A research team studied early perimenopausal women and compared two groups: one doing hormone therapy, one doing only squats and deadlifts twice a week. For lumbar spine bone mineral density, the lifting group came out ahead.
Most women in their 40s have no idea that finding exists. They’re managing perimenopause symptoms, asking their doctors about HRT options, reading about calcium supplements — and walking right past the weight room every day.
That gap between what the science shows and what women actually do is something I’ve watched play out for 25 years. Everything is already there — the information, the research, the barbell itself. Still, most women never pick one up.
What Perimenopause Actually Does to Your Bones
Estrogen does more than regulate the menstrual cycle. One of its lesser-known roles is protecting bone density — it slows the natural breakdown process that happens throughout life. During perimenopause, estrogen levels begin fluctuating and eventually dropping, and that protective effect diminishes with them.
Bone loss doesn’t wait for menopause to arrive officially. For many women, it begins years earlier — quietly, without symptoms, without any sign that something is shifting. Women can lose up to 20% of their bone density in the years surrounding menopause, with the hips and lumbar spine taking the most significant hit. Those happen to be the same sites most associated with fracture risk later in life.
Most women don’t find out any of this until a DEXA scan surfaces a problem that’s been quietly building for years.
What Is the Sumo Deadlift — And Why Does It Matter Here?
The sumo deadlift is a barbell exercise performed with a wide foot stance — feet set well beyond shoulder width, toes angled outward, grip inside the legs. Unlike the conventional deadlift, the sumo stance creates a more upright torso position, which shifts the load toward the hips and reduces stress on the lower back.
That matters for bone health specifically because of where the mechanical stress lands. Every rep of a sumo deadlift places significant compressive and tensile forces directly on the hip and lumbar spine — precisely the sites perimenopause puts at risk. Bone responds to that stress by signalling new tissue formation. No stress, no signal. No signal, no adaptation.
Walking doesn’t provide enough load. Yoga doesn’t provide enough load. Even many gym machines fall short because they reduce the mechanical demand the body actually needs. Free weight compound movements — deadlifts especially — deliver that demand in a way most other exercises simply don’t.
What the Research Actually Found
A study by Maddalozzo et al. followed early perimenopausal women and found that performing only squats and deadlifts twice a week was more effective than hormone therapy alone for preserving lumbar spine bone mineral density. A separate line of research confirmed that resistance training — regardless of whether women were also on HRT — prevented bone loss at the spine in early postmenopausal women.
The mechanism is direct: at intensities of 80–90% of maximum effort, forces at the hip and spine during deadlifts approach five to eight times body weight. That mechanical load is the stimulus bone needs to stay dense.
Two things are worth saying clearly here. First, HRT and resistance training are not an either/or — many women benefit from both, and that’s a conversation to have with a doctor. Second, the research isn’t arguing against hormone therapy. It’s showing what resistance training does on its own — and what’s lost when women skip it.
Why Most Women in Perimenopause Still Aren’t Lifting
Awareness is part of it. Nobody hands women a pamphlet at 42 that says “your bones are entering a critical window and a barbell twice a week could change your trajectory.” This conversation almost never happens in a GP’s office, and it rarely happens anywhere else.
But awareness isn’t the whole story. After decades of working with women in Downtown Vancouver, the pattern I see most often is this: women know they should be doing something, but the weight room still feels like it belongs to someone else. Heavy lifting carries assumptions — that it’s for younger people, for athletes, for people who already know what they’re doing.
Perimenopause doesn’t announce itself with urgency. Bone loss is silent. Nobody feels it happening. Silence makes it easy to postpone — until a scan, a fall, or a fracture makes it impossible to ignore.
Starting before the urgency arrives is the entire point. What you build now compounds as protection over time. Waiting until the problem is visible means beginning from a much worse position.
Every woman moving through her 40s deserves to know what the research actually shows — and to have someone in her corner who knows how to act on it. Working with a trainer who understands this stage of life changes what’s possible.