Your Hormones & Autoimmune Disease: Why Strength Training Might Matter Even More

What if your workout is doing more than building muscle?

We tend to think of exercise as something we do to burn calories, change our body composition, or get stronger.

But your muscles are actually part of a much bigger conversation happening inside your body—one involving metabolism, hormones, inflammation, insulin sensitivity, bone health, brain health and healthy aging.

And one hormone pathway that deserves more attention as we move through menopause and beyond is DHEA → testosterone → estrogen and other sex steroids.

Let’s break it down.

First: What exactly is DHEA?

DHEA stands for dehydroepiandrosterone.

It is produced primarily by your adrenal glands and is often described as a prohormone—basically, a building block your body can use to produce other steroid hormones.

DHEA can be converted through several pathways into androgens, including testosterone, and into estrogens. After menopause, peripheral tissues become particularly important sites for producing sex steroids from adrenal precursors such as DHEA. (PubMed)

And here’s something that matters:

DHEA declines as we age.

So does testosterone.

And while we often talk about estrogen during menopause, testosterone doesn’t suddenly become irrelevant just because estrogen has dropped.

Testosterone is involved in things like muscle and bone physiology, sexual function, energy and overall body function.

Menopause AND andropause involve changes in testosterone

Women experience a dramatic decline in ovarian estrogen production during menopause, while androgen levels—including testosterone and DHEA—also change with age.

Men experience a more gradual age-related decline in testosterone, sometimes referred to as andropause, although it isn’t a direct male equivalent of menopause.

Here’s where things get interesting:

Your hormones and your muscles have a two-way relationship.

Hormones influence your ability to build and maintain muscle.

And your muscles influence your metabolic and hormonal environment.

That means your workout isn’t just about what happens during the workout.

It’s also about what your body becomes capable of doing because you train.

So… does exercise increase DHEA?

Potentially—but let’s be precise.

Research isn’t strong enough to say that every woman who exercises will significantly increase her DHEA.

The evidence is actually mixed.

A systematic review of exercise training in adults over 40 found that many studies reported increases in testosterone and DHEA with exercise training in both men and women. (PubMed)

But research specifically examining postmenopausal women has found conflicting results for DHEA/DHEA-S. Resistance training appears more consistently associated with increases in testosterone than aerobic exercise, although results aren’t uniform. (PubMed)

In other words:

Exercise isn’t a guaranteed DHEA supplement.

But regular training can create an environment that supports healthy hormone regulation, metabolic health and physical function.

And that is a very different—and much more useful—message.

And this is where I really want women over 40 to pay attention…

Because we have spent decades being told that the answer to aging is:

Eat less.
Do more cardio.
Burn more calories.
Get smaller.

But what if the goal isn’t simply to become smaller?

What if the goal is to become more metabolically resilient?

More muscle.

More strength.

Better insulin sensitivity.

Better cardiovascular fitness.

Stronger bones.

Better physical function.

And a body that has the capacity to adapt to stress.

That is where resistance training becomes incredibly important.

A 2023 systematic review and meta-analysis found that resistance training in postmenopausal women can improve functional capacity and may improve bone mineral density and some menopausal symptoms, although the researchers rated the certainty of much of the evidence as low or very low. (PubMed)

Another 2024 meta-analysis found substantial improvements in upper- and lower-body strength and aerobic capacity among postmenopausal women participating in resistance training. (PubMed)

That’s not about chasing a smaller body.

That’s about building a body that can age well.

But what about autoimmune disease?

This is where we need to be careful.

You may hear claims that low testosterone causes autoimmune disease.

That’s too simplistic.

There is evidence that sex hormones—including testosterone, estrogen and DHEA—interact with the immune system, and researchers have observed differences in hormone profiles and immune responses across various autoimmune conditions.

But autoimmune disease is incredibly complex.

Genetics, immune regulation, environmental exposures, infections, sex hormones, age, metabolic health and many other factors can all play roles.

So we shouldn’t tell someone:

“Your testosterone is low, therefore you have an autoimmune disease.”

Or:

“Lift weights and you’ll cure your autoimmune disease.”

That’s simply not supported by the evidence.

But here’s the more scientifically defensible—and arguably more empowering—message:

Exercise can influence several systems that are relevant to immune and inflammatory health.

Regular physical activity can improve metabolic health, cardiovascular fitness, insulin sensitivity, body composition, sleep and physical function.

And skeletal muscle isn’t just tissue that moves your body.

It is metabolically active tissue that communicates with the rest of your body through signaling molecules called myokines.

So when you train your muscles, you’re not just burning calories.

You’re sending signals throughout your body.

Your muscles are part of your endocrine system.

Think about that for a second.

Your muscles aren’t simply there to make your arms look toned.

They’re metabolically active tissue.

They help your body handle glucose.

They support bone.

They help maintain physical independence.

They contribute to metabolic health.

And exercise creates a cascade of signals throughout the body.

This is one reason I don’t want women entering menopause to respond by simply eating less and doing more cardio.

You need to build.

Build muscle.

Build strength.

Build capacity.

Build resilience.

And there’s another important piece: stress.

Because more exercise isn’t automatically better.

If you’re under-fueled, chronically stressed, sleeping poorly and hammering yourself with high-volume exercise, your body isn’t necessarily going to respond by becoming hormonally optimized.

Your body needs:

training + recovery + adequate nutrition + sleep + stress management.

That’s the equation.

Not:

exercise harder + eat less = better hormones.

So can working out help your hormones?

Yes—but don’t think of exercise as a hormone replacement therapy.

Think of it as one of the most powerful lifestyle tools you have for supporting the systems that influence healthy aging.

Resistance training can help you preserve and build muscle.

It can improve strength and physical function.

It can support bone health.

It can improve metabolic health.

And research suggests exercise can influence androgen hormones, including testosterone and DHEA, although the response varies considerably between individuals and types of training. (PubMed)

And if you have an autoimmune condition?

Exercise may still be an important part of your overall health strategy—but your program should be individualized to your condition, medications, symptoms, recovery capacity and medical guidance.

And here’s my biggest takeaway…

Don’t wait until your hormones decline to start taking care of the body that produces and responds to them.

Don’t wait until you lose muscle.

Don’t wait until your bones become fragile.

Don’t wait until your energy disappears.

Don’t wait until you feel like your body has suddenly become foreign to you.

Start building your physiological reserve now.

Lift weights.

Eat enough protein.

Fuel your training.

Move your body.

Sleep.

Manage stress.

Recover.

And stop thinking of exercise as punishment for what you ate.

Your workout isn’t something you do because you need to burn off dinner.

Your workout is an investment in the woman you’re going to be 10, 20 and 30 years from now.

Because longevity isn’t simply about adding years to your life.

It’s about having the strength, energy, metabolic health and physical capacity to actually live those years.

And that?

That’s why I lift.

Lift, Love, Laugh... Live Longer

Lisa