We’ve long been told that muscle loss, also known as sarcopenia, is a natural part of aging. But new evidence shows that menopause and muscle loss are closely linked, and the process starts much earlier than we thought.

A landmark study published in The Journal of Physiology followed women ages 18 to 80, measuring muscle tissue, hormone levels, and physical performance. The results back up what many women have noticed: A sharp decline in strength begins in your 40s when hormone changes speed up muscle loss.

Changes to bone and muscle health aren't talked about as widely as other menopause symptoms, yet about 71% of all women will experience menopause-related symptoms in their bones and muscles. The signs and symptoms range from decreased flexibility and muscle weakness to joint pain to more severe problems, such as adhesive capsulitis (more commonly known as frozen shoulder), that can cause severe pain and difficulty with movement.