint stability and insulin sensitivity.

In simple terms, stronger muscles mean stronger bones and better protection against falls and fractures.

For women who carry responsibility, strength is capacity. Capacity to keep going. Capacity to recover. Capacity to remain capable.

Two to three sessions per week is a realistic starting point. If you've not strength trained before then start with light weights and build up. If you don't like to go to the gym there are loads of online programmes you can try.

Adequate protein intake

As we age, our bodies become less efficient at using protein. This is sometimes referred to as anabolic resistance.

Current evidence suggests that midlife and older women may benefit from around 1.0 to 1.2 grams of protein per kilogram of body weight per day. For those strength training regularly, some research suggests up to 1.6 grams per kilogram.

For a 65 kg woman, that is roughly 65 to 80 grams per day as a minimum.

Protein provides the building blocks for muscle repair and maintenance. Without enough protein, strength training becomes far less effective.

Vitamin D

Vitamin D plays a key role in calcium absorption and bone health. Low levels are associated with reduced bone density and increased fracture risk. It also appears to support muscle function.

Even in sunny climates, many women have suboptimal levels due to indoor lifestyles. In the UK, vitamin D supplementation is recommended by the NHS during autumn and winter months.

Final Thoughts

For me, this is not about fear of ageing. It is about being proactive.

I do not want to arrive in my 70s and discover I can no longer do the things that make me feel alive.

So I lift weights. I prioritise protein. I get outside and get in my steps for health. I think about this now, not later.

Midlife is not an ending, it is a transition.

If we want to keep living fully and carrying responsibility with calm and vitality, we need bodies that can sustain us.

Strength is not vanity. It is capacity.

Are you building that capacity now for the life you want at 80?

References

Chidi-Ogbolu, N. and Baar, K. (2018). Effect of estrogen on musculoskeletal performance and injury risk. Frontiers in Physiology, 9:1834. Available at: https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2018.01834/full

National Health Service (NHS) (2022). Vitamin D. Available at: https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/

Rizzoli, R., Stevenson, J.C., Bauer, J.M., van Loon, L.J.C., Walrand, S., Kanis, J.A. and Cooper, C. (2014). The role of dietary protein and vitamin D in maintaining musculoskeletal health in postmenopausal women: A consensus statement from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Maturitas, 79(1), 122–132. https://doi.org/10.1016/j.maturitas.2014.07.005

Tiidus, P.M. (2011). Benefits of estrogen replacement for skeletal muscle mass and function in post-menopausal females: evidence from human and animal studies. Eurasian Journal of Medicine, 43(2), 109–114. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC4261347/

Wright, V.J., Schwartzman, J.D., Itinoche, R. & Wittstein, J. (2024). The musculoskeletal syndrome of menopause. Climacteric, 27(5), 466–472. DOI:10.1080/13697137.2024.2380363

University Hospitals (2025). How to protect against age-related muscle loss. Available at: https://www.uhhospitals.org/blog/articles/2025/09/how-to-protect-against-age-related-muscle-loss