The Missing Link in Menopause Research: Where Are the Active Women?

We keep hearing the same headlines: "HRT increases risk of X" or "reduces risks of Y" "Hormones aren't a magic fix." "Natural is better."

But here’s the thing no one seems to be asking: Where are the active women in these studies?

Because when you look closely, the research being cited by "natural wellness" influencers, nutritionists, and even some medical professionals is almost always based on general population data. Not athletes. Not women who lift. Not women who run, sprint, hike, or push sleds for fun.  And certainly not an athlete in surgical menopause!

The women we coach? They aren’t sedentary. They aren’t afraid of progressive overload. They’re not skimming through peri/menopause hoping to survive on bone broth and vibes. They’re training with intention.

And that changes everything.

Most studies linking HRT to osteoarthritis or other joint-related issues:

• Don’t account for muscle mass, joint mobility, or movement quality

• Don’t separate by activity level or strength training habits

• Rarely distinguish between oral vs transdermal hormone therapy

• Treat women as a monolith instead of diverse movers with different demands on their bodies

Which means these studies are missing critical context for interpreting risk.

Women who progressively lift:

• Build stronger connective tissue

• Improve joint loading mechanics

• Develop better force absorption

• Maintain or increase lean mass—a protective factor for bones and joints

So when you put a woman on HRT and she’s lifting smart, eating well, and recovering with intention? Her risk profile for joint breakdown looks nothing like the general population.

And yet, she’s still being lumped in with it.

The data being used to fearmonger around HRT and joint health isn’t useless—but it’s incomplete. It paints a picture without half the color.

We need studies that:

• Include athletic, active women across the age and menopausal spectrum

• Differentiate by training modality, intensity, and duration

• Factor in lifting history and movement skill

• Examine the synergistic effects of HRT and strength training on joint and connective tissue health

• Consider who conducted the research and why

• Disclose the source of funding and any potential bias in study design or reporting

Until then, we’re making broad assumptions that don’t serve the very women who are most proactive about their health.

1. Who was included in the study population?

2. Were women stratified by activity level or training history?

3. Was the type and delivery method of HRT specified (oral vs transdermal)?

4. Did the study account for strength training or resistance-based exercise?

5. Were there any pre-existing joint issues or injuries in the group?

6. Was BMI, body composition, or lean mass considered?

7. How was osteoarthritis or joint degeneration diagnosed—imaging, self-report, or medical record?

8. Were surgical menopause or premature ovarian insufficiency accounted for?

9. Was this study observational or experimental (RCT)?

10. Who conducted the study, who funded it, and what narrative does it conveniently support?

Asking these questions doesn’t make you contrarian. It makes you critical. And critical thinking is what cuts through fear-based narratives that reduce women to fragile, hormone-fearing bystanders.

Maybe the problem isn’t that women in menopause are being misrepresented in research… Maybe it’s that they’re being erased by a system that never expected them to still be this strong, this active, or this damn loud.

Instead of asking for inclusion, maybe it’s time to start disrupting.

Because the default woman in most studies? She’s sedentary, thin, postmenopausal by age, not surgery. She’s not lifting. She’s not fueling. She’s not thriving—she’s quietly declining.

And athletic, well-fueled, high-performing women in menopause? We challenge all of that.

Maybe that’s why we’re not included. Not because we don’t exist—but because we complicate the narrative.

We’re not just surviving menopause. We’re rebuilding our strength. Reclaiming our energy. And calling out the weak science pretending to represent us.

So no, we’re not outliers. We’re the new baseline.

Before you throw out another "HRT causes joint degeneration" soundbite, ask yourself:

• Was that study looking at women who train like athletes?

• Was it considering the effect of load, recovery, and neuromuscular control?

• Or was it just another cohort of underfed, under-muscled, under-supported women trying to survive a hormonal shift without the tools they need?

Women are more active than ever. The research needs to catch up.

And until it does, we’ll keep training, keep fueling, keep advocating, and keep calling out the half-truths masquerading as health advice.