Strength Training Built Mental Skill—For Women Who Need Resistance Work Most

The rate of fat gain doubles at the start of menopause. Lean mass declines. These changes persist for 2 years after the final menstrual period. Strength training counters both processes by building muscle mass and bone density during the exact window when your body is actively losing them. Yet most physical activity interventions for women approaching menopause ignore strength training entirely.

A 12-week randomized pilot trial examined whether a strength-focused intervention could increase physical activity among pre and perimenopausal women ages 40 to 50. Thirty-nine low-active women were randomized to either a twice-weekly intervention combining cardiovascular and strength training or waitlist control. Sessions included bodyweight exercises, aerobics, and resistance bands, plus behavioral coaching informed by Self-Determination Theory and Habit Formation Theory. All participants received Apple Watch devices to monitor activity.

The Menopause Transition Demands Different Programming

Women in their 40s face accelerated physiological changes that demand strength training, not just aerobic activity. Fat accumulation increases while muscle mass decreases. Bone density declines. Metabolic rate slows. Walking is the most common form of physical activity among women, but research shows it does not prevent the weight gain associated with menopause. Strength training does.

Despite this evidence, most physical activity interventions target 150 minutes of moderate to vigorous activity per week without addressing whether any of those minutes include resistance work. Meeting strength training recommendations receives minimal attention in both research and clinical practice. This represents a significant gap for women who need resistance training most.

The Activity Results Were Null

The intervention did not produce significant differences in physical activity. The intervention group increased activity by 21 minutes per week while the control group decreased by 2 minutes, but this difference was not statistically significant. Move calories showed a similar pattern with no between-group differences.

Both groups entered the study with higher baseline activity than expected. The intervention group averaged 143 minutes per week and the control group 115 minutes per week, despite eligibility requiring less than 90 minutes per week. Participants self-reported activity during telephone screening but wore Apple Watch for baseline measurement. The discrepancy suggests either underreporting during screening or reactive measurement effects from wearing the device. The intervention group also had 28 more minutes per week of baseline activity than controls, leaving less room for improvement.

The Psychological Variables Changed Significantly

The intervention successfully shifted multiple psychosocial targets. Relative to waitlist control and adjusting for baseline values, intervention participants reported higher self-efficacy for physical activity, stronger habit formation and automaticity, better self-regulation and goal setting, greater exercise enjoyment, and increased feelings of revitalization and tranquility from exercise. No differences emerged for impulse control, positive engagement, or physical exhaustion.

Self-efficacy increased significantly in the intervention group. This reflects confidence to exercise when facing common barriers like feeling tired, being in a bad mood, lacking time, being on vacation, or dealing with bad weather. These are the exact circumstances when most women stop exercising. Higher self-efficacy predicts continued activity when motivation fades.

Habit formation and automaticity also increased significantly. The intervention emphasized scheduling exercise like an appointment and training at consistent times to build automated behavior. Habit strength determines whether physical activity persists long-term. When exercise becomes automatic rather than requiring active decision-making each time, adherence improves.

Exercise enjoyment increased in the intervention group. Participants reported higher pleasure from movement itself, not just from outcomes like weight loss or appearance changes. The behavioral coaching encouraged women to identify positive feeling states during and after activity, and to reframe negative associations. Enjoyment predicts both adoption and maintenance of physical activity.

Feelings of revitalization and tranquility from exercise both increased significantly. These represent positive affective responses to physical activity. The intervention explicitly targeted these by asking participants to notice how they felt during and after sessions, particularly the energized and calm states that often follow resistance training. Research shows that positive feeling states during exercise predict continued engagement more reliably than outcome expectations alone.

Why Psychological Shifts Matter for Long-Term Adherence

These psychosocial variables predict sustained behavior change. A 12-week intervention may be too brief to detect activity differences, particularly when baseline activity was higher than expected. But the mental framework built during those 12 weeks supports consistency over months and years.

Self-efficacy, habit automaticity, and exercise enjoyment form the foundation for maintenance. These are the factors that keep you training when work gets demanding, when family obligations multiply, when weather disrupts your routine, and when motivation inevitably fluctuates. Building these psychological skills may matter more for long-term outcomes than short-term activity increases.

The intervention targeted these variables through specific behavioral strategies. Participants identified barriers to exercise and developed solutions to build self-efficacy. They scheduled consistent training times to develop habits. They focused on positive feeling states during sessions to increase enjoyment. The coaching component emphasized intrinsic motivation rather than external regulation like appearance or weight.

Group Dynamics Predicted Adherence

An exploratory analysis examined group cohesion. Higher scores on the group integration task subscale correlated with better attendance. Women who perceived the group as unified around the shared goal of physical activity showed up more consistently. This finding has direct implications for intervention design. Emphasizing group bonding early through team building and collaborative exercises may improve adherence throughout the program.

The Strength Training Gap Persists in Research and Practice

Most physical activity interventions aim for 150 minutes of moderate to vigorous activity per week without distinguishing between aerobic and resistance work. This approach fails women approaching menopause who require strength training to counter muscle loss and weight gain. Current guidelines recommend resistance training at least twice per week, but this threshold receives minimal attention in both research trials and clinical recommendations.

Future intervention trials need to address strength training as a distinct and essential modality, not an optional addition to aerobic activity. Cardiovascular and resistance work can be combined within single sessions through circuit training or interval formats that alternate aerobic bursts with bodyweight or band exercises. As research on strength training for perimenopausal women expands, the current twice-weekly guideline may need revision based on accumulating evidence about optimal volume and frequency.

What This Study Contributes

This trial targeted women ages 40 to 50 during the critical menopause transition window when physiological changes accelerate. The intervention specifically integrated strength training using bodyweight exercises and resistance bands, making it accessible without gym equipment or sophisticated machinery. Validated measures assessed both activity and the psychological mechanisms theorized to support behavior change.

Feasibility metrics were strong. Retention reached 97% at 12 weeks. Participants attended an average of 17 out of 24 sessions despite work and family demands. Consumer satisfaction averaged 5.34 on a seven-point scale. These findings support testing the intervention in a larger trial.

The study has limitations. The 12-week duration may have been insufficient to detect activity changes. Technology requirements for participation may have introduced selection bias. The sample was 72% white, representative of the recruitment area but limiting generalizability. Apple Watch data came through participant screenshots rather than direct device export.

The significant psychosocial changes and high retention support testing this intervention in a larger randomized controlled trial with longer duration and follow-up. The mental skills built during these 12 weeks may translate into sustained activity changes that this pilot could not capture. For women approaching menopause who face accelerated muscle loss and fat gain, interventions that successfully build strength training habits address a critical and largely unmet need.

Lewis, B. A., Schuver, K. J., Swinney, K. B., Dregney, T. M., & Linde, J. A. (2025). Examining the feasibility and preliminary efficacy of a group-based physical activity intervention integrating strength training among pre- and perimenopausal women: A randomized pilot trial. Women's Health, 21, 1-12.