Written and edited by Sarah Bonza MD, MPH, MSCP, DipABLM, NBC-HWC

As someone who wears many hats—family physician, lifestyle medicine specialist, and a woman navigating midlife—I’ve seen firsthand how shifting hormones and changing body composition affect us during the perimenopausal years. When so much feels unpredictable—mood changes, sleep disruptions, and fluctuating energy levels—it helps to know there’s at least one area where you can maintain a solid sense of control: your physical strength.

Teaming up with an exercise trainer might seem like a big decision, especially if you’re feeling unsure about where to start. But there’s a certain relief that comes from handing over the planning and technique to someone who knows the ropes. Instead of spending hours researching the best exercises or second-guessing your form, you can place your trust in a professional who tailors workouts to your needs and goals. It can feel like a weight has been lifted—both literally and figuratively. And when working out already takes enough willpower, having a skilled guide can be the difference between giving up and building lasting habits.

In perimenopause, the body goes through changes that make strength training more than just a fitness trend. It’s about preserving muscle, protecting bone density, and feeling confident in your day-to-day activities. When I started my own strength journey, I barely knew how to approach weight training. I was even told I had “dead butt syndrome” from sitting at my desk all day—basically, my glutes had stopped firing properly because I spent too much time on my chair instead of using those muscles regularly. My trainer helped me understand why this had happened and showed me how to correct it. The process was humbling at times, but it felt good to address weaknesses and work toward becoming stronger, steadier, and more comfortable in my own body.

Why Strength Training Matters in Perimenopause

Muscle mass tends to decline as we age. Hormonal shifts that occur during perimenopause can accelerate that process, making it trickier to hold onto the strength and tone we once took for granted. This loss of muscle, also known as sarcopenia, can lower metabolism, reduce energy, and affect how well we get around. Many of us notice that tasks we once did with ease—lifting a heavy box, carrying groceries, or climbing a flight of stairs—feel harder than they used to. Strength training helps counteract these changes, preserving muscle tissue so that everyday activities remain comfortable and safe.

But it’s not just about looking toned or feeling capable. Strong muscles support joints, improve posture, and help maintain balance. If you’ve ever worried about taking a fall or straining a back muscle while doing yard work, building strength can offer some peace of mind. It’s a practical form of self-care that supports long-term independence.

Importance of strength training in perimenopause

Protecting Your Bones

Another key reason to train with weights during perimenopause is bone health. Declining estrogen levels can contribute to bone density loss, raising the risk of osteoporosis. By loading the bones through weight-bearing activities and resistance training, we stimulate the body to maintain and even improve bone density. This can help reduce the chances of fractures down the road, making strength exercises a protective measure just as much as they are a fitness strategy.

Weightlifting, bodyweight exercises, and even certain forms of Pilates or yoga that require bearing your own body weight can encourage the bones to stay strong. With the guidance of a trainer, you can find the right intensity and progression to safely challenge your bones. It’s an investment in your future health and mobility, a way to help ensure that you remain active and independent as the years pass.

The Value of Working with a Trainer

Some of us grew up with the impression that physical fitness should be self-directed, almost like a moral test of willpower. But there’s no shame in seeking help from an expert—someone who has made it their job to understand biomechanics, exercise progression, and proper technique. A skilled trainer brings more than knowledge to the table. They bring a calm voice to reassure you when you’re unsure, a set of watchful eyes to correct your form, and a compassionate perspective when you need motivation.

Proper Form and Injury Prevention

One of the biggest benefits of working with a trainer is that they keep you safe. Proper form is everything. Even the strongest person can injure themselves by performing a movement incorrectly. A trainer can spot your tendencies—maybe you arch your back too much during a squat or let your knees cave inward when lunging. They will correct these habits before they lead to pain or strain. This is especially important as you learn new exercises or increase weights. Good form not only prevents injuries but also ensures you’re targeting the right muscles, making your workouts more effective and productive.

Accountability and Consistency

If you’re anything like many busy professionals, it’s all too easy to let exercise fall by the wayside when life gets chaotic. Scheduling regular sessions with a trainer can provide the structure you need. Knowing that someone is expecting you at the gym (or on a Zoom call, if you train virtually) creates a sense of commitment that is harder to break. This external motivation helps you maintain consistency, turning exercise from an occasional effort into a dependable routine.

