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Understanding Menopause: Key Changes and Challenges

Understanding these changes and their potential impact is essential for developing effective strategies to manage your symptoms and maintain your wellbeing.

Menopause is a natural biological process that marks the end of a woman's reproductive years, typically occurring between the ages of 45 and 55. While menopause is a normal part of ageing, the lead in phase - known as perimenopause - can bring about a range of physical and emotional changes due to fluctuating hormone levels, particularly oestrogen and progesterone. These hormonal shifts can lead to symptoms such as hot flashes, night sweats, exhaustion, mood swings, weight gain, and changes in sleep patterns.

One of the most significant changes during perimenopause and menopause is the shift in body composition. As oestrogen levels decline, women may experience an increase in abdominal fat and a decrease in muscle mass (sarcopenia) and bone density (osteopenia). This shift not only affects physical appearance but also poses risks to overall health, including increased risk of osteoporosis and cardiovascular disease. With a reduction in muscle mass, the metabolic rate tends to slow down, making it easier to gain weight and harder to lose it.

Emotional and psychological challenges are also common during menopause, from mood swings to anxiety and even depression. The sense of losing your youthful vitality can impact self-esteem and body image. Coupled with general fatigue or even exhaustion, many women lose the energy, motivation and confidence to exercise.

Understanding these changes and their potential impact is essential for developing effective strategies to manage your symptoms and maintain your wellbeing.

The Importance of Exercise During Perimenopause and Menopause

Exercise is a powerful tool that can help reduce many of the challenges associated with menopause. Regular physical activity or movement offers a multitude of benefits, from improved cardiovascular health, stronger bones and muscles, to enhanced mood and better weight management. By finding ways to include even a little bit of exercise in your daily routine, you can experience significant benefits.

Bone Health

Weight-bearing and resistance exercises stimulate bone formation and slow down the rate of bone loss, which is essential for preventing osteoporosis. Activities like walking, jogging, dancing, and strength training can help maintain bone density and reduce the risk of fractures.

Heart Health

Vascular stiffening is the loss of elasticity and increased rigidity of artery walls, a process common with aging and worsened by conditions like high blood pressure and diabetes. Stiff arteries require the heart to work harder and can increase the risk of heart attack, stroke and related conditions. Regular aerobic exercise is a proven method to reduce vascular stiffness. Even short bursts of activity can have a positive effect.

Managing Weight and Body Composition

Aerobic activities like swimming, cycling, and brisk walking can help to lower body fat, while strength training exercises or resistance training build muscle mass, which boosts metabolism and helps maintain a healthy weight. Muscles are metabolic powerhouses, so building muscle is very beneficial for maintaining a healthy body weight.

Mood and Motivation

Regular physical activity has been shown to improve mood and reduce symptoms of anxiety and depression, thanks to the release of endorphins and other feel-good hormones during exercise, along with increased social engagement and a sense of accomplishment.

Each type of exercise offers unique benefits that contribute to overall health and well-being.

Types of Exercise Beneficial for Menopausal Women

To maximise the benefits of exercise during menopause, it's essential to incorporate a variety of workouts that address different aspects of fitness. A well-rounded exercise regimen should include:

aerobic exercises
strength / resistance training
flexibility, mobility and balance training
mind-body movement, and
pelvic floor exercises.

Each type of exercise offers unique benefits that contribute to overall health and well-being.

Aerobic Exercise / Movement

Excellent for improving cardiovascular health, burning calories, and reducing the risk of chronic diseases. Activities such as walking, running, cycling, swimming, and dancing are great options. The Australian Physical Activity Guidelines for Adults recommend at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity exercise per week.

However, if you’re new to exercise or have limitations, start small and work up, and do shorter sessions throughout the week to make it more manageable - any amount of aerobic activity or movement is helpful.

Strength Training

Critical for maintaining muscle mass, improving bone density, and boosting metabolism. Incorporate resistance exercises such as weight lifting, bodyweight exercises (e.g., push-ups, squats, lunges), and resistance band workouts into your routine. Aim to perform strength training exercises at least two to three times per week, targeting all major muscle groups.

If you’re new to exercise, have joint or muscle pain or other limitations, start with a simple routine, even as little as 5 - 10 minutes.

If you’re more experienced with exercise, high-intensity interval training (HIIT) can have a greater impact on body composition and fat loss.1 Some studies show a greater effect in pre- and peri-menopausal women, but it can still be effective in post-menopause, especially when using cycling-based HIIT. But seek advice from an exercise professional: HIIT requires proper recovery and nutrition, and may be unsafe for some people (e.g. osteoporosis).

Flexibility Exercises

Maintaining joint mobility helps to reduce the risk of injury. Incorporate stretching exercises, yoga, or Pilates into your routine to improve flexibility and promote relaxation. Many forms of flexibility exercises include mind-body benefits which can reduce stress and calm the mind.

Balance Training

Alongside strength training, balance training is a key part of reducing the risk of falls, which increases with age. Exercises such as tai chi, yoga, and specific balance exercises can help enhance stability and prevent falls.

