Perimenopause & Strength Training
Why it’s vital and how to make it happen
By Claire Callaghan – B.PTY MSC Chartered Physiotherapist
Perimenopausal women in the UK face a 1 in 2 lifetime risk of bone fracture, and the loss of up to 20% of their bone mass in the 5-7 years post menopause. This loss of bone mass can result in bone thinning – often referred to as osteopenia and osteoporosis. In the short term, women can experience stress fractures from relatively low impact falls or overloading the body during sport, while in the longer term, hip fractures and reduced longevity.
We all lose 3-8 % of muscle mass each decade from the age of 30 too if we are sedentary and don’t take steps to prevent it. For women, this effect is compounded by the drop in oestrogen, and women can lose up to 10% muscle mass during menopause alone. Our connective tissues, such as collagen and elastin, also rely on oestrogen to keep them strong. We often think about this in relation to our skin, but the increase in sag and thinning of tissues affects our pelvic floor strength and control too. In real terms, this can result in leaking urine and even pelvic organ prolapse.
A recent scientific review titled “Musculoskeletal syndrome of the Menopause”confirms that these changes in bone strength, muscles, joints, inflammation and even our ability to repair after injury can be affected by menopause and the associated drop in oestrogen. The net result – a drop in women physical capacity, confidence, ability to perform at their best and, as they get older, independence.
There is good news – there’s so much women can do to protect themselves and prevent problems. Being informed and taking active steps before and during perimenopause – a transitional period which last from a year or 2 or up to 10 years – can help soften the impact of changes and keep you at your best. Not all exercises have the same impact at this stage of life. While any exercise is helpful, perimenopausal women’s bones, muscles and pelvic floors benefit most from targeted weight bearing and resistance exercise that gives them maximum benefit for the effort they put in. This type of strengthening also helps women regulate their metabolism and blood sugar levels, improves body composition and can serve as a crucial tool in mitigating memory loss and cognitive decline in later life.
Benefits for working women and their employers
Large scale scientific reviews show that lifestyle factors, including physical fitness and strength, affect our capacity and performance at work too. Strength also helps women in physically and emotionally taxing roles, allowing them to continually meet the high demands of their roles. This can be critical to retaining experienced, knowledgeable women in the workplace.
Which exercises are best and give the maximum benefits?
I have broken the essentials down into 4 simple elements.
Postural strength and control
The postural muscles – often referred to as the ‘core muscles’ – are active when we are doing day to day tasks, like standing or sitting upright. Strengthening them stops us stooping forward and giving the appearance of losing height. It also helps stop neck and back pain. We need to strengthen all 3 layers of abdominal muscles, especially the deepest layer, which wrap around our middle like a corset, protecting our backs. Simple pilates style exercises, some of which can be done in a 5 minute break, or even at the desk, will help.
Weight bearing exercise
This is literally exercise which involves taking weight through our arms and legs. It’s vital for maintaining bone density and mass, as the pressure from weight bearing stimulates the bone turnover. Examples of weight bearing exercise on the legs include
- Walking and running
- Aerobic classes
- Sports such as hockey, netball, racket sports
- Dance
- Lunges with weights
- Press ups
Resistance exercise
Resistance exercise is anything where you are working against an external force. It strengthens bones and stimulates the cells that help women maintain good quality muscle. 2 popular forms of resistance are
- weights – free weights and machines
- resistance bands
Here are some straightforward ways women can strengthen with resistance to get maximum gains.
Pelvic Floor Control
The pelvic floor muscles support our pelvic organs and function. Weakness can cause leakage, and overactive tight muscles can also cause problems and pain. Control is key. See here for my active woman’s guide to the pelvic floor.
Where to start and making movement happen
Ideally, you would do some physical work against resistance 2-3 times a week, but if you haven’t done it before, start slower and build up. If you’ve not done strengthening before, as little as 10 minutes of strengthening is useful. Gradual progression and consistency will help. You don’t need a gym – you can do bands and weights at home and keep them out somewhere where it’s easy to use them. Weight bearing exercise requires no equipment at all, and you can use the floor or wall to work against. Some people find it easier to commit if they put it in the diary or do it others.
The regularity and difficulty of strength work depends on your starting point. Start low and build up slowly if you’re new to strengthening, and challenge yourself with new or slightly heavier work if you’re already doing strength work. Real changes can happen with short, high quality efforts, and greater, consistent commitment brings better results. More meditative activities like yoga and pilates help support our physical and mental wellbeing, balance and coordination, and nicely compliment strength work.
For more on moving well through midlife, see Claire’s website.