Menopause is a natural phase in a woman’s life that marks the end of her reproductive years. It occurs when a woman stops having her monthly menstrual periods for at least 12 consecutive months. It can happen typically between ages 45 and 55, which is a part of the aging process. Prior to menopause, women enjoy a lower risk of heart attacks compared to men, thanks to the protective effects of estrogen. However, after menopause, women face an increased and surpassing risk of cardiovascular disease (CVD) compared to men. While both genders experience a higher risk of CVD as they age, post menopausal women face a significantly higher risk compared to premenopausal women with the risk being two to six times higher across the age range of 40 -54 years.

 

 

Approximately 80% of women will encounter menopausal symptoms at some point with around 20% experiencing moderate to severe hot flashes or night sweats.

Premature or early menopause happens before the age of 40. It can happen due to various reasons such as certain medical treatments, genetic factors, or autoimmune diseases. If menopause occurs before the age of 45, it is considered an early menopause. Perimenopause is the stage that precedes menopause. During this period, women experience hormonal changes as their ovaries produce less estrogen gradually. This phase, which can begin several years before menopause, is characterized by irregular periods, hormonal fluctuations, and menopausal symptoms like hot flashes and mood swings. While the likelihood of getting pregnant during perimenopause is reduced compared to the reproductive years, it is still possible to conceive. As ovulation becomes irregular during perimenopause, it can be challenging to predict fertility accurately. If you do not wish to conceive, it is important to continue using contraception until you have reached menopause (12 consecutive months without a menstrual period) or as advised by your healthcare provider.

 

Understanding the Changes

  • Hormonal Changes: During menopause, there is a decline in the production of two important hormones in a woman’s body: estrogen and progesterone. These hormones play a critical role in regulating the menstrual cycle and supporting reproductive fertility. The decrease in these hormones can lead to various changes in the body.
  • Common Physical Symptoms: Menopause can bring about physical symptoms such as hot flashes, night sweats, vaginal dryness, changes in libido (sex drive), irregular periods, and changes in the urinary system. Hot flashes, in particular, are a common symptom characterized by a sudden feeling of heat and sweating, often accompanied by a rapid heartbeat.

 

Medical Interventions and Therapies

  • Hormone Replacement Therapy (HRT): Hormone replacement therapy is a medical treatment that involves taking hormones (such as estrogen and progesterone) to help manage menopausal symptoms. It can be beneficial for some women in reducing hot flashes, night sweats, and vaginal dryness. Nevertheless, it is essential to consult with a healthcare provider to discuss the advantages and disadvantages of this treatment, as it can have potential risks and side effects.
  • Non-Hormonal Medications: There are non-hormonal medications that can be used to relieve specific symptoms associated with menopause. These medications may target specific symptoms like hot flashes, mood swings, or sleep disturbances.
  • Complementary and Alternative Therapies: Complementary and alternative therapies, such as acupuncture, herbal supplements, or mind-body techniques, are sometimes used to manage menopausal symptoms.
  • Discussing treatment options with healthcare providers: When contemplating medical interventions and therapies for menopause, it is vital to engage in transparent and candid conversations with a health care professional. They can evaluate specific symptoms, medical background and overall well–being to determine the most suitable treatment choices for individuals. It’s important to ask questions, express concerns, and work together to make informed decisions about managing menopausal symptoms.

 

Impact of Menopause

  • Sexual health: Menopause can have an impact on sexual health. During menopause, the decline in estrogen levels can cause vaginal dryness, thinning of vaginal tissues and reduced natural lubrication. Additionally, changes in hormone levels can affect libido or sexual desire. However, there are treatments available, such as vaginal moisturizers, lubricants, and hormone therapy, that can help manage these symptoms and support sexual well-being.
  • Cholesterol levels: Menopause can have an impact on cholesterol levels. As estrogen levels decline during menopause, there may be changes in cholesterol metabolism, leading to an increase in low-density lipoprotein (LDL) cholesterol, also known as “bad” cholesterol. This increase in LDL cholesterol can contribute to an increased risk of heart disease. It’s important to monitor your cholesterol levels during menopause and make lifestyle changes, such as adopting a healthy diet and engaging in regular physical activity, to help manage cholesterol levels and reduce the risk of heart disease.
  • Urinary incontinence: It is the unintentional loss of urine that can occur during menopause due to changes in hormone levels and pelvic floor muscles. To address urinary incontinence, individuals can attempt pelvic floor exercises commonly referred to as kegel exercises to strengthen the muscles responsible for controlling urine flow. To effectively manage urinary incontinence, it is beneficial to avoid bladder irritants like caffeine and alcohol, maintain a healthy weight and ensure proper hydration.
  • Breast cancer: As women age, the risk of developing breast cancer rises and menopause is a natural phase within the aging process for women. While menopause itself does not cause breast cancer, the hormonal changes that occur during menopause, such as a decrease in estrogen levels, can influence the risk of developing breast cancer. Women who have undergone menopause may have a slightly higher risk of breast cancer compared to premenopausal women. However, it’s important to note that many factors contribute to breast cancer risk, including genetics, family history, lifestyle factors, and hormone replacement therapy use. Performing regular self–exams of the breasts, undergoing clinical breast exams and following recommended mammogram screenings are crucial steps in detecting breast abnormalities early and ensuring timely intervention.

