Menopause. A word that carries so much weight in a woman’s life. A time characterized by physiological changes surrounding the loss of menses, or a regular monthly period for over one year (1). Symptoms during this time may include sweating and hot flashes, sleeping disorders, cardiac complaints, sexual discomfort, urinary frequency and leakage, as well as notable changes to bone mineral density. For some women, the loss of their menstrual cycle comes with a “good riddance” mentality, while for others it can be a time of grief with a feeling of loss of womanhood. 

Exercise is often a hot topic of conversation when it comes to menopause. What type of exercise should be prioritized? How can menopause impact exercise? And what ratio of strength training to cardio is the right amount?

Aunt Flow may no longer be visiting, but the time to start visiting the gym is now. Let’s chat about why in this blog.

Menopause and Exercise

The World Health Organization recommends 150 minutes of moderate physical activity per week or 75 minutes of vigorous physical activity per week. In addition, strength training should occur for all major muscle groups on two or more days during the week (1). And the truth is? These recommendations hold true even during and after menopause.

Here’s why this is so important…the notable decreasing levels of estrogen during menopause can cause bone mass loss which can then lead to osteoporosis (2). It’s no secret that strength training improves bone mineral density, yet what is even more compelling is the recognition that strength training alone may also positively impact hormonal and metabolic changes in menopausal women compared to those that are inactive (2). While we know that strength training can do wonders for overall health, did you know that hot flashes seemingly can be modified with consistent strength training during menopause?

 

READ: BEST EXERCISES FOR OSTEOPOROSIS

 

Time to break a sweat at the gym instead of breaking a sweat at 3 am. 

Aerobic exercise also has proven to be beneficial during perimenopause and menopause. A study assessing the impact of high intensity physical activity on menopausal symptoms found that greater exercise intensity resulted in a decrease of menopausal symptom severity, specifically the impact of urogenital symptoms, such as urinary leakage (1). High intensity exercise included activities that increased both heart rate and breathing rate; performed at least 3 days per week. Such activities included running, cycling, or tennis. Moderate intensity aerobic exercises also proved to be beneficial, but seemingly had to be performed at a greater frequency throughout the week. Such activities included swimming, recreational cycling, walking, or yoga which cause a slight increase in heart rate and breathing.

 

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Ready to get back in the gym but aren’t sure where to start? Our Home Fitness Program is designed for you! Made to be performed in the comfort of your home with a few pieces of equipment, you can get back to feeling confident with working out! Get started with a free 7-day trial today! 

 

A big concern for many during perimenopause and menopause is the changes that occur to the pelvic floor and the impact that those changes can have on willingness to exercise. You guessed it…urinary leakage. The loss of estrogen causes the muscles in the pelvic floor to weaken, and with that many women can experience urinary leakage with sneezing, coughing, laughing, lifting, jumping, or chasing their dog in the front yard. While urinary leakage is common during perimenopause and menopause, it does not have to be your new normal! Pelvic floor physical therapy has been proven to be effective in managing urinary incontinence both during perimenopause and menopause (4).

 

READ: PHYSICAL THERAPY AND PELVIC FLOOR EXERCISES: THE PERFECT DUO

 

Just a small plug for pelvic floor PT and exercising during menopause…don’t let incontinence keep you from exercising when we know how instrumental exercise can be in the management of menopausal symptoms. Do yourself a favor and find yourself a pelvic floor physical therapist who can guide you through strengthening not only your pelvic floor, but also strengthening your body out in the gym. Your hot flashes and panty liners will thank you.

 

So, what exercises should I be doing during menopause?

The honest answer…do it all! Ultimately we know that exercise is important during menopause but there is no perfect recipe. Research continues to support that a combination of both strength training and aerobic exercise should be implemented during perimenopause and menopause, and there is no confirmation that a certain type of strength training is better than others (2).

 

 

However, it should be highlighted that if strength training is not already a consistent part of your exercise regimen, perimenopause and menopause are a wonderful time to introduce it into your routine! Full body, challenging, and functional strength exercises are promising as they target many muscle groups at the same time and translate effectively into day to day activities. Check out a few of my favorites below! 

 

 

If you are perimenopausal or postmenopausal and unsure where to start, research has shown that guided exercise protocols demonstrate the most consistency and success. Do your best to incorporate 2-3 days of strength training into your week. These days should target every major muscle group and feel challenging enough to elevate both your heart rate and breathing. The remaining time should consist of aerobic exercise that also elevates both heart rate and breath. Not sure where to start? Check out all of our programs and workouts through the [P]rehab App to take the guesswork out of your workout routine!

