In 40 peri- and early post-menopausal women aged 45-60, nine months of twice-weekly supervised heavy lifting (building to 5 × 5 at 80-85% of 1RM) with drop landings, against a waitlist, went with more total lean mass (+0.90 kg, 95% CI 0.08 to 1.72), more jump power (+97 W, 2 to 193) and more lumbar-spine density (+0.020 g/cm², 0.001 to 0.039), with no clear difference at the hip
A feasibility trial whose authors present these intervals as descriptive, not as proof of efficacy
Main caveat: Powered for feasibility, not for these outcomes; the authors present the confidence intervals as descriptive and three of the four headline intervals have…
Whitman and colleagues at the University of Calgary ran STOP-EM, a feasibility trial asking whether women in the menopause transition would take up and keep attending a nine-month heavy strength and impact programme modelled on the LIFTMOR trial; this paper reports its prespecified secondary outcomes.
Forty women aged 45-60, about half perimenopausal, were randomised to twice-weekly supervised training or to a waitlist with their usual lifestyle.
The programme ran a month of technique work, two months of building load, then three 8-week strength phases of five sets of five at 80-85% of 1RM in deadlift, back squat and a press, plus drop landings from a platform raised to each woman's comfort. All 20 trained women and 18 of 20 controls were retested.
Against the waitlist, the trained group ended with more total and appendicular lean mass, more countermovement-jump power and higher lumbar-spine density; femoral neck and total hip density, isometric knee strength, grip, balance and estimated VO2max did not differ, and 1RM rose by 13-31% in the trained group, which had no control comparison.
The authors stress that the trial was powered for feasibility and that a definitive trial must confirm efficacy.
Participants
40 women randomised, 38 analysed (20 intervention, 18 waitlist; two controls dropped out); mean age 52.9 (SD 4.1) years; BMI 27.0 (6.8).
Menopausal status by STRAW+10: 19 perimenopausal at baseline (47.5%), 39.5% at follow-up; the rest within five years of the final period.
Hormone therapy: 3 users at baseline (2 intervention, 1 control); during the trial 4 intervention women started and 1 in each group stopped, so 5 (13.2%) at follow-up.
Bone: 15 with low bone mass (35% of the intervention group, 44% of controls), one intervention woman with osteoporosis; mean T-scores near zero at the spine and hip.
Activity: 94.6% of those with valid data met 150 min a week of moderate-to-vigorous activity. Excluded: progressive strength training in the previous 6 months, low-trauma fracture in the past 5 years, osteoporosis drugs, metabolic bone disease, glucocorticoids, low vitamin D or calcium, low back pain, uncontrolled cardiovascular disease.
Protocol
Training: twice weekly for nine months, 1-h sessions supervised by a clinical exercise physiologist or certified trainer: 10-min warm-up, about 45 min of four main lifts (box squat, modified deadlift from a platform, bench or shoulder press, assisted pull-up or one-arm row), drop landings, balance and core work, 5-min cool-down.Phases: 1 month foundation, 2 months building, then three 8-week strength cycles at 5 × 5, 80-85% of 1RM, load raised 5% once 5 × 5 at 85% was completed. Drop landings progressed from heel drops to a 7-inch platform and then higher, to comfort.
Control: keep the usual lifestyle; offered the programme after nine months.
Measures: DXA lean mass and areal density (lumbar spine L1-L4, femoral neck, total hip); countermovement-jump peak power on a force plate; isometric knee extension; grip; 1RM (intervention only, weeks 12-36); four-square-step test; VO2max estimated from a 6-min walk; menopausal symptoms (MENQoL) and quality of life (SF-36), reported descriptively without between-group comparison.
Analysis: sample size set by feasibility criteria (n = 40); outcome-specific complete cases; means with 95% confidence intervals for within- and between-group change, which the authors say are descriptive only.
Funding and interests: University of Calgary seed grants, an Alberta Health Services and McCaig Institute grant and a Canadian Institutes of Health Research award on female athlete health; the senior author reports support from Alberta Health Services and CIHR; no industry funding stated.
Key Results
| Outcome | Waitlist change | Intervention change | Between-group difference (95% CI) |
|---|---|---|---|
| Total lean mass, kg | −0.38 | +0.52 | 0.90 (0.08 to 1.72) |
| Appendicular lean mass, kg | −0.20 | +0.39 | 0.59 (0.20 to 0.98) |
| Lumbar-spine density, g/cm² | −0.006 | +0.013 | 0.020 (0.001 to 0.039); the abstract prints 0.001 to 0.034 |
| Femoral-neck density, g/cm² | −0.003 | 0.000 | 0.002 (−0.012 to 0.016) |
| Total-hip density, g/cm² | −0.006 | −0.004 | 0.002 (−0.008 to 0.012) |
| Jump peak power, W | −28 | +70 | 97 (2 to 193) |
| Jump power per kg, W/kg | +0.05 | +0.79 | 0.74 (−0.66 to 2.15) |
| Isometric knee extension, N·m | +1.12 | +6.01 | 4.89 (−9.43 to 19.22) |
| Grip, dominant hand, kg | +0.8 | +1.6 | 0.8 (−1.5 to 3.0) |
| Estimated VO2max, mL/kg/min | +0.57 | +0.40 | −0.17 (−1.47 to 1.14) |
In percent: lean mass +1.2 ± 3.0% vs −0.8 ± 2.8%; lumbar spine +1.1 ± 2.5% vs −0.5 ± 2.4%; jump power +3.7 ± 5.6% vs −0.9 ± 8.1% (intervention vs waitlist).
