For women, perimenopause marks the beginning of a phase in which their own body changes, sometimes loudly, sometimes quietly: the phase of menopause. The hormonal change heralds the end of the fertile years. A completely natural development that can still bring with it many questions, worries and physical challenges. Many seemingly inexplicable symptoms are accepted as “normal” and “you just have to get through it”. But just as I am firmly convinced that no menstrual problems are part of being a woman, I am also of the opinion that we can go through the menopause phase much more comfortably. In this context, we can look at many aspects of our everyday lives: sleep, nutrition, exercise, relaxation, social interaction, self-esteem – simply all the areas that make up and influence our lifestyle.
Especially in times of change, it is worth focusing on something that you can actively shape: your own activity behavior.
But what effects does regular exercise have in the context of menopause?
What should the training include?
What should you pay attention to?
How can the training be designed so that it is not overwhelming but has a positive effect for you?
I would like to present this in a little more detail here. To understand the impact exercise can have during perimenopause, it’s worth taking a look at what happens in the body.
What happens during menopause?
Menopause itself refers to the time of the last menstrual period, which is retrospectively defined as twelve months without bleeding. The period before and after – the so-called perimenopause – begins around the end of your 40s and can last for several years. During this transition phase, the hormonal balance gradually changes, in particular the production of estrogen and progesterone decreases individually. These hormones influence not only the cycle, but also numerous other systems, such as bone metabolism, the cardiovascular system, muscle function, the (vaginal) mucosa, mood and also sleep (Polotsky & Polotsky, 2010; Monteleone et. al, 2018; Nair & Nair, 2021).
Let’s take a closer look at the physiological processes that take place in the female body over time. The total number of eggs in the ovaries that a woman will have available over the course of her life is determined at birth. At this point, the female body has around one to two million eggs. This so-called ovarian reserve continually decreases over the course of life due to natural aging processes and genetic and environmental factors. If the egg reserve falls below a critical threshold, the menstrual cycle becomes increasingly irregular – a typical sign of the approaching menopause. As the activity of the ovaries decreases, the body activates processes to compensate for the decreasing production of sex hormones. During this phase, many women experience cycle fluctuations, joint inflammation, emotional changes, sleep problems or weight gain, even though their lifestyle seemingly hasn’t changed much.
The good news: With the right care and targeted lifestyle changes, many symptoms can be significantly alleviated. Just as the body continually adapts over the course of life, we can also change our lifestyle from time to time. And since change always goes hand in hand with exercise, let’s now look at the role of exercise during menopause.
What are the benefits of exercise during perimenopause?
Sport not only influences physical performance, but also has a regulating effect on the autonomic nervous system, stabilizes blood sugar levels, improves sleep quality, ensures more bone stability and helps maintain muscle mass. So exercise is an important factor for a good starting point during menopause (Zhang et al., 2014; Leite et al., 2010). On a psychological level, training also supports stress reduction and has a mood-enhancing effect (Zhao et al., 2022). In short: Sport is less of a “lifestyle factor” in this phase of life, but rather a fundamental basis for alleviating symptoms.
Which types of training make sense in this phase of life?
Strength training is a central process for maintaining structures during perimenopause (and of course before and after). Falling estrogen levels accelerate age-related muscle loss and reduce bone density. Targeted strength training counteracts this natural change. Depending on the training level, the training formats can be adjusted accordingly. If you have been active in previous years and have done strength training regularly, this is a great advantage for maintaining your structures.
Endurance training, such as walking, cycling, running or swimming, not only improves cardiovascular health but also supports stress management. Moderate to intense exercise sessions help to bring the autonomic nervous system into balance. It can also get tiring at times. The most important thing here is regularity and not the idea of performance. To support stress regulation and relaxation, calm training formats such as yoga, autogenic training or a body scan with a focus on breathing and body awareness are very effective.
How often should you train?
There is no general answer to how often you should exercise during perimenopause. Rather, it depends on the individual lifestyle, current complaints, level of training and of course also on resilience. Anyone who manages to integrate exercise as an integral part of everyday life will benefit in the long term. It is important to keep an eye on not only your physical performance, but also your mental health on the day. During the hormonal upheaval, energy levels can fluctuate greatly. Training plans should therefore remain flexible and leave room for adjustment. On some days a quiet yoga session is just the thing, on others a demanding strength training session. Ultimately, it’s less about rigid guidelines and more about being aware of your own body.
As with any form of physical activity, the same applies during perimenopause: exercise is healthy – as long as it is measured, adjusted and carried out consciously. In practice, this means that not every form of training or intensity of exercise makes sense for every woman. Falling estrogen levels can, for example, affect the resilience of tendons and joints, which increases the risk of injury under unusually high levels of stress. Sleep is also often underestimated in this phase as an important element of regeneration. Anyone who constantly exerts themselves too intensively risks additional stress for the already irritated nervous system. At the same time, lack of exercise is an equally serious risk: it promotes, among other things, weight gain, depressive moods and increases the risk of metabolic diseases. The goal should therefore not be to take it easy out of concern about possible risks, but rather to design exercise consciously: adapted to the current energy level, with clear regeneration phases and the willingness to listen to the body’s signals. Competent support from qualified trainers or therapists can be valuable here.
The most important message for you:
It’s better to get 5 minutes of exercise every day than to fully exert yourself once a month!
The change in lifestyle
With the right diagnosis, individually tailored medical/therapeutic treatment and supportive lifestyle measures, many complaints can be drastically alleviated.
Understanding the changing mechanisms is fundamentally important.
What exactly makes you feel restless and stressed?
What helps you wake up regularly at night or even be able to fall asleep? How does body weight change and why is high blood pressure also an issue now?
When it becomes clearer what exactly is happening in the body and what it leads to, lifestyle changes with the right measures become easier. With the right motivation and support, the accompanying symptoms of menopause can be counteracted. In addition to exercise, this includes, among other things, eating habits, sleep hygiene, stress regulation, energy distribution at the metabolic level, attention to inflammatory processes and, of course, cardiovascular activity.
It is crucial for the training that it is not about achieving an “end goal”, but rather a dynamic process that can be based on your own phases in life. Movement is fundamentally essential, and in the best case scenario we should never stop.
You want support and preferably with like-minded people:
RE-treat MenoPause – Reset your rhythm.
The content is reduced to the most essential specialist knowledge and shortened in some places, otherwise this would exceed the content of the article. For more in-depth knowledge, I am happy to provide personal literature recommendations upon request.
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