Can Exercise Help My Menopausal Symptoms?
During menopause, your ovaries stop producing estrogen, resulting in an estrogen deficiency. This abrupt hormone change can cause a variety of symptoms including, but not limited to, hot flashes, mood changes, weight gain, change in fat distribution, and worsening bone health. A plant based diet has been shown to be helpful with these symptoms. Exercise plays a vital role as well. Below we will focus on the role of exercise in the perimenopausal/postmenopausal female.
Weight gain and fat distribution
In the menopausal transition and early postmenopausal years, weight gain and increased fat distribution around the stomach/midsection can occur. Studies report a mean weight gain of 5.5 to 7.5 lbs during this transition. Research suggests this is related to a decrease in energy output, meaning less activity and exercise, along with increased levels of follicle stimulating hormone, which occurs abruptly during the menopausal transition. These body changes can then increase blood pressure, cholesterol, and blood sugar levels, which increases your cardiovascular risk of heart attacks and strokes. Hormonal therapy (estrogen) does not prevent this weight gain.
Higher levels of physical activity are needed to maintain body weight after menopause. Whereas the typical recommendation is a minimum of 30 minutes of aerobic exercise per day (for a total of 150 minutes per week), studies find that a minimum of 60 minutes of exercise per day (300 minutes per week) is required to maintain a stable weight during midlife for females. Intensity of exercise should be moderate. So now you may ask yourself: what does that mean? What does that look like?
The American Heart Association classifies moderate intensity aerobic exercise as:
Brisk walking (at least 2.5 miles per hour)
Water aerobics
Biking (<10 miles per hour is moderate, >10 miles per hour is vigorous) - can be stationary!
Dancing
Gardening
Doubles tennis
Resistance training is also important. The amount/frequency of resistance training is not as clear, though 2-3 days per week is generally recommended. Resistance training essentially means muscle strengthening. Example exercises are listed below. One day of these exercises should include 2-3 sets (each set being 8-12 repetitions) of a few different exercises.
Weightlifting (machines or hand held)
Elastic/resistance bands
Body weight activities (such as push ups, pull ups, planks, squats, lunges)
Gardening
Yoga
Bone health
Decreased estrogen levels after menopause can also result in lower bone density. Low bone density can result in fractures. Maintaining adequate calcium and vitamin D supplementation is important. Exercise can also prevent this decline in bone health, reduce the risk of hip fractures, and actually increase bone density slightly. Bone strengthening exercises are commonly referred to as “weightbearing exercises”. These exercises are recommended for at least 30 minutes per day 5-6 days per week. These overlap with the above aerobic that utilize gravity and resistance exercises. Briskwalking, yoga, and weight lifting exercises are examples. The benefits of exercise are lost after stopping exercise, so it is important to continue this lifelong.
In conclusion, the hormone changes from menopause cause a variety of symptoms. Both healthy diet and exercise choices can help with some of these symptoms, namely the weight gain, change in fat distribution, and bone health. Aerobic and muscle strengthening exercises are both important. Moderate intensity aerobic exercise for 60 minutes per day 5 days per week and resistance training 2-3 days per week is recommended during the menopausal transition period and early postmenopause.
Studies referenced:
Effects of exercise training on metabolic syndrome risk factors in post-menopausal women – A systematic review and meta-analysis of randomised controlled trials. (2023, March). https://www.sciencedirect.com/science/article/pii/S0261561423000109
American Heart Association recommendations for physical activity in adults and kids. (n.d.). https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults
Piercy, K. L., Troiano, R. P., Ballard, R. M., Carlson, S. A., Fulton, J. E., Galuska, D. A., George, S. M., & Olson, R. D. (2018). The physical activity guidelines for Americans. JAMA, 320(19), 2020. https://doi.org/10.1001/jama.2018.14854
Overview of the management of low bone mass and osteoporosis in postmenopausal women. (n.d.). UpToDate.
Obesity in adults: Role of physical activity and exercise. (n.d.). UpToDate.
