Exercising during the perimenopause and menopause

How to keep fit and feel good even when you’re experiencing symptoms

Keeping active can help alleviate menopausal symptoms
But symptoms can prevent you from exercising
Discover how to work out safely and make exercise part of your routine

By the time you reach perimenopause, you’ll be well aware of the benefits of exercise – whether that’s because you’ve felt them for yourself, or read enough articles about it! For some people, exercise is something that is part of their routine, just like brushing their teeth. But many of us struggle to consistently exercise or even if we once did, symptoms of the perimenopause or menopause can disrupt our exercise habits.

Why should I exercise now?

If you’ve fallen off the exercise wagon and want to get back on, it’s first worth remembering the benefits to help increase your motivation.

Physically, exercise can benefit pretty much every part of you. A 2015 study found that middle-aged women could significantly lower their risk of heart disease and stroke by exercising just two to three times a week [1]. According to the charity Alzheimer’s UK, of all the lifestyle changes that have been studied, taking regular physical exercise appears to be one of the best things you can do to reduce your risk of getting dementia [2]. Studies have also shown that weight-bearing exercise can help to slow bone loss and may even help to build bone [3].

Mentally, exercise is proven to boost mood. It can help you get a good night’s sleep – both in terms of quality and duration – something some women struggle with during the menopause [4]. Menopause can also affect your confidence, especially if you gain weight during this time. Exercise can help you build muscle and burn calories more efficiently, to help shed excess weight.

What if I’ve left it too late?

Fitness experts and doctors agree – it’s never too late to start exercising or to get back to exercise. But for many of us the issue is finding the motivation to do so. A poll of nearly 6,000 women for balance founder Dr Louise Newson’s book, the Definitive Guide to Perimenopause and Menopause, found that while three quarters (77%) of women recognised the physical and mental health benefits to exercising, nearly a third admit they exercise less than once a week or not at all.

The main barriers to exercise, according to the women in the survey, were a lack of motivation (51%), followed by a lack of time (42%). And nearly a third were unable to exercise more due to their menopausal symptoms.

Have a think about your obstacles to exercising. Is it a lack of energy? Fear of having a hot flush while exercising? Worry that working out will make your joints ache even more? Concern about leaking urine while exercising? Do you feel too self conscious, or intimidated, or worried that exercise will make you feel bad about yourself? If you used to exercise, are you avoiding facing how much harder you might find it now? Recognising your barriers is an important step to coming up with a plan to overcome them.

Consider your mindset

Dr Hussain Al-Zubaidi, the Royal College of GPs Lifestyle and Physical Activity Lead, fitness coach and Ironman triathlete, says before you get down to exercise, focus on your outlook:

Tweak your language

Reframing the way you think about exercise can help make physical activity a consistent part of your routine. Instead of viewing it as “exercise,” consider it as “physical activity” or “movement”. This shift in language can make it seem less daunting. The goal is to be active, not necessarily to become a super athlete. Understand that physical activity comes in many forms, and it doesn’t have to be intense or structured.

Set realistic goals

Identify what you want to achieve through physical activity – whether it’s boosting your mood, managing weight, improving sleep, or enhancing wellbeing. Setting realistic, specific goals can give you a sense of purpose. Do not compare yourself to others and don’t pick goals based on anyone else. Make them relevant and meaningful to you.

Celebrate small wins

Once you start moving, acknowledge and celebrate your achievements, no matter how small. This positive reinforcement can help build a positive association with physical activity, making it more likely that you’ll continue.

How to exercise during the perimenopause and menopause

Dr Hussain has these tips:

Try something new or fun

There is no wrong way to be physically active and every little bit helps. NHS physical activity guidelines include doing 150 minutes of moderate intensity a week – this means anything that will get your heart rate up, your blood pumping and you’ll feel out of puff but that you could still hold a conversation if you needed to.