 

LEARN MORE ABOUT OUR HOME FITNESS PROGRAM

 

Pickleball, running, walking, cycling, and yoga are all some great examples of potential activities that can be both enjoyable and productive when trying to get in those 150 minutes of moderate physical activity per week. Find what feels good for you and do it! 

 

Closing Thoughts

Menopause can come with a slew of varying emotions for many women. Some are happy to move past monthly visits with Aunt Flow, while others grieve the loss of their womanhood. While many women are emotionally coming to terms with menopause, the physical changes can also be troubling and challenging. Symptoms during this time may include sweating and hot flashes, sleeping disorders, cardiac complaints, sexual discomfort, urinary frequency and leakage, as well as notable changes to bone mineral density.

During a time when it feels like so much is changing, a consistent and comprehensive exercise routine can help to provide not only a bit of normality, but also can help to manage symptoms associated with menopause.

 

LEARN MORE ABOUT OUR HOME FITNESS PROGRAM

 

While there is no one perfect recipe for exercising during menopause, we do know that a combination of both strength training 2-3 times per week and aerobic exercise has proven to be very beneficial. Not only does high intensity exercise and strength training improve bone mineral density, but it also has been shown to decrease hot flash severity and improve menopausal symptoms. Need we say more?

It’s time to ditch the panty liners and sleepless nights and trade them in for a squat rack and a tennis game with friends. Goodbye Aunt Flow, hello fitness forward YOU. 

 

Resources

1. Dąbrowska-Galas M, Dąbrowska J, Ptaszkowski K, Plinta R. High Physical Activity Level May Reduce Menopausal Symptoms. Medicina (Kaunas). 2019 Aug 11;55(8):466. doi: 10.3390/medicina55080466. PMID: 31405242; PMCID: PMC6722698.
2. Capel-Alcaraz AM, García-López H, Castro-Sánchez AM, Fernández-Sánchez M, Lara-Palomo IC. The Efficacy of Strength Exercises for Reducing the Symptoms of Menopause: A Systematic Review. J Clin Med. 2023 Jan 9;12(2):548. doi: 10.3390/jcm12020548. PMID: 36675477; PMCID: PMC9864448.
3. Mohebbi R, Shojaa M, Kohl M, von Stengel S, Jakob F, Kerschan-Schindl K, Lange U, Peters S, Thomasius F, Uder M, Kemmler W. Exercise training and bone mineral density in postmenopausal women: an updated systematic review and meta-analysis of intervention studies with emphasis on potential moderators. Osteoporos Int. 2023 Jul;34(7):1145-1178. doi: 10.1007/s00198-023-06682-1. Epub 2023 Feb 7. PMID: 36749350; PMCID: PMC10282053.
4. Malinauskas AP, Bressan EFM, de Melo AMZRP, Brasil CA, Lordêlo P, Torelli L. Efficacy of pelvic floor physiotherapy intervention for stress urinary incontinence in postmenopausal women: systematic review. Arch Gynecol Obstet. 2023 Jul;308(1):13-24. doi: 10.1007/s00404-022-06693-z. Epub 2022 Jul 13. PMID: 35831758.

About The Author

Lyndsay Centrowitz, PT, DPT

[P]rehab Writer & Content Creator

Dr. Lyndsay Centrowitz graduated from Colorado State University with a BS in Health and Exercise Science and a concentration in Sports Medicine. After multiple personal sports-related injuries and discovering a passion for healing through movement, Lyndsay attended Creighton University to receive her Doctorate of Physical Therapy. An avid runner herself, she has a particular interest in working with high school, recreational, and elite endurance athletes and has undergone specialty training in pelvic floor rehabilitation, postpartum care, and management of the female athlete to better serve her clientele. Through this specialty training, she has acquired a Certificate of Achievement in Pelvic Health Physical Therapy through the American Physical Therapy Association.  Lyndsay now owns her own practice StrongHER in Park City, UT where she specializes in female athletics and care of pregnant and postpartum individuals. Additionally, Lyndsay is BSPTS C2 certified in scoliosis specific exercises and has found a niche working with adolescents with scoliosis to improve overall spinal health. No, you’re not seeing double! Lyndsay is an identical twin to Lauren Lynass, one of our [P]rehab rockstars. A native of Colorado, Lyndsay is an adventure seeker who loves to hike, camp, and race her twin sister on the mountain trails. When she isn’t exploring Park City’s outdoor playground, you can find her curled up with a cup of tea and a good book. Follow along @strongher_dpt on Instagram!

Disclaimer – The content here is designed for information & education purposes only and is not intended for medical advice.