A novel urine biomarker identified significant differences in muscle health between menopausal and nonmenopausal women, based on data from 113 individuals.

Menopause is known to accelerate muscle loss because of hormonal changes, especially declining estrogen levels, but current identification of muscle deterioration is mainly limited to DEXA scanning, which is expensive, often inaccessible, and impractical for routine monitoring, according to Rafaela Andrade-Vieira, PhD, of Dalhousie University in Halifax, Nova Scotia, Canada, and colleagues.

In a poster presented at The Menopause Society 2025 Annual Meeting, the researchers evaluated whether biomarkers could detect differences in muscle health between menopausal and nonmenopausal women and found that urine biomarkers identified early-stage sarcopenia.

The researchers collected urine samples from 85 menopausal and 28 nonmenopausal women after overnight fasting. They identified five key metabolites related to muscle metabolism and used a proprietary algorithm to combine biomarker concentrations into a single muscle health score for each study participant.

The biomarker-based test showed a 91% concordance rate with DEXA for detecting sarcopenia. Based on the biomarker, muscle health scores were significantly lower in menopausal vs nonmenopausal women (44.21% vs 53.98%, P = .003).

In addition, menopausal vs nonmenopausal women had significantly lower markers associated with protein building (89.95 μM vs 189.01 μM, P < .0001) and significantly higher markers of oxidative stress (99.87 μM vs 52.67 μM, P < .001).

Menopausal vs nonmenopausal women also had significantly lower concentrations of markers involved in fatty acid metabolism, based on the urine biomarkers (1.98 μM vs 6.04 μM, P < .0001).

The findings showed an association between menopause and measurable changes in muscle health, and interventions based on diet and exercise recommendations helped improve overall muscle health scores over time, the researchers noted in their abstract. A noninvasive urine-based biomarker panel was able to detect these changes accurately and offers a practical and accessible tool for early identification of muscle deterioration, which may support other proactive clinical strategies, the researchers said.

In clinical practice, the study results may support the creation of personalized dietary recommendations targeting muscle protein synthesis, energy metabolism, and oxidative balance based on individual biomarker profiles as a way to help preserve muscle health during menopause, the researchers wrote.

“Building on this foundation, the study also laid the groundwork for developing a rapid, at-home test that enables women to assess their muscle health and receive a tailored action plan, empowering early intervention and personalized care,” they concluded.

Potential Value in Exploring Muscle Changes

Understanding the dynamic muscle changes that occur in midlife and menopause could be useful, said Stephanie Faubion, MD, medical director for The North American Menopause Society, in an interview.

“We know that there are bone and muscle changes associated with menopause and aging,” said Faubion, who was not involved in the study.

However, the findings were limited by the small sample size, Faubion said. Looking ahead, more research is needed to clarify measurements of muscle health for the results to have clinical implications, she added.

The study was supported by the National Research Council of Canada and Atlantic Canada Opportunities Agency. Andrade-Vieira disclosed having no financial conflicts of interest.

Faubion disclosed having no financial conflicts of interest.