Sarcopenia in Menopausal Women: Prevalence, Risk Factors, Hormonal Mechanisms, and Management Strategies.

Sarcopenia, an age-related loss of muscle mass and function, represents a significant musculoskeletal condition in menopausal women, affecting up to 80% of those with musculoskeletal complaints, and poses a growing public health concern in India where 71% of the population lives in rural areas with high prevalence of risk factors like poor nutrition and physical inactivity. This systematic review aimed to examine the prevalence, risk factors, hormonal mechanisms, and management strategies for sarcopenia in menopausal women, with emphasis on implications for maternal health and preventive interventions. A literature search from 2015 to 2025 was conducted via PubMed and Google Scholar using terms such as sarcopenia, menopausal complaints, and preventive measures, including only original, peer-reviewed, English-language full-text articles relevant to menopause and sarcopenia. From 92 identified articles, 12 met the criteria, revealing sarcopenia prevalence in India ranging from 10% to 43.6%, higher in rural settings and among diabetics. Hormonal declines in estrogen, testosterone, dehydroepiandrosterone (DHEA), progesterone, and growth hormone (GH)/insulin-like growth factor 1 (IGF-1), coupled with increased cortisol, contribute to muscle loss. Effective interventions include protein intake of 0.8-1.2 g/kg/day, vitamin D supplementation of 800-1000 IU/day, physical activity comprising 150 min/week of aerobic exercise plus resistance training, and hormone therapy. Maternal complications encompass elevated fall risk and physical disability, which indirectly impact fetal health in perimenopausal pregnancies. Overall, sarcopenia in menopausal women demands heightened awareness and targeted interventions, especially in rural India, with future research needed on biomarkers and optimized protocols.