Menopause & Exercise – Planning your fitness for a successful transition
Menopause has long had negative connotations within our society, largely because it is tied to the stigma of aging. But, it’s a normal and natural part of a woman’s life and a time in life that can be just as well lived as earlier stages. It is not a disease or disorder but a natural biological process. If you are approaching the age of menopause, you may be unsure, or even a little fearful, of what to expect.
Menopause not only signals the end of a woman’s menstrual cycle, but also a period of transition which affects each woman uniquely. Some women experience exhausting physical and mental symptoms that can affect day to day life, while others won’t have any issue with menopausal symptoms and may even feel relieved when they no longer need to worry about painful periods or getting pregnant.
It is important to speak to your doctor if you find that you are developing symptoms related to menopause. Understanding the challenges you may face is the first step to easing the fear of the menopause roller coaster. Having the right treatment, changes in lifestyle, a good exercise routine, a healthy diet and regular emotional support, can play an important part in the management of the symptoms.
In this article, you will find out more about what to expect during menopause and how we, at Motivate PT, can best support and help you in this stage of your life.
What is the menopause?
According to NHS website, “menopause is when a woman stops having periods and is no longer able to get pregnant naturally.” It usually occurs between the ages of 45 and 55 and is normally diagnosed after you have gone 12 months without a menstrual cycle.
As you grow older, your body’s sex hormones, such as oestrogen and progesterone, balance out, leading to menopause. A woman experiences this when her ovaries stop producing oestrogen and no longer release an egg every month.
In some rare cases, women may show signs of menopause as early as 30 or as late as 60. These may depend on genetic history or health factors such as medical procedures like hysterectomy (removal of uterus), oophorectomy (removal of the ovaries) or changes in the ovaries caused by chemotherapy or radiation therapy.
As part of the natural woman’s ageing cycle, the frequency, intensity and duration of menopausal symptoms can last from 7 to 14 years on average. Below are the three main stages:
Perimenopause: This stage is mostly known as “pre” menopause and its symptoms may start as early as your 40s. During this stage, your ovaries slowly begin to produce less oestrogen while still releasing eggs. You’ll probably start noticing some changes in your period and/or mood swings.
Menopause: This phase will last 12 months from when you had your last period. At this point, oestrogen has significantly reduced and the ovaries are no longer releasing any eggs, causing you to become infertile and no longer have menstrual bleeding. Many of the symptoms start at perimenopause but become more pronounced during this stage which will be discussed further in this article.
Post menopause: Once you have past the 12 months, you will then transition to post menopause. While you will no longer need to worry about the symptoms of the menopause, you need to be aware that there are health risks related to the loss of oestrogen increase, including osteoporosis, heart disease, cataracts, and macular degeneration.
Hormones levels tends to vary widely in a woman, making it difficult to determine if you are going through your menopause. For this reason, the menopause transition cannot be reliably predicted by a single blood test. Therefore, you can only diagnose menopause in the absence of menstruation for 12 months.
What are the symptoms of menopause?
There is no way to know exactly what to expect when a woman goes through the menopause. The hormonal changes impact the body and mind creating a roller coaster of emotions which vary from person to person.
Menopausal symptoms appear months or even years before your last period and can be prevalent for around 4 years post-menopause. They can be severe in some cases which may significantly affect your quality of life.
The most common signs and symptoms can be described as:
- Irregular menstrual periods
- Vaginal dryness, itching, irritation, and pain during sexual intercourse
- Hot flashes or chills, and palpitations
- Night sweats leading to sleep disturbances and tiredness during the day
- Insomnia caused by hormonal changes
- Weight gain and slowed metabolism
- Thinning hair and dry skin
- Loss of breast fullness, sore or tenderness
- Mood swings, fatigue, trouble with focus or memory loss, irritability, anxiety and depression
- Regular headaches or migraines, muscle and joint pain
- Recurring UTIs (urinary tract infections)
Most of these symptoms and complications are manageable when taken with the right approach and having the right support.
