What is Menopause and Perimenopause?
Menopause is the permanent end of menstruation. It typically occurs naturally after a woman's final menstrual period, which is usually defined as 12 months after their last bleed. However, menopause can also be induced by medical interventions like a hysterectomy or certain cancer treatments that affect the ovaries.
The transition period leading up to menopause is known as perimenopause. During this time, hormone levels, particularly estrogen and progesterone, fluctuate. Perimenopause can last anywhere from 1 to 10 years, with an average duration of 4 to 6 years. Symptoms often include irregular menstrual cycles, hot flashes, sleep disturbances, and mood changes.
Early onset menopause occurs when a woman's final menstrual cycle happens before the age of 45. If this occurs before the age of 40, it's classified as premature menopause. Both early onset and premature menopause can be caused by natural factors, medical treatments, or surgical procedures.
Menopause and Bone Health:
Hormonal changes that come with menopause, can have significant consequences for bone health. These changes often lead to a more accelerated loss of bone mineral density than at any other life stage. Tendon degeneration and muscle loss are also common occurrences.
To mitigate these risks, resistance training and pelvic floor muscle training are recommended. These exercises help to load bones, muscles, and tendons, reducing the likelihood of conditions such as:
Osteopenia and osteoporosis (reduced bone mineral density)
Fractures
Pelvic floor dysfunction (e.g., urinary incontinence, prolapse)
Chronic joint pain
Menopause and Cardiovascular Health:
Menopause can have a significant impact on cardiovascular health. Common effects include:
Endothelial dysfunction: Impaired function of the blood vessel lining
Increased systolic blood pressure: Higher top number in blood pressure readings
Increased LDL (bad) cholesterol and triglycerides: Elevated levels of fats in the blood
Decreased HDL (good) cholesterol: Lower levels of cholesterol that help protect against heart disease
To reduce these risks and improve cardiovascular health, aerobic exercise is highly beneficial. Activities like walking, swimming, biking, dancing, or participating in social sports can help to:
Improve cardiovascular health markers
Reduce the risk of atherosclerotic changes (plaque buildup in arteries).
Menopause and the Metabolic System:
Menopause can increase the risk of metabolic syndrome, an umbrella term for conditions including obesity, high blood pressure, high blood sugar, and abnormal cholesterol levels. These are caused by increased insulin resistance due to hormonal changes.
Indigenous Australian, Polynesian, South Pacific Islander, and Indian women are particularly at risk for developing metabolic syndrome.
To improve insulin sensitivity and manage metabolic syndrome, moderate-intensity aerobic exercise (where you can talk comfortably but not sing) and resistance training can be effective. Combining both of these types of exercise will often get the best results.
How does exercise help Menopause?
Exercise is key to optimizing long-term health after menopause. It can help:
Maintain bone mineral density and reduce the risk of osteoporosis or osteopenia.
Reduce cardiovascular risk factors and improve heart health.
Maintain a healthy weight and manage metabolic health.
Strengthen pelvic floor muscles and improve pelvic health.
Improve balance and reduce the risk of falls.
Exercise can also help manage specific menopausal symptoms:
Hot flashes and night sweats
Psychological symptoms like depression, anxiety, impaired memory, and concentration
Physical symptoms such as joint pain, headaches, and dizziness
Incontinence
For post-menopausal and perimenopausal women, exercise can lead to:
Preservation of bone mineral density
Reduced risk of cardiovascular disease
Improved endothelial function (reducing the risk of atherosclerosis and high blood pressure)
Enhanced sleep quality
Increased insulin sensitivity (lowering the risk of diabetes and blood sugar issues)
Improved mental health and well-being
A higher quality of life
What types of Exercise are best for Menopausal Women?
To ensure you're exercising safely and effectively, it is always best to consult with an Exercise Physiologist or Physiotherapist for an individualized exercise plan. However, the research advises an exercise plan should meet the general physical activity guidelines of 150 minutes per week of moderate intensity exercise or 75 minutes of vigorous exercise and two non-consecutive days of resistance training sessions per week. These are the minimum requirements for adults to achieve general good health and well-being.
Exercise prescription should always consider your:
Exercise history
Individual goals
Exercise that is enjoyable for you personally
Other chronic health conditions or injuries
Exercise prescription from an Exercise Physiologist would ideally include resistance training, pelvic floor training, balance training, aerobic activity and bone loading or power-based training. Studies have shown exercising in a social setting, such as a small group or class can enhance mental health, quality of life and program adherence.
Try these:
A note on pelvic floor:
If pelvic floor dysfunction is suspected or diagnosed, the exercise plan should minimize intra-abdominal pressure and avoid straining the pelvic floor organs and muscles to reduce the risk of prolapse or incontinence. This might involve modifying or eliminating exercises that require holding your breath (Valsalva maneuver).
Your AEP will guide you on appropriate techniques so you can safely participate in more challenging exercises like certain abdominal or Pilates moves, or high-impact activities like running and jumping.
Women with pelvic floor dysfunction or other health conditions should consult a trained women's health physiotherapist or AEP for more thorough assessment. Your allied women’s health professional will assess and prescribe suitable exercises and educate you on modifications. They'll help you improve pelvic floor function so you can fully resume all activities without limitations.
At MOVE Sports Physio , we’re here to help you embrace this transition with a tailored exercise plan that works for you. Whether it’s resistance training, pelvic floor exercises, our team of professionals can guide you in creating a fitness routine that suits your individual needs and goals. Ready to take the first step?
Book a personalized consultation with one of our experienced Exercise Physiologists or Physiotherapists to get started.
Have questions? Reach out to us, and we’ll be happy to provide the support you need.
Contact us today:
Email: info@movesportsphysio.com.au
Phone: 0352226868
References and further information:
Exercise is Medicine Australia
Exercise Right Menopause Fact sheet