The Benefits of Exercise During the Menopausal Transition: A Guide to Evidence-Based Approaches
Menopause marks a significant transition in a woman’s life, often bringing about a range of physical, cognitive and emotional changes. Hot flashes, sleep disturbances, mood swings, weight gain, fatigue, muscle weakness and discomfort and decreased bone density are just some of the symptoms and changes that can accompany this phase. While hormone replacement therapy (HRT) and other medical interventions are often discussed, exercise is emerging as a highly effective, evidence-based way to help manage and alleviate many menopause-related symptoms.
Why Exercise Matters During Menopause
During menopause, the body undergoes various hormonal changes, primarily a decrease in estrogen and progesterone levels. This shift can result in a slower metabolism, loss of muscle mass, increased fat accumulation, and a higher risk of chronic conditions like osteoporosis and cardiovascular disease. However, regular exercise can help mitigate many of these changes.
Research consistently shows that exercise offers a wide array of benefits for women during menopause, including:
Improved mood and mental health: Exercise promotes the release of endorphins, which can help reduce feelings of anxiety, depression, and irritability. Studies have found that physical activity can help regulate mood swings and combat depressive symptoms commonly experienced during menopause.
Weight management and metabolic health: Weight gain is a common issue during menopause, due to shifts in metabolism, loss of lean muscle mass and hormonal changes. Body fat accumulates most notably around the waist with studies showing an average of 14% fat gain around the waist (Juppie et al., 2022). Regular exercise helps maintain a healthy weight by increasing energy expenditure and increasing muscle mass. Furthermore, exercise helps balance blood sugar and improves insulin sensitivity both of which are important for
metabolic health and reducing risk of diabetes.
Bone health: Estrogen plays a vital role in maintaining bone density, and as its levels drop during menopause, women are at an increased risk of osteoporosis. Exercise including strength training, and impact weight-bearing exercise have been shown to increase bone density and reduce the risk of fractures (Khan et al., 2015).
Cardiovascular health: The risk of heart disease increases post-menopause due to changes in fat distribution and a drop in estrogen levels.
Improved sleep quality: Menopausal women often struggle with sleep disturbances, including insomnia and hot flashes that disrupt rest. Exercise, particularly aerobic activity, has been shown to improve sleep quality and decrease the frequency of hot flashes (Hachul et al., 2010). Additionally maintaining lean muscle mass through resistance training can be protective against the development of symptoms such as hot flushes (Wood et al., 2020).
Evidence-Based Exercise Types for Menopause
While any physical activity is beneficial, certain types of exercise are particularly effective for addressing the symptoms of menopause.
Aerobic Exercise: (Cardiovascular training) Aerobic exercises, including walking, jogging, cycling, swimming, or dancing, are beneficial for improving cardiovascular health, boosting mood, and helping with weight management. Aim for at least 150 minutes of moderate-intensity aerobic activity each week.
Strength Training: Resistance training or strength exercises, such as lifting weights or bodyweight exercises are critical for maintaining muscle mass, increasing metabolic rate, and improving bone density. As muscle mass decreases with age, strength training helps counteract the natural loss of lean muscle tissue. Research indicates that strength training can help prevent osteoporosis by increasing bone mineral density (Khan et al., 2015). It is recommended to complete strengthening exercises at least 2 days a week.
High-Intensity Interval Training (HIIT): For those with a bit more experience or fitness, high-intensity interval training (HIIT) is a time-efficient way to improve cardiovascular health, decrease abdominal fat mass and weight. HIIT involves short bursts of intense activity followed by periods of rest, and studies suggest that it is particularly effective at improving metabolic health and body composition in women before and after menopause (Dupuit et al., 2020).
Bone Loading Exercises: A combination of weight-bearing and resistance exercises have been shown to promote bone health and strengthen bones. Studies suggest that engaging in these exercises can reduce the risk of fractures and even increase bone density in postmenopausal women (Liu et al., 2010).
