Physiotherapy for Menopause

Menopause + exercise

The importance of staying active across our lifespan is well known. However, menopause results in a number of changes including the body’s response to exercise. A shift in the way we workout can help mitigate the negative impacts of menopause and get the most out of exercise.

What is happening during menopause?

Estrogen and progesterone are two hormones that play a key role in normal menstrual cycles (along with luteinising hormone and follicular stimulating hormone). They both influence a number of systems throughout the body. This includes the cardiovascular system, sweating/body temperature, muscle and bone health and the central nervous system.

Quite simply put, menopause is the drop-off of these hormones which results in the cessation of menstrual cycles as well as changes to all the other systems normally affected. This can look like:

• Loss of bone mass
• Loss of muscle mass (reduced sensitivity to anabolic stimulus + reduced muscle protein + increased breakdown of muscles)
• Reduced sensitivity to insulin
• Increased serotonin and tryptophan (can contribute to ‘brain fog’)
• Peri-menopausal fluctuations in hormones can contribute to hot flushes, poor sleep and poor cognition

Role of exercise in Menopause

Exercise can be used to help mitigate some of these changes and assist in optimising health. We know that exercise can aid in clearing the mind and assist in getting a good night’s sleep. Regular exercise is also one of the best ways to improve sensitivity to insulin. Any form of exercise is beneficial, so go with what you enjoy most!

On the other hand, more specificity is required to minimise loss of muscle and bone mass. As the body is less sensitive to ‘anabolic stimulus’ (eg resistance/strength training), the stimulus needs to be increased. Likewise, new bone mass is laid down in response to ‘novel stimulus’ so the body needs to be exposed to something new.

Exercise Examples for Menopause

Typically this can look like:

• Heavier weights – for example swapping out 3 sets of 10 reps for 5 sets of 6 reps at a heavier weight (or adding in weight training if it hasn’t been part of your routine before)
  
• Plyometrics (eg squat jumps, bounding, skipping, box jumps etc) – make sure you have an adequate base of strength/control before adding this in!
  
• HIIT style training – moving the focus away from slower or ‘steady-state’ exercise and including some short high intensity efforts on short recovery (total session of ~20 minutes)
  
• Some slow/steady-state exercise (eg going for a walk, long cycle or run) certainly still has its place. The higher intensity of exercise needs to be balanced with low intensity, easy days and rest days (otherwise everything just ends up at a medium intensity). These sessions also often serve the purpose of nourishing your soul! However, for best outcomes they shouldn’t make up the majority of exercise in the post-menopausal population
  

If you are interested in optimising your exercise to match your stage of life or just change your routine, make sure you chat to your physio to make sure the changes are done gradually to minimise the risk of injury. To book an appointment with a Barefoot Physiotherapist please click here. If you enjoyed this blog please check out out blog on Women’s Health Physiotherapy and Pelvic Floor Physio is Important for Everyone.