Resistance Training vs. Hormone Replacement Therapy: Can Training Offset Perimenopausal Hormonal Shifts?

Perimenopause is a hormonally dynamic transition characterized by erratic declines in 17-β-estradiol, leading to a wide array of physiological and psychosocial symptoms that can significantly impact quality of life. While hormone replacement therapy (HRT) is effective for many, it is not a viable option for all due to medical contraindications and potential risks. This commentary explores resistance training (RT) as a non-pharmacological alternative for managing perimenopausal symptoms. RT has demonstrated benefits in mitigating metabolic dysfunction, improving mood and cognitive health, and potentially alleviating vasomotor symptoms through mechanisms that partially mimic estrogen’s effects. Despite these promising outcomes, RT remains underrepresented in perimenopausal research compared to other exercise modalities. Future studies are needed to assess the effectiveness of RT alone and in combination with HRT to better inform evidence-based strategies for improving female health during this critical life stage.