Progression, Programming, and Tailored Guidance

A trainer does more than just cheer you on or critique your form. They handle the nuts and bolts of progression, choosing when to increase weight, vary exercises, or shift the number of sets and reps. By adjusting these variables, they keep your muscles challenged and prevent plateaus. One week you might focus on building strength, and another week you might work on endurance or hypertrophy to add muscle size. Over time, you’ll notice gradual improvements—in how much you can lift, how stable you feel during certain movements, and how quickly you recover from intense workouts.

Because your body changes over time—especially during perimenopause—an individualized exercise plan matters. A knowledgeable trainer will listen to your feedback about how you’re feeling, any new aches or pains, and when you feel particularly energized or fatigued. They’ll tweak your program so it remains aligned with your body’s evolving needs. This not only helps you progress more smoothly but also reduces frustration, making the entire process more sustainable.

My Own Experience: From Beginner to Feeling More Capable

I remember how I felt when I first started lifting weights. As a physician, I knew the benefits of exercise, but book smarts don’t always translate into practical know-how. I was self-conscious, unsure of what equipment to use or how to hold my body. That’s when I learned I had what’s affectionately termed “dead butt syndrome”—my glutes were not firing effectively, probably due to sitting for hours at my desk seeing patients. My trainer explained that I needed to re-engage those muscles through targeted exercises like glute bridges, hip thrusts, and carefully coached squats.

It’s not always fun to realize you have weaknesses, but it felt much better to face them head-on with a trainer’s support rather than remain in the dark. Over time, those inactive glutes woke up. Movements that once felt awkward started to flow more smoothly. I noticed better posture, less discomfort in my lower back, and more confidence when tackling daily tasks. When I travel or have busy weeks, I still rely on the exercise strategies I learned from my trainer. The routine they helped establish keeps me anchored, even when life gets hectic.

Practical Tips for Getting Started

Getting started with weight training in perimenopause

Find the Right Fit:

Your trainer’s personality and approach should resonate with you. Some people prefer a firm, disciplined style, while others respond better to a kind, encouraging demeanor. Whatever your preference, look for credentials and feel free to ask about their experience working with perimenopausal clients.

Be Honest About Your Goals and Limitations:

Let your trainer know about any aches, past injuries, or concerns. Share what you hope to get out of these sessions. Do you want to gain strength, support bone health, improve posture, or build confidence with weights? The more information they have, the more personalized your sessions can be.

Start Slowly:

Don’t worry if you feel like a “beginner,” even if you’ve exercised before. Starting slowly is smarter than jumping into an overly intense program. Your trainer can adjust the difficulty as you get stronger and more comfortable.

Ask Questions:

Never hesitate to speak up if you’re unsure why you’re doing a certain exercise or if something feels off. A good trainer will welcome your feedback and explain the reasoning behind each element of your workout.

Expect Changes Over Time:

As your body adapts, your trainer will change the exercises, add new movements, or increase resistance. This helps you continue making progress while preventing boredom. Remember, you don’t have to figure out these adjustments on your own. That’s what your trainer is there for.

Supporting Strength During Perimenopause

Perimenopause can stir up all sorts of emotions. You might feel a sense of loss as certain parts of your body change, or concern about what lies ahead. But this stage of life isn’t just about accepting decline—it’s also a time to find your footing in new ways. Strength training provides a means to support your body, maintain your mobility, and build a sense of confidence. Working with a trainer offers skilled guidance, reassurance, and the gift of not having to shoulder every detail by yourself.

As a physician, I’ve seen how beneficial it is for patients to feel confident in their ability to lift, move, and stand tall. As a woman who has gone through the self-consciousness of being a beginner, I’ve experienced the relief that comes from having someone knowledgeable at my side. My trainer not only helped me correct “dead butt syndrome” but also showed me that it’s never too late to learn new skills, strengthen neglected muscles, and care for my body in meaningful ways.

If you find yourself at this stage of life, wondering how to maintain—or even improve—your strength, consider seeking help from a professional. Let them handle the planning, form corrections, and progression of exercises. With guidance and encouragement, you can create a relationship with movement that leaves you feeling more assured and better equipped to handle whatever the next phase brings.

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Working with a Trainer During Perimenopause: Why Strength Matters and How Guidance Can Help