Learn why you should put the spotlight on strength training during perimenopause and beyond.
Menopause is a season of change.
The ovaries produce fluctuating, but on the whole declining, amounts of estrogen and progesterone in the transitional phase known as perimenopause. Hot flashes, flow changes, and irregular menstrual cycles can become the new “normal” for two to eight years. After menopause — marking 12 months since your last period — levels of those key hormones remain low, according to the U.S. Department of Health & Human Services’ Office on Women’s Health.
The problem: Estrogen plays a role in regulating bone remodeling, so this decline can worsen bone density and increase the risk of osteoporosis, one of the major causes of fractures in postmenopausal people. Simultaneously, muscle mass is dwindling, with 3 to 5 percent drops every decade starting at age 30. Studies suggest that menopause-related hormonal changes can further influence this fall in lean mass, up to two years after a person’s final period. (One 2020 study found an average 4-percent difference in lean mass in the arms and legs between premenopausal and postmenopausal participants.)
With all of these physiological changes happening, is it necessary to change your workout routine, too?
Your Guide to Exercise During Perimenopause and Beyond
To be clear, you don’t need to overhaul your fitness program, but you do need to emphasize certain training elements.
To offset the natural declines in muscle mass, strength training — especially a routine built with progressive overload in mind — is crucial, says Shelby Frantz, a COACH+ at Equinox Paramus. In fact, she says it’s her top priority when working with clients who are in perimenopause or menopause.
It can be tough for clients to flip their mindset around lifting heavy. “A lot of women are scared of weight. They think that's going to get them bulky. They think they're going to get hurt,” she says. “[But] it's very hard for women to get bulky — you're not going to get bulky if you pick up weight. And it's also true that we're already doing it; if you're picking up luggage, you're picking up groceries, or you're picking up children or grandchildren, you're picking up more than 10 pounds.”
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Preserving your muscle during this season of life ensures you’re able to move well and independently as you age. It may also help manage the uncomfortable symptoms associated with perimenopause, including hot flashes; research suggests that performing progressive resistance exercises more than twice a week can be beneficial for menopausal symptoms.
When your muscles are challenged via heavy resistance training, your bones also strengthen, which can mitigate the risk of fractures, says Frantz. Specifically, exposing bone tissues to a load that’s greater than what they experience in everyday life can stimulate bone mass accretion (read: growth).
Consider a study published in the Journal of Bone and Mineral Research. Twice a week for eight months, 101 postmenopausal women with low bone mass performed either 30 minutes of high‐intensity resistance and impact training (five sets of five reps with loads greater than 85 percent of their one-rep max) or low‐intensity training. At the end of the trial period, the participants in the high-intensity resistance and impact group showed greater improvements in bone mineral density and functional performance than the low-intensity group.
Still, “[your program] doesn't have to look like the bodybuilders’ in the gym,” adds Frantz. “What it needs to look like is these functional stabilizing movements: deadlifts, squats, bench pressing, overhead pressing. These foundational movements, and progressing and adding weight, are really what's going to not only even you out in the short-term, but lead to a better quality of life down the road.”
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Yes, cardio is important, too. The exact type that’s best for you depends on your current routine and your goals, says Frantz. But generally, she recommends incorporating low-intensity, steady-state cardio (think: walking, swimming) once or twice a week.
Don’t forget to bake in shorter-duration activities that are explosive, powerful, and get your heart rate up quickly. This movement should be intense enough that you feel like you’re breathing hard and you can’t carry on a full conversation without having to stop and catch your breath, she says. “My beef with only ever incorporating long walks is that you're never really challenging your top-level capacity,” says Frantz. “So thinking of something like once a week, something where two or three times in a session, you're pushing your capacity closer to your actual max, to 70 percent of your max, to 80 percent of your max.” Try tennis, pickleball, running one fast mile, or doing sprints around the block, she suggests.
“When we think about cardio as longevity, it is that steady-state [work], but it's also lifting that cap on what you can really do,” adds Frantz. “Just like anything else with your body, your cardio needs a little bit of a challenge, that might be walking up and down steps, that may be taking the stairs — it doesn’t have to look like killing yourself on the treadmill.”
It may sound boring to some, but Frantz says sticking with the basics is one of the most effective strategies to maintain and enhance fitness during and after perimenopause. “A shiny new workout or a shiny new supplement is always more appealing to people,” she says, “but it's like, actually, you need to look at what you're doing and say, ‘Okay, what is the piece I'm missing?’”
It can be difficult to recognize that missing piece by yourself. That’s why Frantz says the menopausal period of life is a great time to work with a Coach, who can help tweak your routine to better serve you. Remember, “it's still the basics,” says Frantz, “but it's just that your basics change.”