Exercise in perimenopause and menopause

Exercise in perimenopause and menopause
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Should you change how you exercise in perimenopause and menopause? Not necessarily. But there are some key things to consider as your estrogen declines. And that’s especially true if you’re just starting out or challenging yourself with more intense workouts.

Body composition changes in perimenopause and menopause

Around perimenopause and into menopause, declining hormones can affect body composition. Low progesterone and estrogen tend to show up as weight gain around the abdomen. Sometimes, the scale doesn’t even shift for you to notice differences. Even if you maintain your weight, fat storage may shift from the lower body to the belly.

When clothes fit differently or you see your body changing, it can be upsetting and frustrating. To combat weight gain or as part of an overall health refocus, many women decide to start working out for the first time or to push themselves harder during these stages of life.

Things to consider when starting or increasing exercise in perimenopause and menopause

Being active is a great way to ward off stress, get stronger, and feel healthier. But anyone with chronic health conditions (or at risk for chronic health conditions) will want to consider a few key factors before starting a new workout.

Check on the side effects of any meds you’re taking

It’s always a good idea to check in with a professional before starting a fitness program or regimen. This is true for a number of reasons. But, as we age, it’s more likely we’re dealing with at least one chronic health condition or taking some type of medication. Getting the go-ahead for activity becomes extra important. (For example, anyone taking meds for hypertension needs to aim for a lower target heart rate than those not on hypertensive medication.)

Work with a trainer on cardio and strength training

For clients in perimenopause or menopause, I recommend an exercise regimen that includes strength training, steady-state cardio, and flexibility components combined with balance.

Whether you use body weight, resistance bands, or weights, including strength training in your workout is vital. After age 30, you lose between 3–5% of muscle mass with each decade. Building muscle mass becomes a big help to keeping your metabolism high, minimizing weight gain, and maintaining bone density.

Most women can safely aim for at least 30 minutes of aerobic exercise daily that gets their heart rate elevated. But, because low estrogen decreases bone density, ask your provider about high-impact cardio exercise. If you’re at risk for osteopenia or osteoporosis, you’ll want to stick to low-impact exercises, like walking, swimming, or biking. All three of these activities can be turned into low-impact HIIT workouts by combining fast and slow intervals. HIIT workouts are great for fat loss, building muscle, increasing endurance, improving thyroid function, and promoting positive gene expression.

Stay flexible and work on balance with yoga

Studies have found that consistent yoga can boost estrogen levels in menopausal women and help with symptoms. (Some women report relief from hot flashes and other vasomotor symptoms, which may be from reduced stress.) But, along with the more obvious benefit of flexibility, yoga helps with balance, which is a good way to improve strength and stability.

Many yoga poses engage the abdomen and pelvic floor muscles, which naturally weaken as we age. Pelvic floor disorders cause pain and other symptoms and affect nearly 27% of women between the ages of 40 and 59.

Making the time to exercise

In addition to the inward hormonal changes during perimenopause and menopause, these stages of life are often so outwardly busy and chaotic. Many women are raising children, managing careers, and caring for themselves and their families. Making the time to exercise can seem impossible, but time-blocking can help you squeeze it into your schedule. No matter what brings you to want to start or increase your exercise regimen, make sure to pick activities that are not only right for your body but that you also enjoy.

Rachel Rotabi, PT, PN L1, AFMC L1
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