Physical activity to support you through the perimenopause, the menopause and beyond

Blog by Anna Coles, Level 4 personal trainer and GP referral exercise specialist

I have consistently collaborated with midlife women to address the often-debilitating conditions that present themselves during the ageing process. I suspect, in terms of my own experience, that I have been perimenopausal for at least 10 years. Experiencing this first-hand places me in a position to have an understanding of how it actually feels to live with these symptoms and equally the salient results of managing them through movement and activity.

Through regular tweaks to my own exercise patterns and nutrition, I have been able to manage my symptoms and consider myself truly fortunate. However, ageing is a constantly changing process and we need to be continually open to adapting and changing the way we move, to accommodate these changes and live well for longer.

What type of exercise should you be doing and what are the benefits of exercise in general?

First off, it is worth noting that physical activity and exercise are not the same thing, but both are beneficial to your health and will help enormously through midlife and also as we continue to age.

·       Physical activity is any activity that works your muscles and requires energy and can include work, household, or leisure activities.

·       Exercise is a planned, structured, and repetitive body movement done to improve or maintain physical fitness.

The word "exercise" may make you think of running laps around the gym but exercise includes a wide range of activities that boost your activity level to help you feel better.

Certainly running, lifting weights, playing tennis and other fitness activities that get your heart pumping can help but so can physical activity such as gardening, washing your car, walking around the block, or engaging in other less intense activities. Simply any physical activity that gets you off the sofa can help improve your mind and body.

Aerobic or cardio exercise is good for your heart and lungs. Walking, for example, is one of the best choices, because you can do it anywhere, anytime. Other examples of aerobic exercises include swimming, cycling, tennis, and dance.

How much should you do to feel the benefits? Exercise moderately for at least 30 minutes most, if not all, days of the week (the government guidelines state that we should all be aiming for 150 moderate intensity exercise per week).

I think of cardio or aerobic exercises as the foundation of good overall fitness and health, and you can build from here depending on your individual goals and needs.

You don't have to do all your exercises or other physical activities at once. Broaden how you think of exercise and find ways to add small amounts of physical activity throughout your day. For example, take the stairs instead of the lift. Park a little further away from work to fit in a short walk. Or, if you live close to your job, consider cycling to work.

How physical activity can help during midlife

Let us look at some of the different symptoms we may experience:

Anxiety, depression and mood swings

The links between depression, anxiety and exercise aren't entirely clear, but we do know regular exercise releases feel good endorphins and other natural brain chemicals that enhance our sense of well-being. It also stimulates the growth of new brain cells improving concentration and slowing down age related decline.

On a more basic level, it can take your mind off worries so you can get away from the cycle of negative thoughts that feed depression and anxiety.

Regular exercise has many psychological and emotional benefits too. It can help you:

·       Gain confidence. Meeting exercise goals or challenges, even small ones, can boost your self-confidence. Getting in shape can also make you feel better about your appearance.

·       Get more social interaction. Exercise and physical activity may give you the chance to meet or socialise with others. Just exchanging a friendly smile or greeting as you walk around your neighbourhood can help your mood.

·       Cope in a healthy way. Doing something positive to manage depression or anxiety is a healthy coping strategy. Trying to feel better by drinking alcohol, dwelling on how you feel, or hoping depression or anxiety will go away on its own can lead to worsening symptoms.

Weight gain

What is it about menopause that makes it so hard to keep off the weight?

One of the reasons we gain weight during midlife and our body shape changes, is loss of muscle mass and consequently an increase in visceral fat, which in turn lowers our resting metabolism. Muscle stores and uses energy more efficiently than fat so it’s vital that we maintain as much muscle as possible. It is therefore SO IMPORTANT for midlife women to introduce strength training into their exercise regime (more on this in a moment).

The rate at which we can use energy during exercise also declines. To use the same energy as in the past, and achieve weight loss, you will most likely need to increase the amount of time AND intensity you're exercising, no matter what your past activity levels were. This is one of the reasons why those 10 miles runs that always kept the waist trim suddenly don’t work!

How exercise and specifically strength training helps with weight management, bone density and lean muscle mass in menopause

Weight management will primarily come from your nutrition, but it is essential to support it through exercise. Strength training helps build lean muscle mass and in turn improves metabolic rate. Strength training also helps you maintain bone mass. Because you lose muscle mass as you age, add strength training to your workouts, if you haven't before. Aim for two or three times a week.

Examples of strength training include using your own body weight and the force of gravity, e.g.

·       squats

·       Plank variations and push ups

·       Weight machines

·       Dumbbells

·       Exercise bands

·       Gardening.

Forget the myths that weight training will make you “bulk out” - the heavier you lift the leaner you will become! Because muscle is metabolically more active than fat, strengthening your muscles will make you into a more efficient calorie-burning machine, even when you're at rest!

General benefits of exercise during and after menopause

Exercise has many other benefits aside from weight loss, including:

• Lower risk of osteoporosis by increasing bone density

• Lower risks of metabolic syndrome, heart attack, and other cardiovascular diseases

• Improved insulin sensitivity

• Keeps joints and muscles strong

• Helps bowels work more efficiently

• Relieves depression and anxiety

• Improves overall health

Good exercise choices during and after menopause and their specific benefits

It needs to be about balance, and it needs to be what you enjoy but there are certainly guidelines which will help!

Resistance training

For improved muscle mass, bone density, to improve body composition, less fat, more lean muscle – at least twice a week.

·       Can be with body weight, bands, or weights.

·       Demo push ups, seated row, shoulder press.

Functional movement

here are seven basic movements the human body can perform, and all other exercises are merely variations of these seven:

·       Pull

·       Push

·       Squat

·       Lunge

·       Hinge

·       Rotation

·       Gait

When performing all these movements, you will be able to stimulate all of the major muscle groups in your body and benefit from improving your day-to-day quality of movement.

Examples: squat, plank, bent over row and chest press

Regular aerobic exercise

For improved cardiovascular and respiratory fitness, daily 30 minutes

This is a steady, rhythmic, moving pattern at an intensity that should be comfortably maintained. The foundation or building block of good fitness and the impact of running and walking is important for bone health.

HIIT Exercises

High Intensity Interval Training. HIIT is an exercise method designed to burn more calories in a shorter amount of time. For many women, HIIT workouts can be significantly more effective than endurance workouts for overall weight and fat loss and change in overall body composition during menopause. Again, this explains why so many of us who have stuck to cardio for years suddenly stop seeing the results we have previously got.

Aim for once or twice a week - intensity should be at least 80% of MHR (maximum heart rate) and doesn’t need to be high impact. Your general endurance, fitness and stamina will improve.

Recent studies are pointing to the fact that it’s intensity, rather than duration, which leads to the weight loss during the menopause. This is where another type of exercise comes in to play.

Yoga, Pilates, stretching (Daily)

For improved mobility and flexibility. This is so important to help counter the stiff and sore joints often experienced during menopause and to stop the body functioning in a limited range of motion.

 About the author

Anna Coles is a Level 4 Personal Trainer and GP referral exercise specialist with a keen interest in metabolic health and supporting women through perimenopause and menopause.