1RM, intervention only (n = 17), week 12 to week 36: deadlift +21.7 ± 12.9%, back squat +30.5 ± 19.7%, shoulder press +15.3 ± 10.1%, chest press +12.6 ± 14.6%; median deadlift 83.9 kg and back squat 69.4 kg at week 36. The waitlist did no 1RM test, so the "increased muscle strength" in the abstract has no control comparison; the strength measures taken in both groups (knee extension, grip) did not differ.
Symptoms (medians, descriptive): vasomotor symptoms unchanged in both groups (0.0%); the physical domain fell 20.9% with training vs 1.3% on the waitlist and the psychosocial domain fell 12.4% vs rose 10.1% (lower = fewer symptoms), with wide interquartile ranges and no between-group test.
Safety and adherence: two intervention women stopped training before the second strength phase because of undisclosed earlier injuries but were retested; one was injured outside the programme and trained on a modified plan; four reported unrelated injuries that briefly lowered 1RM. Attendance figures and a count of training-related adverse events are not in this paper.
Practical Application
Heavy lifting with impact, started in the menopause transition, went with more muscle, more leg power and a small gain in spine density within nine months, in one small feasibility trial of active women who were not lifting before: against a waitlist, +0.90 kg lean mass, +97 W of jump power and +0.020 g/cm² at the lumbar spine, all with lower confidence limits near zero, and no difference at the hip.It supports what SYNTH-96 prescribes and is the first trial of heavy lifting with impact in the base run in the transition itself rather than years after it.
The programme tested: two supervised 1-h sessions a week; a month of technique and two of building before 5 × 5 at 80-85% of 1RM in squat, deadlift and a press; drop landings raised gradually to comfort. Women retested 20 of 20 in the training arm.
Where it differs from the base's tested shape: SYNTH-96 leans on LIFTMOR (REF-1405), which raised both spine and femoral-neck density in older women with low bone mass; here, in mostly normal-density women in the transition, only the spine moved and the hip did not. The authors suggest normal density at the start may have limited the gain. This does not contest the guide's advice; it narrows what the bone result can promise.
Hot flushes did not change with training (median 0.0% in both groups, descriptive); physical and psychosocial symptom scores fell more in the trained group, untested. SYNTH-96's line that the base has no evidence exercise stops hot flushes stands.
Not treatment advice: with osteoporosis, a past fragility fracture or bone pain, heavy lifting starts with the doctor's agreement and a qualified coach (this trial excluded recent fragility fractures and osteoporosis drugs), and hormone therapy, which more trained women started during this trial, is her decision with her clinician.
Limitations
Powered for feasibility, not for these outcomes; the authors present the confidence intervals as descriptive and three of the four headline intervals have lower limits close to zero.
Unblinded participants and a waitlist control that kept its usual lifestyle; no attention-control or light-exercise arm, so any training, not this programme in particular, may explain the difference.
Hormone therapy changed more in the intervention arm (four starts vs none on the waitlist), a possible influence on bone and lean mass that the analysis does not adjust for.
Complete-case analysis; 1RM measured only in the trained group, from week 12 rather than baseline.
The abstract and Table 3 give different upper limits for the lumbar-spine difference (0.034 vs 0.039 g/cm²); the abstract's conclusion that strength increased rests on uncontrolled 1RM tests; the highlights say menopausal symptoms improved although symptoms were only described, never compared between groups, and the Discussion calls the waitlist changes 'expected declines' although their within-group intervals cross zero.
Active, healthy women from Calgary recruited mostly through social media or word of mouth; peri- and post-menopausal women were not compared with each other; no fracture, fall or sport-performance outcome.
Attendance (a primary feasibility outcome of the trial) and a count of training-related adverse events are not reported in this paper.
Funded by university, provincial health-service and federal research grants; no industry funding or product ties stated.
How this entry was checked and changed
Why this level
a parallel randomised trial with 20 randomised per arm (the rubric's A- size by the randomised count; 18 analysed in the control arm), held at B+ because these outcomes are secondary outcomes of a trial powered for recruitment, retention and adherence, the authors present the intervals as descriptive rather than as evidence of efficacy, participants were unblinded against a waitlist, and more intervention women started hormone therapy during the trial