Choose something you genuinely enjoy and don’t feel limited by “traditional” exercise options – the sky is the limit. It could be something as simple as throwing a Frisbee around a park, trying a new dance class or trying rockclimbing at a local centre. Cold water swimming has become popular in recent years, particularly with perimenopausal and menopausal women – a 2020 survey in Outdoor Swimmer magazine revealed 87% swimmers are aged over 40 and 65% of swimmers are women [6]. Some women find the cold water the best place to be when experiencing a hot flush, while others enthuse over its mind-clearing benefits.

Make it a habit

Make being physically active part of your everyday life – by taking the stairs rather than the lift and parking in the spot furthest from the supermarket, for example. And think consistency over intensity – it’s better to engage in moderate activities regularly than to sporadically engage in intense workouts. Commit to a particular time each day, put it in your diary and think of it as me-time to look forward to – nothing else can get in the way.

Make it social

Movement can be more enjoyable when done with others and helps you to stick to it as you’ll not want to let a friend down. Consider joining group classes, clubs, or participating in activities with friends or family. In Dr Louise Newson’s survey, walking was by far the most popular form of exercise, with 75 per cent of respondents saying it benefited their physical and mental health. Yoga, strength training and Pilates were also popular and these can be done with a friend or in a group.

Incorporate variety

Mix up your activities. Trying different movements not only prevents boredom but also ensures that you’re working different muscle groups. This could include a combination of aerobic exercises, strength training, and flexibility exercises. This is the key to longevity!

Consider your wellbeing

Activities that involve a mind-body connection, such as yoga or tai chi, can be particularly beneficial during menopause. These practices not only provide physical benefits but also help in managing stress, improving mental wellbeing and focus.

Get strong

Strength training is particularly important in midlife and beyond, when our muscle mass starts to diminish as we’re at increased risk of osteoporosis. Dr Hussain advises women going through the menopause to follow a well-rounded strength training program and to consult with a healthcare professional or fitness expert beforehand, especially if there are pre-existing health conditions.

Listen to your body

Maybe you used to enjoy running but now it hurts your knees, or perhaps your high-intensity HIIT class feels too exhausting after a disrupted night’s sleep, or a spin class would be agony when you’re experiencing vaginal dryness. Don’t fight your symptoms – seek help from a medical practitioner if they are stopping you from exercising. Similarly, if you have specific health concerns, consider consulting with a healthcare professional or a certified fitness trainer for personalised advice.

It’s OK to make adjustments while your body is physically changing – some forms of exercise can feel too intense so choose lower impact exercises while you get your symptoms under control. If you experience days when exercising feels too overwhelming, call a friend and arrange to walk and talk – remember, all movement is good!

Resources

Follow Dr Hussain @irondoctorhaz

References

Armstrong ME, Green J, Reeves GK, Beral V, Cairns BJ. (2015) ‘Frequent physical activity may not reduce vascular disease risk as much as moderate activity: large prospective study of women in the United Kingdom’, Circulation.131(8), pp721-9. doi: 10.1161/CIRCULATIONAHA.114.010296
Alzheimer’s UK
Benedetti M.G. et al (2018), ‘The effectiveness of physical exercise on bone density in osteoporotic patients’, BioMed Research International, doi.org/10.1155/2018/4840531
Pinheiro M.B., Oliveira J., Bauman A., et al. (2020), ‘Evidence on physical activity and osteoporosis prevention for people aged 65+ years: a systematic review to inform the WHO guidelines on physical activity and sedentary behaviour’, International Journal of Behavioral Nutrition and Physical Activity, doi: 10.1186/s12966-020-01040-4
Dolezal B.A., Neufeld EV, Boland DM, Martin JL, Cooper CB. (2017), ‘Interrelationship between sleep and exercise: a systematic review’, Advances in Preventive Medicine, doi: 10.1155/2017/1364387
Kelley G.A., Kelley K. (2017), ‘Exercise and sleep: a systematic review of previous meta – analyses’, Journal of Evidence-based Medicine, 10 (1), pp. 26–36. doi: 10.1111/jebm.12236
Nuffield Health (2022), ‘The Nuffield Health Healthier Nation Index’, https://www.nuffieldhealth.com/healthiernation#key–insights
Outdoor Swimmer magazine (2021) ‘Trends in outdoor swimming report’