Health risks at post menopause
The hormone oestrogen plays a critical role in protecting a number of different parts of your body, including your heart, blood vessels, bones, brain, skin, and vagina. Once you reach the post-menopause phase, the drop of oestrogen levels has shown to be related to causing certain types of health conditions. The severity of these conditions can vary from person to person and is affected by factors such as medical history, genetic factors, and lifestyle.
Possible health issues include:
Cardiovascular disease: Oestrogen helps to protect your arteries by reducing the accumulation of fatty plaque. When your oestrogen levels drop, it increases the risk of the coronary arteries narrowing down and cholesterol levels increasing.
Osteoporosis: It is characterised by the brittleness and weakness of bones, which increases the risk of fractures, particularly on the spine, hips and wrists. The risk increases due to rapid loss of bone density caused by the low level of oestrogen.
Urinary incontinence: This condition refers to the loss of bladder control causing involuntary urinary leakage or stress incontinence, following a cough, laughing or lifting. Oestrogen plays an important part in the health of your bladder and urethra. The lack of oestrogen may cause the pelvic floor muscles to become weaker and your vagina and urethra to lose elasticity, making it harder to control the functions of the bladder. UTI (urinary tract infections) may also be more common.
Sexual function: Postmenopausal woman may experience a lower desire for sexual activity, due to decreased sensitivity, discomfort and slight bleeding when engaging in sexual intercourse. The reason for this is due to the loss of elasticity and moisture production in the vaginal area, affecting libido e.g. the desire for sexual activity.
Weight gain, loss of muscle mass and skin changes: An increase in oxidative stress, pro-inflammation markers, and hormonal changes during menopause coupled with aging, medical and lifestyle factors, may negatively influence your body to loose muscle mass and increase the risk of weight gain. The loss of lean muscle tissue slows down your metabolism (calories used by your body), making it easier for your body to gain weight, particularly around the abdomen. The lower levels of oestrogen also cause your body to produce less collagen and increase dryness, making you more liable to thinning, sagging, and wrinkling skin.
Weaker vision such as cataracts and macular degeneration: Although it is yet unclear how exactly the menopause affects the eyes, it is possible that the hormone fluctuation cause stiffness of the cornea and affects how light is refracted through the eyes, causing blurred vision, dry eyes and an increased pressure.
Depression, anxiety and sleep disturbances: oestrogen levels are responsible for the management of a brain chemical called Serotonin, responsible for the sense of wellbeing and happiness in our body. Lower levels of oestrogen causes the serotonin levels to drop which, together with lifestyle and stressor factors, can contribute to depression, anxiety, palpitations and sleep disturbances.
Higher risk of dementia and Alzheimer’s disease: According to research by Alzheimer’s Society, the decrease of oestrogen levels can affect the brain in many ways, including reducing the number of connections in the hippocampus, the area responsible for memory and certain types of learning, and affecting the way chemicals such as serotonin, acetylcholine and dopamine are used to send signals throughout the brain. Oestrogen may also help to protect the brain from the effects of a protein called amyloid-β protein (highly present in Alzheimer’s patients) which is believed to damage or kill brain cells. Lower levels of oestrogen post menopause may cause the woman to become more prone to the effects of this protein.
Preventing the effects of menopause on your health, relationships, and career by seeking advice early from your GP, nurse or Woman’s Health Specialist. You may choose not to have any treatment when they are mild but, if severe or prolonged, they can be treated in a variety of ways.
What are the treatments available?
There are many ways to support your body during the menopause. Some are totally drug-free and beneficial for your overall health and longevity. If further treatment is required, it is important to follow the advice from your doctor, particularly if you have any other health condition that could be affected by any of the treatments.
The following are some treatment options to consider,
Non-hormonal drug treatments: Hot flushes and night sweats can be reduced with several prescription medications. For example, the use of certain low-dose antidepressants – SSRIs (venlafaxine, escitalopram, citalopram, paroxetine for example), drugs used to treat chronic pain such as gabapentin, and clonidine which is used for the management of blood pressure.
