Menopause and exercise

March 29, 2022

In the UK, the average age a woman experiences menopause is 51, which means that women in their 40’s are becoming peri-menopausal. 1/100 women under the age of 40 and 1/1000 women under the age of 30 have an early menopause. Menopause can also be enforced through cancer treatment or if the ovaries are removed in an operation. As a woman, it’s not a question of will you go through menopause, it’s a case of when.

It is not an older person’s condition. It is a hormone deficiency that is going to affect every woman, and as such, all women should have an understanding of how their changing hormones affect how she should train.

A little about hormones

We do not give our hormones nearly enough credit for what they do for us. From the age of 35, our sex hormones start declining, and I’m not sure that we are forewarned about what affect this is going to have.

Oestrogen

Oestrogen is an anabolic hormone, which means it promotes the build-up of tissues. When it starts to decline from about age 40, we start to notice it.

Physically, oestrogen;

  • Promotes the build-up of muscle and bone.
  • Assists with muscle strength, meaning day-to-day life is easier.
  • Helps in maintaining a healthy metabolism.
  • When oestrogen drops off, we see an increase in insulin sensitivity which leads to changes in body composition (anyone notice the way the tummy is not so flat these days?)

If that’s not enough,

  • Oestrogen helps with memory, learning, and dementia.
  • Helps to prevent symptoms of depression.
  • Reduces the risk of cardiovascular disease by keeping the blood cells healthy and pliable.

Progesterone

Progesterone starts to decline around the age of 35. This hormone is sometimes thought of as a miracle hormone. It is classified as a neuro steroid, which means that it has a strong link with the nervous system.

Not only does progesterone,

  • Have a calming effect, easing anxiety, improving low moods, and increasing the ability to handle stress
  • Promote memory
  • Improves insomnia

As it is a catabolic hormone, meaning it promotes the breaking down of tissue, it;

  • Helps to prevent the overgrowth of certain cells, which can help protect against some cancers
  • It helps the metabolism by contributing to the use of fat for energy
  • Reduces inflammation and joint pain

It makes sense now why symptoms of irritability, low mood, brain fog, joint and muscle pain, insomnia, etc rear their ugly head as we begin to age.

What does this mean for our training?

There is no need to start googling “exercise for seniors” any time soon! However, there are some key areas that you should be aware of when it comes to training. When I work with any lady over the age of 35-40, I consider the effect depleting hormones have on the body and use training to try to counteract this within Personal Training.

So what do you need to know?

Functional strength

Bones

As your bones are responsible for keeping the entire structure of your body stable and protecting your vital organs, it’s important that we do something to help fight back against bone loss.

Bones are at their strongest until roughly the late 20’s, and from around the age of 30/35, you gradually start losing bone. It is widely known that this is happening, but why? Lower oestrogen levels mean there is a higher level of bone breakdown (remember, oestrogen is protective). Low oestrogen means fewer vitamin D receptors in the gut are turned on and absorption of vitamin D and calcium is reduced.

Men’s bone density goes down as well, but levels start higher because the bones are bigger and more men are performing physical jobs. On top of this, testosterone reduces at a much slower rate than oestrogen. So, with smaller bones and the menopause, the risk of osteopenia and osteoporosis is much greater in women.

Along with osteopenia (lower than average bone density) comes sarcopenia (muscle loss), and with sarcopenia comes osteopenia. It’s a vicious circle and a circuit that you should be trying to break.

Although it is a part of the natural ageing process, it is something that everyone should be working on. It’s never too late to start focusing on healthy lifestyle factors to promote bone building, but if you are reading this in your 30’s, start now!

Training to build bone density

To promote bone building during exercise, you need to load the bones. Even if you have osteoporosis, it is still ok to load. Guidelines around this are very conservative. However, there is no need to be restricted to seated exercises, provided the risk of falls is reduced.

Walking doesn’t do a huge amount when it comes to building bones. Research still needs to be done, but it makes sense that if the load was increased (to include hills or carries) then there would potentially be more benefit.

Impact is a good thing! I don’t mean you should dig out the pogo stick, but short exposure to jumping, hopping, skipping, and stomping movements is good for laying down new bone. Brownie points for performing impact movements in different directions!

You can also put the bones under load by engaging in resistance training. Either with weights, resistance bands, TRX, or using your own bodyweight to provide the resistance.

As you train, the muscles pull on the bones, which stimulates bone growth. It is important to realise that bone density is site-specific, which means that you must target all muscle groups to get benefits for the full body. No missing leg day! The bones in your legs are the largest, and you need them to be able to carry you around for life.

Muscles

Along with a decline in bone density, we also start losing muscle mass as part of the ageing process, and as with bones, if you don’t do anything to counteract this, you’re going to get weaker and weaker, and day-to-day life is going to get harder and harder. We take our independence for granted when we have it, but without maintaining a level of functional fitness and strength, independence is at risk.

It is a common myth that weight training will make women bulky. Even before our hormones started their steady descent, it is very challenging for women to gain a considerable amount of muscle. This is because of our much lower levels of testosterone. After the age of around 35 / 40, we should be trying to cling on for dear life to our ever-depleting muscle mass, not worrying that we are a complete anomaly and genetically super charged! Fears of turning into Arnie really need to take a back seat because getting bulky is not going to happen. Will lifting weights make me bulky?