Pelvic Floor Exercises

Many women experience pelvic floor dysfunction during menopause, which can lead to urinary incontinence. Pelvic floor issues have different causes, from childbirth and ageing to obesity or trauma. Treatment depends on whether the muscles are weak or tight; weak pelvic floor muscles can benefit from Kegel exercises or pelvic floor physiotherapy.2

Creating a Balanced Exercise Routine

Start by assessing your current fitness level and setting realistic goals.

Creating a balanced exercise routine tailored to your needs and preferences is key to staying consistent and reaping the benefits of physical activity during menopause. Start by assessing your current fitness level and setting realistic goals. Consult with a fitness professional or personal trainer who can help design a personalised exercise plan that aligns with your health status and fitness objectives.

A balanced exercise routine should include a mix of aerobic, strength, flexibility, and balance exercises. For example, you might schedule aerobic activities like brisk walking or cycling on Mondays, Wednesdays, and Fridays, and dedicate Tuesdays and Thursdays to strength training. Incorporate flexibility and balance exercises into your routine on weekends or as part of your cooldown sessions after other workouts.

It's important to listen to your body and adjust your exercise routine as needed. Menopause can bring about fluctuations in energy levels and motivation, so be flexible and compassionate with yourself. If you're feeling fatigued or experiencing symptoms such as joint pain or hot flashes, consider modifying your workouts or taking rest days to allow your body to recover. The key is to stay active and consistent while honouring your body's needs.

Tips for Staying Motivated and Overcoming Barriers

Staying motivated to exercise during menopause can be challenging, especially when dealing with symptoms like fatigue and mood swings. However, there are several ways to stay motivated and overcome common barriers - at Sage Womens Health, we recommend the BASE approach:

B = Bite Sized

Planned exercise is great, but daily movements also count. Find opportunities to be more active - fidget, stand, climb stairs or walk a bit further, tap your feet to music. Regular, bite-sized movements increase your Non-Exercise Activity Thermogenesis (NEAT), boosting calorie burn and improving body weight regulation.

A = Appealing

Some people cringe at words like “exercise,” “gym”, “fitness”etc., and this in itself can be a mental barrier to being more active. Find other words that feel more appealing, like “movement snacking”, “being active” or similar, to help you feel more motivated about doing it.

S = Social

It’s often more fun and motivating to do things with other people - and you enjoy the added benefit of social connection, which is an important factor in longevity and healthspan. Join a group, invite a friend, work with a qualified trainer, join a challenge - anything that creates community and a reason to move.

E = Entertaining

Being consistent with movement is easier if it’s enjoyable. Find activities that you enjoy and look forward to, that make you laugh, or lift your mood. Whether it's dancing, swimming, hiking, beach swimming, 10-in bowling or practising yoga, choosing activities that bring you joy will make it easier to stick with them.

Work With Your Schedule

Most of us know what to do - but we face challenges like lack of time, energy, or motivation that get in the way of consistency.

These tips will help you fit exercise into your day:

Schedule formal workouts at a time of day when you feel most energised and least likely to be interrupted.
Prepare your workout clothes and equipment in advance to minimise excuses.
If you're short on time, remember that even short bursts of activity, such as a 10-minute walk or a quick home workout, can be beneficial.
Enjoy a quick win by increasing NEAT activities such as fidgeting, foot tapping or walking a bit further.
Prioritise self-care and make exercise a non-negotiable part of your routine, just like brushing your teeth or eating meals.
Use habit stacking (simple activities tagged onto the end of an existing habit)
Work with a health coach to help you become consistent with healthy routines that fit with your schedule, lifestyle and health goals.

Conclusion: Embracing a Healthier Lifestyle During Menopause

Menopause is a natural and inevitable phase of life, but it doesn't have to be a period of decline. By embracing a healthy lifestyle that includes regular exercise, you can navigate this transition with confidence and vitality. Effective exercise not only helps alleviate menopausal symptoms but also enhances overall physical and mental well-being, empowering you to live your best life.

Remember that every woman's menopause journey is unique, and there's no one-size-fits-all approach to exercise. Listen to your body, be patient with yourself, and make adjustments as needed. Surround yourself with a supportive community, whether it's friends, family, or a fitness group, to stay motivated and inspired. Celebrate your progress and acknowledge the positive changes you're making for your health and well-being.

Empower yourself by taking proactive steps to prioritise your health during menopause. With the right exercise regimen, you can not only survive but thrive during this transformative stage of life. Embrace the opportunity to rediscover your strength, resilience, and inner radiance. Here's to a more vibrant, healthier, and empowered you!

References

Sims, S. (2025) Why HIIT Matters for Women’s Body and Brain Health

Cleveland Clinic (2024) Pelvic Floor Dysfunction: What It Is, Symptoms & Treatment

Empower Yourself: The Ultimate Guide to Staying Active During Menopause

Understanding Menopause: Key Changes and Challenges