Why is exercise important to emotional and physical health during perimenopause and menopause? Menopause can be a difficult time in a woman’s life both emotionally and physically. Emotionally, women must face the fact that they are no longer fertile. For some women this is a relief, but for others – particularly those who never had children, but wanted them – there may be a period of grieving. Even for women who have happily completed their families, menopause can be a sign of getting older, which women in our youth-obsessed culture may find difficult to accept. The hormone changes that occur during menopause can contribute largely to mood swings or feelings of depression and anxiety. Physically, menopause can be difficult not only because of the hot flashes and other short-term symptoms it causes, but because the loss of estrogen puts women at risk for health problems as diverse as brittle bones and heart disease. Fortunately, a program of regular exercise can improve both emotional and physical well being. Its many benefits include boosting your mood, strengthening your heart and even promoting bone density. Physical activity is one of the best antidotes to the problems that arise at menopause.

How can exercise influence menopausal symptoms? Some research suggests that being physically active can reduce the frequency and severity of symptoms such as hot flashes and, night sweats and sleep disturbances. Research does show that exercise has a positive effect on mood and can be useful for the depression that often coincides with “the change of life.” Exercising in the morning may improve your sleep at night and exercise can certainly be one of the best defenses against the weight gain many women experience as they get older.

How can your fat-to-muscle ratio and BMI affect how you feel during perimenopause and menopause? As we age, our fat-to-muscle ratio increases as we tend to lose muscle mass and add fat – particularly around the abdomen. This so-called visceral fat, which turns our bodies from a pair to an apple shape, has been linked to an increased risk of type II diabetes, heart disease and gallbladder problems and even breast cancer. Carrying around extra fat and less muscle may or may not affect body mass index (BMI), but it will likely affect your risk of certain health problems, and it can also affect the way you feel. You may be more sluggish and have difficulty doing some of the things you did when you were leaner and in good shape (of course, some of that is to be expected due to aging). As fat shifts from your thighs and hips to your abdomen and upper body, you may notice your waistband and tops are feeling tighter, even if the scales aren’t showing you have gained weight.

What special considerations should women in their 40s, 50s, and 60s make in regards to exercise? The main consideration is to play it safe. Exercise should be about making you healthy, not putting you at risk of an injury! This means you are going to need a little longer warm-up time than you did when you were younger. Allow about 10 minutes to warm up gradually – walking slowly, stretching, for example – before an exercise sessions. You should also avoid any exercises that may be unsafe – such as jarring exercises such as jogging, jumping or high-impact aerobics if you have bone or joint problems.

What are your top tips to women who are beginning an exercise routine during menopause? Again, my suggestion would be to play it safe – take time to warm up before your exercise routine, avoid exercises where injury is likely, start slowly and build gradually. You can’t get fit instantly – it is going to take time. I would also recommend that women make exercise enjoyable. Experiment with different types of exercise – dancing, walking, or working in the garden contribute to physical fitness – until you find something you really like. Try taking classes when you can meet people or arrange to walk with a friend. Mix up your exercise program to make it interesting – maybe dancing one day and yoga the next. If you like to walk try a change of scenery now and then. Even though it is convenient to walk the same streets in your neighborhood, take a walk through a friend’s neighborhood, at a historic site in your town or even at the mall on days when the weather is cold or bad.

What are the best forms of exercise for women in their 40s, 50s, and 60s? Staying physically active consistently is more important than engaging in any particular form of exercise; however, women in their 40s, 50s and 60s should make it a point to engage in three different forms of exercise:

• Aerobic/ cardiovascular. This type of exercise, which includes walking, jogging, cycling, tennis, aerobics, working out on elliptical machine – strengthens the heart and lungs and burns calories to help with weight loss or maintenance.
• Resistance training. Exercises such as working out with dumbbells, resistance bands or exercise machines are helpful for strengthening muscles and bones and increasing metabolism to help with weight management.
• Flexibility/stretching/range of motion. Stretching exercises, yoga and pilates can help keep aging bodies more flexible can be particular helpful for improving or maintaining joint function if joints are affected by arthritis.

Beyond this, the particular exercises women do should be based on their likes and any health problems they might have. For example, women who have arthritis in their knees should avoid running or jogging, which would put extra stress on their knees. Women with osteoporosis (brittle bones) should avoid activities such as bicycling or sports that could put them at risk of impact that could break a bone. The best exercise is one you enjoy and will do regularly.

Are there any forms of exercise that menopausal women should avoid? Women should only avoid exercises that present a risk to their health or safety. You should never try anything too strenuous or difficult for your fitness level or abilities. It takes time to gain strength, so go slowly. If you have joint or bone problems, avoid exercises that are jarring or that might involve impact that could cause an injury.

How can women minimize the loss of muscle as they age? Heed the old saying “use it or lose it.” If you don’t use your muscles you will lose muscle mass. For that reason, strengthening exercises are particularly important for women in their 40s and beyond. This includes working out with dumbbells, weight machines or resistance bands. For women who are just getting started with strengthening exercise or who have health concerns, I would recommend working with a physical therapist or personal trainer who can recommend an appropriate strengthening program.

As alway, consult your physician before begining any exercise program.