Training to build muscle

Why you should be lifting heavier weights

To maintain the muscle mass that you have, you need to do strength training once per week. To build any extra muscle, make it 3 times per week.

I talk about it all the time, so apologies if you’ve heard this a hundred times before, but I cannot stress the importance of this enough, so it’s worth me keeping telling you! You need to be lifting weights that are challenging, not performing a ridiculously large number of reps with a tiny weight or stopping just because you’ve hit your target rep range.

Research indicates that sets of 8–10 repetitions where you end the set with only 1–2 reps left in the tank (with good form) will stimulate human growth hormone, which for women, is the hormone we want to stimulate for muscle building.

Compound movements, which are exercises that use more than one joint, are not only functional, but they use big muscles and more than one muscle group, so these are the ones that are going to give you the best results.

Power

Getting older does not mean you have to slow down when it comes to training. If anything, the opposite is true! We have 2 different types of muscle fibres, and you should be training both. Slow twitch fibres, which help to keep you moving at a slow pace for longer, and fast twitch fibres, which fire quickly. Fast twitch muscle fibres decline as we age, and once again, us ladies have drawn the short straw because the decline is faster for women. Ladies tend to be more hesitant to do this type of training, but training with load, impact, speed, and agility is essential.

Our fast twitch muscle fibres allow us to respond quickly, which is important when it comes to fall prevention. And don’t think that only older people fall over because I have the war wounds to demonstrate that it happens in your younger years as well! Think about it for a minute. If you are going to fall, what needs to happen? Your muscles need to respond quickly to protect you from falling or enable you to fall in a safer way (hands down to protect your face). Catching that cup of coffee before it falls off the table, muscles need to fire and respond quickly. 

It’s not just your muscles and bones that benefit from exercise

Metabolism

I’ll keep this brief as it’s something that I have written quite a bit about previously, but lean tissue mass (how much muscle you have) directly influences metabolism. Weight gain is common, particularly around the waist. With this in mind, keeping the muscles that you have and building some more is going to help prevent the slowing down of your metabolism, which will help with weight gain.

Neurological brain health

Exercise is not just for the body. We are all aware of that “feel good factor” we get when we have finished training. Exercise is the most underrated antidepressant out there. But we don’t perhaps appreciate that the exercise we are doing (particularly aerobic) is very beneficial for maintaining brain health.

While exercising won’t completely prevent or cure normal cognitive decline, doing it consistently can help reduce or delay the onset of it.

Physical exercise benefits the brain by improving blood flow to the brain, reducing inflammation, and lowering levels of stress. Exercise improves cognitive function. Reaction times are improved, and concentration is better.

New skills and habits create more connections between brain cells and brain areas, and the more things we learn, the more connections there are. Here’s where a few of my online clients might realise why we do aerobic exercise routines with lots of different moves!

Cardiometabolic health

Oestrogen provides a certain level of protection from high blood pressure, type 2 diabetes, and cardiovascular disease. When oestrogen drops, good cholesterol goes down while triglycerides go up, which increases the risk of heart disease. Aerobic exercise boosts your good cholesterol and lowers the bad cholesterol, which reduces the build-up of plaques in your arteries.

There are many well-established nutrition and lifestyle factors that contribute to our cardiometabolic risk, some of which we have no control over, such as ethnicity, age, and family history, but there are others that we have significant control over, such as diet, body composition, exercise, smoking, stress levels.

Cardiovascular disease is the leading cause of death in post-menopausal women, so it’s important to ensure that we engage in some aerobic activity. Being of a healthy weight is very important, but that does not mean that you are not at risk. The heart is a muscle and, like any other muscle, benefits from exercise; a strong heart can pump more blood around your body with less effort.

Insulin sensitivity

Some of the changes that occur during menopause put you at a greater risk of type 2 diabetes. Oestrogen and progesterone affect how the cells in your body respond to insulin. A drop in these hormones may make your body more resistant to insulin.

The metabolism gets slower, and the body doesn’t burn as many calories, which can lead to weight gain, particularly around the middle. Premenopause, oestrogen moves fat away from the tummy. The more visceral fat you have, the more insulin resistant you become and vice versa. And when the body stops responding as well to insulin, you are more at risk of CV disease and type 2 diabetes. So what do we need to do? Exercise!

Putting it all together

There is so much you can do through exercise to slow down the ageing process and the effect of declining hormones. Menopause is not the time to slow down, it’s the time to fight back!

  • Full body strength training – 2 – 3 times per week
  • Think functional carry over – build your exercise around functional movements; lift, carry, press, pull, push.
  • Use big muscles and challenge yourself with as many as 4 – 6 sets of 8 – 10 repetitions
  • Don’t fear impact – multi directional hopping, jumping, skipping, and stomping. The pelvic floor is another muscle that needs to be trained just like all the others so if a weak pelvic floor is preventing impact exercise, then pelvic floor exercises are a must.
  • Power -incorporate some stairs, hills, sprints – be more badass!
  • Aerobic – Get your heart rate up with some aerobic exercise; walking, cycling, swimming, running, Zumba class – your heart doesn’t know the difference, so do what you enjoy.
  • Include some balance exercises
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