How to stay fit during perimenopause and menopause

In her clinic at Olympic Park, Dr Hilary Grover often works with women who are approaching or experiencing menopause.

“It's an area I really like working in,” says Dr Grover.

“It's really encouraging to see this group of women who are going through such a big transition and the thing that brings them together and drives them is their love of exercise and sport."

“They have an athletic identity – and they don't want it to change just because they're going through this transition.”

Dr Grover says this is a critical life stage to consider what kind of exercise is best for you.

“You can make such a significant difference with simple tweaks and changes [in this time].”

Even if you haven’t been very active throughout your life so far, perimenopause and menopause can be great times to get moving. Here’s what you may need to consider.

When do perimenopause and menopause happen?

Perimenopause is the time leading up to your last period. You’ve officially reached menopause when you haven’t had a period for 12 months. After this, you’re in post-menopause.

Perimenopause commonly starts in your mid-late 40s. It lasts, on average four to six years, though it can range from one to 10 years. The average age of menopause is 51.

Many people experience symptoms in the lead up to menopause, such as hot flushes and night sweats, headaches, sore muscles and joints, as well as mood swings, brain fog and potentially anxiety and depression.

“In perimenopause, you start to get a drop off in hormones,” says Dr Grover.

“Symptoms start creeping in and certain ones happen earlier – so your mood changes, and cognitive fog can happen early – and then as you go on, different things start to change, like an increase in hot flushes.”

What are the benefits of exercising during perimenopause and menopause?

“Exercise is always excellent, but extremely beneficial during this time,” says Dr Grover.

“It can really help with the psychological symptoms of menopause, we know that exercise is an effective tool to treat depression – there's increased risk of depression and anxiety during this time and it can really help with these symptoms, as well as concentration symptoms,” she says.

Staying active has big benefits for physical health too.

“In regard to musculoskeletal health, it can help with joint pain and muscle pain, and we get some wear and tear of our tendons as we age, that can cause significant pain – it can really help with that and reducing those symptoms,” says Dr Grover.

“It can also, importantly, help with urinary and faecal incontinence and pelvic organ prolapse, which I don't think is spoken about enough.”

Exercising in this time may also reduce your risk of developing osteoporosis and heart disease, and can help with the quality of your sleep.

What types of exercise are best during perimenopause and menopause?

Dr Grover says, at all life stages, we want to make sure we’re meeting the minimum physical activity guidelines, which are 150 minutes of moderate physical activity across a week, as well as 2-3 sessions a week of resistance training.

There are specific types of exercise she recommends for people at the perimenopausal, menopausal and post-menopausal stage:

HIIT

“This is a really good time to do some high intensity interval training (HIIT),” says Dr Grover.

HIIT involves short bursts of intense anaerobic activity, with brief rests in between.

“Doing that impact loading, it really helps reduce our risk of cardiovascular disease, which goes up post-menopause.”

Resistance and strength

“Resistance training is very important at this time for our bone health,” says Dr Grover.

“We see people coming in with a lot more tendon issues [at this age] … so making sure that we're doing really good strength programs for them is really important,” she says.

She also recommends lifting weights to build strength throughout your body.

Balance

It’s also an ideal time to start working on your balance, says Dr Grover.

“Whether it's doing some yoga or Pilates, balance work is really important for reducing your risk of falls, especially in a time where your bone density may drop off.”

Like to run?

If you want to keep up or start a running practice, there are specific training exercises you can consider focusing on.

“In particular, for runners, making sure we're doing some really good strength training in the background is very important to help with our tendon health and also our bone health,” says Dr Grover.

“We want to reduce risks of having a fracture from a fall when you're running, and then also some balance training as well alongside that.

“The high intensity interval training is really great for boosting your cardiovascular health, which can really marry up nicely with your endurance running as well at that age.”

READ MORE: Don't let breast pain ruin your run

Are there any forms of exercise that you should avoid during perimenopause and menopause?

“There's nothing specifically to avoid, but it's a really good time to look into our pelvic floor health,” says Dr Grover.

“During the post-menopausal period, we can get pelvic organ prolapse – we're more susceptible to that because of the change in oestrogen levels and connective tissue change.”

She says these issues can be a common barrier to exercise for people at this life stage – but can be managed.

Before you start an exercise program, consider checking in with an accredited physiotherapist who specialises in pelvic floor health to support you to feel more confident when you’re exercising.

Expert tips for staying active during perimenopause and menopause

Look after your general health

Dr Grover suggests making sure you’re eating a healthy diet, sleeping well, and potentially reducing alcohol intake.

“[Alcohol] can bring on some of your symptoms, especially hot flushes; it can impact sleep; it can give you night sweats. Reducing that will help reduce your symptoms as well.”

Talk it through

Perimenopause and menopause are a big life transition, so tending to your emotional needs and talking about what you’re going through can be helpful.

“Exercise will help with the emotional side of things, but besides that … making sure you've got good people to talk to around you – so peers who are going through a similar transition, and also your GP,” says Dr Grover.

“Practising mindfulness or relaxation techniques is also an important way to have those moments to centre yourself as well.”

Fuel your body

Make sure you’re giving your body enough of what it needs to keep up with the demands of exercise – particularly protein and calcium.

“This is a time where we can have decreased bone mineral density, and we actually get lean muscle mass loss when we’re post-menopausal,” says Dr Grover.

“So doing simple things like having more protein around exercise is really important."

Look at the whole picture

When Dr Grover works with athletes in her clinic, she tries to consider their situation holistically. She’ll ask:

“What are their barriers to exercise? Are they struggling with a cognitive load? Or is it pain associated with their menopausal symptoms? Or are they getting hot flushes and trying to work around those symptoms?”

Understanding potential barriers can help them feel confident and comfortable when they exercise.

“Sometimes I'll also engage a GP or endocrinologist to discuss things like hormone replacement therapy, if it's appropriate in that individual.”

Ask yourself what might be holding you back if exercising may be challenging and consider tackling the root cause.

Chat with your GP

If you’re considering ramping up your exercise levels, you may like to check in with your GP first.

“If you haven't previously had a high level of exercise and if you have any cardiovascular or kidney disease or diabetes, before you start a program it's always very reasonable to go and have a chat to your GP,” says Dr Grover.

This can offer the peace of mind you need to get moving safely and be sure you’re doing what’s best for your body right now.

READ MORE: Training? Here’s how to get your nutrition right or explore more women's health articles

The Medibank Better Health Research Hub has partnered with and provided funding towards La Trobe University’s TRAIL W project. Find out more here: MBHRH Research Projects and Partnerships | Medibank and Trail W – HerSport.