The Preventive Role of Resistance Training in Perimenopausal Women: A Literature Review

Perimenopause is associated with profound hormonal fluctuations that accelerate musculoskeletal decline, fat redistribution, and metabolic dysfunction in women. These changes increase the risk of sarcopenia, osteoporosis, and metabolic syndrome—conditions that substantially impair quality of life and elevate long-term morbidity. Despite the proven health benefits of physical activity, resistance training (RT) remains underutilized in this population. This review aimed to evaluate the role of RT as a preventive strategy against age-related muscle loss, bone density reduction, and metabolic disorders in perimenopausal women. A literature review was conducted using articles sourced from PubMed and Google Schoolar. Eligible studies included randomized controlled trials, systematic reviews, and meta-analyses published between 2010 and 2025, focusing on the impact of RT on bone mineral density, muscle mass and function, insulin sensitivity, and body composition in perimenopausal populations. RT was consistently associated with improved muscle mass, strength, and functional capacity, reducing the incidence and progression of sarcopenia. High-intensity RT protocols (≥70% 1-RM) also led to significant improvements in bone mineral density at critical skeletal sites. Moreover, RT enhanced basal metabolic rate, reduced visceral adiposity, improved insulin sensitivity, and positively influenced lipid profiles and systemic inflammation. Adherence was higher in supervised, flexible, and socially supportive environments. RT is a potent non-pharmacological intervention that counteracts the adverse musculoskeletal and metabolic effects of perimenopause. Given its wide-ranging benefits and favorable safety profile, RT should be integrated as a foundational component of preventive healthcare strategies for midlife women. However, further high-quality research is warranted to refine population-specific protocols and improve implementation strategies.