Menopause is the cessation of menstruation and is defined as 12 consecutive months since the last period. During the transition into menopause (perimenopause), the body goes through many physiological changes. In particular, the hormone estrogen starts to decline, and typical menopausal symptoms start to occur: think hot flashes, mood changes, fatigue, headaches, sleep disturbance, and muscle/joint aches. The last thing that is probably on a lot of women’s minds throughout this period is exercise when, in fact, it should be at the forefront.
Why should we exercise during menopause?
A decline in estrogen can, as well as cause the symptoms listed above, pose long term complications if certain lifestyle modifications are not employed. Estrogen helps to maintain and build bone, and the reduction of this hormone throughout the menopausal period increases the risk of osteoporosis. Osteoporosis causes the bones to become weak and brittle and increases the chances of a serious injury when there is impact to the skeleton, such as during a fall. Reduced estrogen levels can also slow the metabolism leading to weight gain, which can increase the risk of diabetes and heart complications. Exercise helps to cancel out these effects and others by:
Increasing/maintaining bone density
Improving/maintaining muscle mass and strength
Helping to create a calorie deficit to minimise weight gain
The symptoms of menopause (listed above) can also have a drastic effect on quality of life. Exercise can help to improve quality of life in these ways:
Stress relief/being better able to cope with stress
Improved mood/confidence/body image
Increased energy levels
Reduced levels of depression
Increasing heart and lung function (overall fitness levels)
Reduce lower back pain
Along with the above, exercise (particularly high intensity) can also help to reduce the amount and severity of hot flashes. Exercise can improve your body's ability to direct blood flow to your skin surface, making your body more efficient at cooling itself down.
What type of exercise?
Aerobic (“cardio”): Aerobic training (such as walking, running, cycling, swimming) is beneficial for cardiorespiratory health – reducing blood pressure, resting heart rate, and reducing the risk of cardiac events. This can also help to negate the negative effects on metabolism that a reduction in estrogen has by creating the caloric deficit required to minimise weight gain. The exercise should get your heart rate up but not leave you breathless or exhausted. For beginners, start small and build it up gradually. Even a 10 minute walk can have its benefit. Take note that cycling and swimming do not load the skeletal system enough to help strengthen the bones and muscles, but they are great for cardiorespiratory fitness and metabolism. If you have been diagnosed with osteoporosis then avoid any jumping or high impact movements.
Strength Training: This is vital to maintain your muscle and bone health. Strength training can be completed using free weights, machine weights, or even bodyweight. Be sure to train the full body (muscles of the upper and lower body, and also the core). Choose a weight that you can complete for 12 reps with correct technique and form, and increase gradually. If you have been diagnosed with osteoporosis, machine weights are a safer option for resistance training than free weights. With osteoporosis it is also safer to avoid any heavy twisting or forward flexing (e.g. sit ups) as they place additional stress on the spine. Complete strength training 2-3 days per week, with at least one day of rest in between.
Stretching, stability and balance: It is important to improve flexibility, reaction times and balance to reduce the risk of falls and the injuries associated with them. Balance exercises can be as simple as balancing on one leg whilst waiting for the jug to boil (make sure you are close to something that you can hold on to if needed).
Stretching improves flexibility and mobility that tends to decrease with age. Focus on your breathing when stretching as this can help to negate the anxiety/mood disturbances that can be associated with perimenopause (yoga/pilates classes can be great for this). Focus on keeping good posture whilst doing these exercises to promote strengthening of the muscles surrounding the spine that stop the shoulders rounding over. If you have been diagnosed with osteoporosis, avoid exercises involving quick reaction times and that could increase the risk of falls, but do add safe exercises to enhance reaction skills that are seated or do not require you to change direction too quickly.
Lastly, make sure you find an exercise that you enjoy! Consistency is key and by doing something you enjoy you are more likely to stick to it and reap the benefits. Exercise with a friend, try exercise classes, try something new, and don’t be afraid to switch things up! Set goals, but make these achievable and realistic. It is never too late to start, so find the exercise that works for you, and if you need help then seek out an expert such as a clinical exercise physiologist.