07/30/2026
This is a conversation I have a lot in clinic. My patients loooove their Pilates. And that’s great! Pilates is a wonderful form of exercise. But if your goal in and around menopause is to maintain your bone density and muscle mass, Pilates is not the same as progressive strength training.
Bone and muscle respond to load.
To preserve them, your body needs to be challenged with resistance that is progressively increased over time. This is why current osteoporosis and exercise guidelines recommend progressive resistance training as part of a bone-healthy exercise program.
That doesn’t mean you should stop Pilates. Definitely not! Pilates has excellent evidence for improving core strength, balance, posture, mobility and physical function and these are incredibly valuable, especially as we age.
It just shouldn’t be mistaken for a replacement for lifting weights if your primary goal is preserving bone and muscle.
The good news? You don’t have to choose.
My ideal prescription for many postmenopausal women is:
✔️ Strength training at least twice per week
✔️ Regular weight-bearing activity such as walking or hiking
✔️ Cardio like running, cycling, or swimming on a weekly basis
✔️ Pilates if you enjoy it, for mobility, core strength, balance and movement quality
✔️At least 1 day a week off for rest
Exercise is one of the most powerful tools we have to support healthy aging. The key is matching the type of exercise to the outcome you’re trying to achieve.
Do you currently do Pilates, strength training, or both? I’d love to hear what’s working for you.