Do I really need to exercise differently during menopause?

Seriously, what does an exercise program look like and what should you do?

I finally can check off an item from my professional bucket list—a byline in the New York Times (gift link).

I know that there’s a lot of mixed feelings about the paper’s coverage in recent years but it’s been my local paper for the past 30 years. It’s the paper that got me to read the news regularly. On my commute, which required learning the now-lost art of folding the paper in half and then in quarters on a crowded subway train. (I always started with the sports section, then science.) On Sunday mornings with the entire paper sprawled out on the kitchen table. So it was a thrill to see my name in print in the paper.

I pitched a story about exercise during menopause. While there’s been a lot more conversation about menopause and what that means for active and athletic women, I’ve been frustrated with the coverage. 

Everyone seems to say, “Lift heavy! Do more high intensity workouts!” And yes, when it comes to menopause, how you exercise should change because your physiology is changing.

But trying to figure out what that means can be overwhelming and confusing. What does that mean for someone who is newer to fitness versus someone who already exercises regularly? How do you progress? And is easy-to-moderate intensity cardio really as bad for people in this phase of life as social media would suggest?

It reminded me of a conversation I had while reporting my book. We were talking about women’s specific gear and the person I was speaking with said that while “women’s specific” skis provides options for women and an entry way into the sport, it also kind of sandbags women from the start. Gear often topped out at an intermediate/intermediate-advanced level, making it harder to progress and advance because there wasn’t the gear available to support those pursuits.  

Fitness and exercise advice often feels like this too. Yes, it’s important to provide the basics and to offer accessible programs but we should also provide women with the information and tools they need to progress as their fitness and athletic goals and interests progress. When I was younger, I wasn’t taught that information. I now realize that I don’t actually know the best way to build a progressive strength training program on my own. Instead, I find that I often default to the same basic workout structure I first read about in women’s magazines back in the late 1990s and early aughts. 

When I first pitched the idea, I wanted to provide more concrete guidance on how to program workouts, something that people could take with them into the gym to get started and to progress their workouts. I also wanted to talk to real people about their experiences to understand what was important to them and how their experience with exercise changed during this time. 

But I only had 1000 words and it quickly became apparent that I wouldn’t be able to include a lot of the detail that I wanted to include. Not just from the experts that I spoke with but from the people who reached out to share their stories. 

I don’t want to just leave all that information in a text file on my computer so I’m going to share it here. First up, more advice from the experts and then in the next issue, excerpts from my conversations with women about their experience of the menopause transition. 

This is also a reminder that I am not a licensed medical professional nor am I a certified fitness professional.

Photo by Victor Freitas on Unsplash

Why focus on muscle

The reason I wanted to highlight the importance of building and maintaining muscle is because for so many people (and especially people my age who are going through this now and who grew up in the 90s), working out has always been about losing weight and losing fat. That sentiment comes roaring back in middle age as you start gaining more weight and fat because of age and hormonal changes.

In some ways, all the menopause advice flooding the market feels like a different shade of the diet culture we were subjected to as young women. 

For me, it's been really helpful to think about gaining and preserving muscle with my workouts vs. trying to lose weight or lose fat, which always feels like a losing battle. That perspective shift has been empowering and I feel like there are concrete things I can do to achieve that goal.

But more than that, muscle is connected to long-term health and quality of life. As I get older, I want to continue to be able to do things of my accord—standing up, squatting down to pick something off the floor, carrying groceries home from the store, lifting my carry-on into the overhead compartment on a plane, not falling. 

"It's not about the fat"

3 components of muscle health

This was one piece that didn’t make it into the article. It’s something that I knew intuitively but didn’t think about in terms of how it influences how you program your strength training.

When we talk about muscle, there’s a tendency to talk about it as one monolithic thing. But really, there are three main components to muscle health:

• Mass or muscle size

• Strength or the amount of load that you can move

• Power or the amount of load you can move within a given period of time, like being able to move load in quick, short bursts

Carla DiGirolamo, who I spoke with for the NYT article, has a great newsletter that covers these three aspects. They’re each different but are all necessary for overall muscle health. For example, she writes, “One can be strong without an over-abundance of muscle mass, and an over-abundance of muscle mass does not necessarily correlate with overall strength.”

Each area requires different stimulus and DiGirolamo explains that you can achieve that by manipulating the amount of weight, repetitions, tempo of your repetitions, sets, and rest. In her post, she outlines examples of how to train for these different areas of muscle health. It’s a way to level up your workouts if you already lift weights regularly.  

Muscle Hypertrophy, Strength and Power: The Keys for Thriving in Midlife

Focus on major movement patterns

Yes, you should lift weights but any resistance training is better than nothing. Yes, you should lift heavy weights but what that means depends on 1) the exercise and 2) you and your experience. There’s no one definition of “heavy.”

In the NYT article, I didn’t discuss the specifics of what a lifting session might actually looks like. For women in mid-life, Alyssa Olenick, PhD, told me that it’s important to load the spine and hips because that’s where women lose bone density the most. 

She suggests focusing on major movement patterns: squatting, hinging, pressing, pulling, and core. Pick an exercise from each group and perform 2-3 sets of 6-12 reps, 2-3 days per week. Olenick emphasizes being intentional with your movement, going for slower, quality reps with adequate rest (think 90 seconds) versus rushing through a set with low rest between. 

Photo by Jeremy Stewart on Unsplash

Aerobic exercise is still important!! 

There’s a lot of chatter about how aerobic exercise, especially endurance exercise, isn’t “good” during perimenpause and menopause. But aerobic exercise still matters because cardiovascular fitness is a predictor of long-term health and because women’s risk for cardiovascular and metabolic disease increases in middle age. 

But here’s where the quality over quantity matters—the natural inclination may be to do more, more, more in response to changing fitness capacity and changing body shape and size. However doing more doesn’t give you body time to rest and recover, which may end up leaving your tired and exhausted, digging yourself into an even bigger hole. 

Instead, make sure each exercise session has a purpose and is strategic versus working out for the sake of working out. It’s not necessarily about the number of minutes you’re working out in total but what you’re doing in those sessions. 

While you can still do your long run or ride, shift some of your workload toward higher intensity workouts like HIIT or sprint-interval training, which can help preserve type II muscle fibers (the ones responsible for short, powerful bursts), stimulates mitochondria, and improves body composition but building muscle. 

Be inefficient

Another thing to consider: Opt for activities that are new-to-you or that you aren’t good at. As we exercise, our bodies become accustomed to the activity and we become more efficient, both physically and metabolically. 

“It's actually better to do things that make you less efficient and the reason that's helpful is you essentially burn more calories doing that activity. It works kind of different muscles and different energy systems,” says Abbie Smith-Ryan, professor of exercise physiology and nutrition at the University of North Carolina at Chapel Hill.

(Fine. I will stop cursing the fact that, no matter how many years I have lived in NYC, I am always out of breath when climbing the stairs from the subway station.)

Recovery matters…a lot

This might be one of the hardest pieces for me. But as we get older—and especially during perimenopause when hormones are chaotic—our ability to recover from exercise sessions might be hampered. That might explain why you (aka I) feel flat, sore, and like I’m not making any progress.

So while you may have been able to cut some corners when you were younger, recovery days, sleep, nutrition all make a big difference now. 

That was a lot of information but I wanted to provide some more context to what you may read and see in the media and social media. I hope that there’s something here you can take with you and that’s helpful in thinking about exercise during this phase of life. 

Questions or other things that your curious about? Let me know in the comments.

Thanks for being here. More soon.

Christine