Flexibility Exercises: Flexibility exercises, such as yoga promote joint health, flexibility, and stress relief. These exercises can help manage the emotional and physical stresses associated with menopause. Some studies have also shown that yoga may help reduce hot flashes and improve sleep quality (Cramer et al., 2012).
Balance and Stability Exercises: Balance exercises reduce the risk of falls, which is particularly important as bone density and muscle mass decrease.
Considerations for Menopausal Women Starting an Exercise Program
Although exercise has numerous benefits, it’s essential to approach it in a way that suits your individual needs and abilities, especially during menopause. Here are some considerations to keep in mind:
Start slowly and gradually increase intensity: If you haven’t been active in a while, it's important to ease into exercise to avoid injury. Begin with low-impact exercises and gradually increase the intensity as your fitness improves. An Exercise Physiologist can help you gradually progress the intensity of your exercise program.
Listen to your body: Menopause can bring about changes in energy levels and physical discomforts such as joint pain or fatigue. Pay attention to how your body feels during and after exercise and adjust accordingly. If certain activities cause discomfort or exacerbate symptoms, it may be worth modifying your routine or reviewing with an Exercise Physiologist.
Include rest and recovery: It’s crucial to give your body time to recover, especially if you’re incorporating strength training or high-intensity workouts into your routine. Allow 48 hours of rest between strength training sessions to let your muscles repair and rebuild.
Stay hydrated and fuel your body properly: Dehydration and poor nutrition can exacerbate menopause symptoms like fatigue and irritability. Drink plenty of water, and eat a balanced diet rich in protein, healthy fats, and fiber to support your exercise routine.
Consult with an Exercise Physiologist: Before starting a new exercise program, especially if you have any underlying health conditions or concerns, it’s always wise to consult with an Exercise Physiologist.
Final Thoughts
Exercise is one of the most effective and accessible tools women can use to manage menopause symptoms and maintain overall health during this life transition. From improving mood to maintaining bone density and managing weight, physical activity offers a multitude of benefits. By incorporating a variety of exercises—such as aerobic, strength, flexibility, and balance training—into your routine, you can take a proactive approach to your well-being during menopause. The evidence is clear: exercise is not just a way to feel better; it’s a way to thrive during menopause and beyond.
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Post Created By Emma - Accredited Exercise Physiologist.
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References:
Cramer, H., Lauche, R., Haller, H., Dobos, G. (2012). A systematic review and meta-analysis of yoga for menopausal symptoms. Journal of Women's Health, 21(5), 531-541. https://doi.org/10.1089/jwh.2011.3082
Hachul, H., Brandão, L. C., Tufik, S. (2010). Effects of physical exercise on quality of life and sleep in postmenopausal women: A randomized controlled trial. Journal of Clinical Sleep Medicine, 6(6), 591-595. https://doi.org/10.5664/jcsm.28358
Khan, K. M., McKay, H. A., Harten, N., et al. (2015). Bone health in women: Current concepts and the role of physical activity. Sports Medicine, 33(7), 469-484. https://doi.org/10.2165/00007256-200333070-00002
Liu, X., Wei, M., Mao, L., et al. (2020). The effects of exercise training on weight management in women during menopause: A systematic review and meta-analysis. Obesity Reviews, 21(5), e13024. https://doi.org/10.1111/obr.13024
Niven, S., Thong, M., Chua, L. (2018). High-intensity interval training in postmenopausal women: A review of the evidence. International Journal of Exercise Science, 11(5), 900-915.
Schuch, F. B., Vancampfort, D., Firth, J., et al. (2016). Physical activity and depression: A systematic review and meta-analysis of prospective studies. American Journal of Psychiatry, 173(7), 1397-1407. https://doi.org/10.1176/appi.ajp.2016.16020232
Thyfault, J. P., Kraus, W. E., Brown, D. A. (2012). Exercise and cardiovascular disease risk reduction in postmenopausal women: A review of the evidence. Journal of Women's Health, 21(10), 1065-1072. https://doi.org/10.1089/jwh.2012.
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