Hormone replacement therapy (HRT): Also know as menopausal hormone therapy (MHT), the main component in HRT is oestrogen and can also contain progestogen to protect the lining of the womb from cancer. This treatment has a 80% effectiveness on the reduction of hot flushes and night sweats, sleep disturbances, osteoporosis and fracture according to numerous sources.
This treatment is safe for most healthy women that developed the symptoms at the natural time of the menopause. However, you should not take it if you ever had bladder, uterine or endometrial cancer, blood clots, liver disease, or stroke. It is recommended that you should not take it for more than 5 years post menopause or after the age of 60, as research shows that there is a correlation between HRT and breast cancer due to the combination of hormones.
The risks and benefits of HRT will vary from each individual and should be discussed with your doctor before you start the treatment.
Lifestyle changes and drug-free treatments: While they do not significantly reduce menopausal symptoms, the use of counselling and psychological treatment such as cognitive behaviour therapy (CBT), hypnosis, acupuncture, sleep routine, exercise and relaxation programs can be helpful for your general physical and emotional health. Adding Vitamin D to support your bone health, quitting smoking (if you do smoke) and following a healthy diet by reducing alcohol, caffeine and spicy foods is also believed to help reduce hot flashes.
There are many other alternative treatments believed to help relieve some of the symptoms, but research is still limited, and you should always consult your doctor before starting them. Some examples are herbal medicines such as black cohosh, evening primrose oil and ginseng; dietary supplements such as vitamin D; and natural remedies based on soy extracts and soy foods which may contain oestrogen-like effects.
How fitness can help you during the menopause
Being physically and mentally active is vital to your health and quality of life. The benefits of exercise, during and after menopause, extend beyond protecting and strengthening the heart, bones, and muscles. It also helps maintain and improve balance, body weight, mood, and overall well being.
For most healthy women, the American College of Sport Medicine (ACSM) recommends 30 to 60 minutes of moderate-intensity physical activity five days or more per week or 20 to 30 minutes of vigorous activity three days or more per week, or a combination of both. Strength training should also be incorporated for at least two days per week.
When planning your workout, it is important to consider your abilities and preferences as not every exercise fits all. Make sure to warm up and cool down on every session!
Cardiovascular training: Losing excess pounds and maintaining a healthy weight can be achieved through aerobic activities. Brisk walking, jogging, biking, swimming or water aerobics are all excellent exercises. Group classes such as Zumba, dancing, Body Combat and spinning are great fun and stress relievers. Start slowly and gradually increase the intensity and duration of your workout to the recommended amount.
Strength training: The benefits of strength training include reducing body fat, strengthening your muscles, and burning more calories. Start by using your own body weight and then, as you get stronger, consider using weight machines, free weights, and resistance bands to gradually increase the resistance – carrying shopping bags or even gardening counts too! Strengthening pelvic floor muscles with Kegel exercises may also help prevent incontinence.
Flexibility, stability and balance: Stretching helps to improve and maintain the range of movement of your joints, helping reduce stiffness and muscle aches, while stability and balance exercises can help prevent falls and create a sense of body awareness and control. Always stretch at the end of your workout session. Classes such as tai chi, yoga and Reformer Pilates are great for flexibility, balance and relaxation. You could also try simple exercises, such as standing on one leg while brushing your teeth.
As the circumstances and symptoms vary from day to day, set realistic and achievable goals. Be mindful and respectful of how you might be feeling and remember that not every workout needs to be intense or take up most of your day. Plan in advance as maintaining a routine is essential and your body and mind will thank you for that. Find a training buddy to join you, as mutual support can be encouraging, fun and sociable.
Engaging in exercise has positive effects on your mood and ability to reduce the stress caused by the changes in your body, helping you to cope better with the menopausal symptoms and live a healthier life. If you are not sure what exercise is right for you, you can find support from a specialised healthcare professional such as a Woman’s Health Personal Trainer. They are trained to support you and advise on the type of exercises that are safe and suitable for you.
Written By Aline: Female fitness expert at MotivatePT – Reps Level 3 Qualified / Pre & Post Natal