Menopause brings about a whole host of changes to our bodies, causing not only bothersome symptoms but potential health issues too such as bone and muscle loss, and weight gain. Movement can help counteract the potential issues, as well as bringing a raft of other benefits for both our mental and physical wellbeing. 

Elisa Withers, founder of APPI Clinics, and her colleagues Cris Malgarotto and Lucy Pattullo, both Exercise in Menopause specialists, talk of the three key benefits of exercise during menopause:

1. Maintaining muscle, strength & metabolism 
As oestrogen levels decline, maintaining muscle mass becomes even more important. Regular resistance and strength-based movement helps maintain muscle, and support a healthy metabolism and general body composition. Resistance doesn’t have to mean gym! It can take the shape of resistance bands, body weight exercises as well as kettle bells and free weights. 
 
2. Supporting strong, healthy bones 
Bone density naturally declines with age and can accelerate around menopause. Weight-bearing and appropriately loaded resistance exercise provide an important way to maintain bone strength.   
 
3. Supporting mood, sleep & cardiovascular wellbeing 
Regular exercise can help manage stress, support mood and sleep quality, as well as long-term cardiovascular and metabolic health.

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But it can be daunting, particularly with some of the myths that have built up around exercise in midlife. Says Rosalia Trupiano, personal trainer and menopause coach: “Of the many myths surrounding fitness in midlife, the biggest is that turning 40 suddenly comes with a new rulebook for exercise: do this, avoid that, train in a particular way. Menopause does bring changes, but no two women experience it in exactly the same way. Our health, injuries, exercise history, symptoms, responsibilities and life experiences all shape what we need. Cortisol is a perfect example of how a useful piece of information can become another rigid rule. It is often presented, especially on social media, as something women should fear and a reason to avoid demanding exercise or cardio altogether. Yet cortisol is an essential hormone that naturally rises and falls, and a temporary increase during exercise is normal. The question is not simply whether an activity raises cortisol, but whether its intensity is appropriate for that particular woman, at that time, alongside her sleep, symptoms, stress and recovery. Looking at the overall picture is essential.” 

Strength training is another area surrounded by myths. “Menopause does not make us fragile, and becoming weaker is not inevitable. Women in perimenopause and menopause can continue learning new skills, lifting progressively heavier weights and improving their overall fitness. Strength training helps maintain muscles and bones, but the right starting point and pace of progression will be different for everyone. This is key to exercising safely and effectively and taking the guesswork out of it.” 

Alongside strength training, cardio shouldn’t be forgotten. The Family treatment Service’s Dr Sian Morris, an experienced GP, whose specialist interest is in menopause care and hormone replacement therapy says: “Strength training is important, particularly for maintaining muscle mass and bone health, but cardiovascular exercise such as jogging, cycling or swimming, as well as restorative exercise such as Pilates and yoga, are also important.” 

Pilates can be especially helpful – but needs to be tailored to the individual. APPI Clinics says that the key is understanding the physiological changes that occur through menopause as well as identifying the needs of an individual. “Pilates springs, bands, body weight, gravity and Pilates props can all create and progressively load the body.  Further, Pilates combines strength training with mobility, balance, coordination and body awareness. But it should be highly personal. The intensity, resistance, range of movement and exercise selection can be progressed or modified according to how one is feeling at the time, their current strength and fitness,  any injuries and most importantly, their own exercise goals.”

Perhaps more important than the activity itself is finding something you enjoy and will stick to. “The single biggest predictor of whether exercise actually benefits you long term is whether you still do it in six months. So if you like walking, walk. If you love to dance, dance. Pilates, barre, Zumba, rock climbing, or lifting weights…. the modality matters much less than the pleasure you get from it, because being consistent is what will ensure that your body stays strong and healthy for the rest of your life. The process of finding your ‘thing’ can sometimes take a few tries, but the journey to that discovery is part of the fun,” says Hillary “Nesse” Cannon, a Registered Clinical Nutritionist (ANutr), and founder of women’s health studio HerSpace London.  

This is particularly important to stay motivated if you’re dealing with fatigue. Says Rosalia: ”Do not wait until you feel ready or energetic enough, for the beginning of a new month or year, or for life to become less busy. Start today, with the energy you have rather than the energy you think you ought to have. When sleep is poor, motivation has disappeared and even ordinary tasks feel demanding, an ambitious exercise plan can become another source of pressure. Make the starting point almost too easy. Walk for ten minutes, do a few simple strength exercises at home or attend one supportive class each week. You do not have to feel motivated before you begin. Motivation often follows action, once you start noticing that movement helps you feel better. It can also help to notice when your energy is usually at its best. If evenings are difficult, move in the morning or at lunchtime.” 

Dr Sian Morris adds: “Symptoms such as fatigue and aches and pains can often improve with exercise, so keep the faith! It can be difficult to get started when you don’t feel well, but even small amounts of activity can make a difference. For some women who are able to take HRT – which is most women – it can be helpful to address troublesome menopausal symptoms with HRT first. Once you are feeling better, it is often much easier to introduce and maintain those positive lifestyle changes.” Sian says to start small. “Start slowly by making small, more active choices throughout your day. Celebrate the small wins – even little ‘exercise snacks’, such as doing 15 squats during the day, all count!” And make it part of your routine. “Try setting up a regular exercise schedule so you don’t have to keep making the decision about when you’re going to exercise. For example, every Monday at 1pm, I walk for 30 minutes with a work colleague.” 

And be aware of your body. Says Rosalia: “Aches, joint stiffness and changes in recovery are common during menopause. They can appear even in women who have always been active, making it difficult to know whether exercise is helping or causing harm. The answer is not necessarily to stop moving, but to pay closer attention to how the body responds. During exercise, working muscles may feel tired or challenged, while muscle soreness can develop a day or two after a new or more demanding activity. This is usually a dull, generalised ache that gradually improves. Sharp or localised pain is different. If it alters the way you move, worsens during exercise or persists afterwards, stop and assess what is happening. New or persistent pain should not simply be dismissed as “part of menopause”. More often than not, the answer is not to abandon movement, but to adapt it.” 

Finally, Hillary shares her five top tips: “Look for movement that makes you sweat and makes you burn. A light sweat means your heart rate is elevated enough to matter. The burn means your muscles are working hard enough to build. Never skip a bone density scan, and if you haven’t had one, book one, because osteopenia and osteoporosis can be improved significantly through exercise, but only if you know what you’re dealing with. Look for exercise modalities that involve balance work and stretching – two facets of exercise that are often overlooked but absolutely key to mobility and safeguarding against falls and other injuries. Weight control comes down mostly to nutrition, and nutrition also plays a real role in bone density, so looking after what you eat matters as much as how you move. And finally, move with other people, ideally to music, if you can. Moving in time with other humans not only raises the bonding hormone, oxytocin, but following even simple choreography forces a strong brain-body connection that supports neuroplasticity. And frankly, we spend enough time alone, staring at screens. Gathering with other people, making human connections… these things feed our brains and our souls and are absolutely fundamental to ensuring a long, healthy life.” 

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