How to Exercise Effectively in Perimenopause and Menopause

The onset of perimenopause and the years before menopause bring significant hormonal shifts that can affect energy levels, muscle mass, bone density, and metabolism. For avid fitness fiends, this stage of life might be a good time to change your workout routines to address some of these symptoms.

If you’re new to fitness or have fallen out of habit, even just committing to walking a few times a week can help counter some of the ways menopause changes your body. “We all have different abilities and bodies, so fitness looks different for everyone. In menopause, whatever gets you moving more than you used to is a good recommendation,” says Jacqueline Mercedes Sanchez, M.D., a gynecologist with the University of Miami Health System.

The national recommendation for exercise is 150 minutes a week. For women in perimenopause and menopause, modifying your workout routine to include more weight training and walking, for example, can help address some of the physical changes that come with this stage of life.

Middle-aged women benefit from more strength training and walking

Changing or increasing your exercise routine at any time is challenging – especially if your body’s already in hormonal flux. Dr. Sanchez recommends making your fitness plan social to keep you motivated and connected to others. “This transition in life can sometimes feel lonely. A gym can serve as a social club that we may be lacking. Adding an extra layer of community has the added benefit of helping you feel better,” she says.

The following are six ways to adapt your exercise routine for maximum benefit before, during and after menopause.

1. Prioritize strength training

As your estrogen levels decline, muscle mass decreases. This can lead to a slower metabolism and increased body fat –– especially in your midsection. Strength training helps counteract these effects by preserving and building muscle.

Even taking breaks during your work day to do squats or planks can help you build muscle mass over time.

• Aim for 2-4 strength training sessions a week.
• Target multiple muscle groups by focusing on compound movements such as squats, deadlifts, lunges and push-ups.
• Gradually increase weights or resistance bands.
• If weights aren’t available, incorporate bodyweight exercises like planks and stepping up and down a stair.

2. Add high-intensity training to your workout

Your metabolism slows with age, which is why so many menopausal women experience weight gain. Mixing up your workout routine with a high-intensity interval training (HIIT) class that includes quick bouts of cardio with strength training can help boost metabolism, improve cardiovascular health and maintain lean muscle.

Women post menopause are at higher risk for cardiovascular disease due to lower estrogen levels. Prioritizing workouts that increase your heart rate can help improve your heart health overall.

• Perform 20-30 minute HIIT sessions 2-3 times per week.
• If you’re a runner or a power walker, you can add spurts of high intensity to your routine by running or walking up a hill or adding speed training to your regular workout.
• Alternate between short bursts of high-intensity effort (30-45 seconds) and recovery periods (15-30 seconds).
• If you can’t get to the gym, apps like Nike, Peloton and YouTube have great HIIT classes on demand.

3. Prioritize joint- and bone-friendly cardio

Lower estrogen levels can affect joint and bone health, increasing stiffness and discomfort. Low-impact cardio options help protect your joints and bones while maintaining cardiovascular fitness.

Meanwhile, the risk of osteoporosis increases post-menopause due to declining bone density.

• Brisk walking, cycling, rowing or swimming are all great cardio workouts that are easy on your joints. Hiking, dancing or even taking the stairs instead of the elevator can help you maintain strong bones and joints.
• Weight training helps you maintain strong bones.
• Resistance bands can help you add load without the extra strain.

In addition to exercise that supports bone and joint health, Dr. Sanchez recommends daily calcium and vitamin D supplements. The recommended daily intake is 1,000 mg of calcium before age 50 and 1,200 mg after 50, with 1,000 IU of vitamin D.

4. Focus on flexibility

Hormonal changes and aging can lead to stiffness and reduced flexibility. Stretching can counter this by enhancing your movement range and preventing injuries.

• Consider adding daily stretching to your morning or night routine, focusing on your hips, shoulders and spine.
• Adding a yoga or Pilates class can be a fun, social way to  improve flexibility, balance and core strength.
• Use a foam roller to relieve muscle tightness.

5. Manage stress with mindfulness activities

Menopause can increase cortisol levels, contributing to fat gain, sleep disturbances and anxiety. Mind-body exercises can help regulate stress and promote relaxation.

• Mindfulness and meditation apps like Calm make it easy to add a daily meditation or breathwork practice to your day.
• Yoga exercises can also calm the nervous system.

6. Allow for more recovery time

Your body might need more recovery time as you age due to changes in muscle repair and energy levels.

• Ensure at least one full rest day per week.
• Prioritize sleep and hydration for muscle recovery.
• Listen to your body and adjust intensity based on energy levels.

Adapting your workout routine during and after the menopause years can help you maintain muscle mass, bone density and heart health. A balanced approach incorporating strength training, HIIT, low-impact cardio, flexibility work and recovery strategies will help you stay stronger and more resilient to the changes this life stage brings.

Always speak to your doctor before making any big fitness or lifestyle changes.

For personalized fitness and menopause advice, make an appointment with the University of Miami Health System’s Comprehensive Women’s Health Alliance. To make an appointment, call 855-3-4-WOMEN (855-349-6636) or click here to request an appointment.

Wendy Margolin is a contributor for the University of Miami Health System.

Tags: Dr. Jacqueline Sanchez, Hormonal balance, Menopause fitness tips, Midlife workout routines, Perimenopause exercise benefits