TL; DR (Too Long; Didn't Read)
Strength training is essential for perimenopausal women to maintain muscle mass, metabolic health, and keep you looking like the snack you are.
The best compound exercises for overall muscle hypertrophy include squats, hip thrusts, lunges, deadlifts, overhead presses, and pull-ups.
Focusing on the eccentric phase, pausing in the lengthened position, and using progressive overload is gnarly…but will maximize results. I've included exercises and modifications that can be done at the gym or at home to suit your space and equipment.
WHY are Compound Movements So Important?
And when I say compound, I DO NOT mean squatting paired with an overhead shoulder press, or some other silly combination of movements (I will go on a rant about these another day).
Working on eccentric control and progressive overload can help prevent injury–which, in addition to muscle growth, is a primary lifting objective in midlife.
If you want to maintain mobility, independence, and a strong physique, resistance training is non-negotiable. As estrogen and testosterone levels fluctuate during perimenopause, muscle loss—partially due to the reduced activation of satellite cells—and bone density decline become real concerns.
For my Dark Roast Bettys: Satellite cells are specialized muscle stem cells responsible for muscle repair and regeneration. They are located between the muscle fiber membrane and its surrounding connective tissue. When muscles experience stress or damage—such as from strength training—satellite cells activate, multiply, donate, and fuse with existing muscle fibers to repair and grow stronger muscles. This process is essential for muscle hypertrophy, allowing muscles to recover and grow after training.
However, during perimenopause, the decline in estrogen and testosterone can reduce the efficiency of satellite cell activation, making muscle recovery and growth more challenging.
This is why progressive overload, eccentric training, and proper recovery strategies become even more critical to maintaining and building muscle mass.
Strength training–particularly compound movements that are multi-joint and multi-muscle movement patterns–stimulates muscle growth, improves joint stability, and supports overall metabolic function.
WHAT are the Most Effective Compound Lifts for Muscle Hypertrophy?
Compound lifts engage multiple muscle groups and joints at once, making them the most efficient way to train for hypertrophy. It also means that the motor coordination and pattern can be more difficult to master because there is a LOT happening at once.
Here are the must-do movements:
1️⃣ Squats: The reigning Queen of lower body exercises, squats work the quads, hamstrings, glutes, and core. Variations include:
- Barbell Back Squat (gym)
- Goblet Squat (home/gym)
- Bulgarian Split Squat (home/gym)
- Wall Sit (home, isometric strength focus)
2️⃣ HIP THRUSTS: Essential for glute development, hip thrusts also engage the hamstrings and lower back.
- Barbell Hip Thrust (gym)
- Dumbbell Hip Thrust (home/gym)
- Glute Bridge (bodyweight, home/gym)
3️⃣ LUNGES: A unilateral movement that improves balance, coordination, and strength.
- Walking Lunges (gym/home)
- Reverse Lunges (knee-friendly)
- Step-Ups (home/gym, great for stability and strength)
4️⃣ DEADLIFTS: A total-body movement that strengthens the posterior chain, including hamstrings, glutes, and back. IF you want a deep line in your back muscles, this is how it's done:
- Conventional Deadlift (gym)
- Romanian Deadlift (hamstring focus)
- Kettlebell Deadlift (home/gym)
- Sumo (yes these count, despite arguments online)
5️⃣ OVERHEAD PRESS: A compound upper-body movement that also engages the core and rotator cuff of the shoulder in addition to the deltoid
- Barbell Overhead Press (gym)
- Dumbbell Shoulder Press (home/gym)
- Landmine Press (joint-friendly variation)
6️⃣ PULL-UPS: Though primarily an upper-body movement, pull-ups engage the entire posterior chain, including the glutes and core.
- Assisted Pull-Up (band or machine)
- Negative Pull-Up (Jump up to the top of the bar and slowly lower / eccentric focus)
- Scapular Retractions while Deadhanging
HOW Can You Implement These Exercises at Home or in the Gym?
✅ Focus on the Eccentric Phase: Lower the weight slowly (3-4 seconds down) to increase muscle tension and stimulate growth.
✅ Pause in the Lengthened Position: Hold at the bottom of squats or lunges for 2-3 seconds to build strength and stability.
✅ Use Progressive Overload: Lift heavy for YOU. Approaching muscle failure is the goal in a range of motion you can own. Gradually increase resistance by adding weight, increasing reps, or adjusting tempo.
✅ Recovery Matters: Prioritize protein intake, sleep, and mobility work to support recovery and maximize results. Aim for 1.8-2.2g of protein per kg of ideal body weight daily.
NOW: 3 Simple Steps to Start Today
1️⃣ Pick 2-3 of these compound movements and add them to your routine 2-3x per week.
2️⃣ Slow down the eccentric phase and pause at the bottom to increase strength and stability.
3️⃣ Track your weights and aim for small increases weekly to keep progressing.
What I Recommend
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Health Optimisation Summit Comes to Austin
It’s official! I’m speaking at the Health Optimisation Summit in Austin, Texas! I'll be talking about perimenopausal strategies like muscle, meals, and stress management.
Europe’s biggest health event lands in Austin on April 12-13. You'll hear game-changing health insights from nearly 40 industry-leading experts covering topics from biohacking and nutrition to functional and preventative medicine.
Spend two full days at the Palmer Events Center surrounded by Paleo-inspired wisdom, innovative health tech, and a community that feels like family.
If you purchase your ticket now and use code DRSTEPHANIE, you'll save 10% on VIP or General Admission.