 

Exercise and Menopause: Alleviating Symptoms through Physical Activity

Exercise can play a significant role in alleviating menopausal symptoms. Here’s how:

  • Hot flashes and night sweats: Regular exercise can help  reduce the frequency and intensity of hot flashes and night sweats.
  • Sleep disturbances: Menopause can disrupt sleep patterns, leading to insomnia or poor sleep quality. Regular physical activity can help improve sleep by reducing stress levels and promoting relaxation. However, it’s important to avoid exercising too close to bedtime, as it may have an energizing effect that can interfere with sleep.
  • Overall health and cardiovascular benefits: Engaging in regular exercise during menopause can provide numerous cardiovascular benefits, such as reducing the risk of heart disease, stroke, and high blood pressure.

Participating in consistency physical activity improves heart health, lower cholesterol levels and promotes the well–being of blood vessels.

 

Exercise and Menopause: Managing Weight Gain and Body Composition Changes

Engaging in regular physical activity can be extremely advantageous for addressing weight gain and alterations in body composition that occur during menopause. Here’s how it works:

  • Calorie burning: Engaging in physical activity increases calorie expenditure, which can help create a calorie deficit necessary for weight management. Regular exercise, such as aerobic activities (e.g., brisk walking, jogging, cycling) and strength training, can burn calories and contribute to weight loss or weight maintenance.
  • Boosting metabolism: The hormonal changes that occur during menopause contribute to a reduction in metabolism. Exercise, especially strength training, helps build lean muscle mass. Having a higher muscle mass can boost your resting metabolic rate, enabling you to burn more calories even when you’ re at rest, as muscle burns more calories compared to fat.
  • Maintaining muscle mass: As women age, they tend to lose muscle mass, which can contribute to weight gain and changes in body composition. Exercise, particularly resistance or strength training, helps to preserve and build muscle. By increasing muscle mass, you can maintain healthier body composition and promote a higher metabolic rate.
  • Hormonal regulation: Exercise influences the production and regulation of hormones in the body. Engaging in physical activity can aid in regulating hormones associated with metabolism, appetite and weight management including insulin, cortisol and leptin.  By regulating these hormones, exercise can mitigate weight gain and aid in maintaining healthy body composition.

 

Exercise and Menopause: Improving Mood and Alleviating Depression/Anxiety

Exercise can play a significant role in improving mood and alleviating symptoms of depression or anxiety associated with menopause. Here’s how;

  • Natural mood booster: When you exercise, your body releases chemicals called endorphins. Endorphins are known as “feel-good” hormones because they help to improve your mood and make you feel happier. So, engaging in regular exercise can give you a natural boost of positivity and help combat feelings of sadness or anxiety.
  • Stress reduction: Menopause can bring about various physical and emotional changes that may lead to increased stress levels. Exercise acts as a stress reliever by reducing the levels of stress hormones in your body, such as cortisol. Physical activity also promotes the release of other brain chemicals, like serotonin and dopamine, which are associated with relaxation and happiness.
  • Distraction and relaxation: Participating in exercise provides a healthy distraction from negative thoughts or worries. It allows you to focus on the present moment, positively engaging your mind and body.
  • Social interaction: Exercise can be a great opportunity for social interaction, whether it’s joining a group exercise class, walking with a friend, or participating in team sports. Connecting with others and engaging in physical activity together can boost your mood, provide emotional support, and combat feelings of loneliness or isolation that may be associated with menopause.
  • Boosting self-esteem: Menopause can sometimes bring about changes in body image or self-esteem. Regular exercise can help improve your body’s confidence by toning muscles, enhancing physical fitness, and promoting a sense of accomplishment. As you achieve your fitness goals and experience the positive effects of exercise on your body and mind, your self-esteem is likely to increase.

Remember, it’s important to start with exercises that you enjoy and feel comfortable doing. Aim for at least 30 minutes of moderate-intensity exercise on most days of the week. Always consult with a healthcare professional before starting any exercise program, especially if you have any underlying health conditions or concerns.

 

Precautions for Starting Menopause Exercise Routine

  • Consult with a healthcare professional before starting an exercise routine
  • Start gradually and increase intensity and duration over time.
  • Listen to your body and stop exercising if you experience pain or concerning symptoms.
  • Choose exercises that address your specific needs and goals (aerobic, strength training, flexibility)
  • Stay hydrated by drinking plenty of water.
  • Wear comfortable and breathable clothing.
  • Take rest days to allow for proper recovery.
  • Tailor your routine to your capabilities and preferences.

 

The Importance of Strength Training for Maintaining Bone Health during Menopause

Strength training is important for maintaining bone health during menopause because it stimulates bone remodeling, increases bone mineral density, builds muscle strength and coordination, targets specific bone-loading areas, and provides long-term protection against bone loss and osteoporosis.

Bone Health and Osteoporosis: Menopause leads to decreased estrogen levels, increasing the risk of osteoporosis, which weakens bones and makes them prone to fractures. To maintain bone health, the following steps can help;

  • Consume enough calcium from sources like dairy and leafy greens.
  • Get adequate vitamin D from sunlight and fortified foods for calcium absorption.
  • Engage in weight-bearing exercises like walking or dancing.
  • Avoid smoking and limit alcohol, as they weaken bones.
  • Include strength training exercises to support bone health.
  • Maintain a healthy body weight.
  • Consider bone density testing to assess bone health.

By engaging in regular strength training exercises, such as weightlifting and resistance exercises, women can strengthen their bones, counteract the decline in estrogen levels, and reduce the risk of fractures and falls. Consistency in strength training is crucial for maximizing the benefits and ensuring long-term bone health.

Weight-bearing exercises: Exercises that involve bearing your body weight are particularly beneficial for bone health. These include activities like walking, jogging, dancing, stair climbing, and hiking. These exercises place stress on the bones, promoting bone remodeling and increased bone mineral density. Certain types of strength training exercises are more effective for improving bone density.

Resistance training: This type of exercise involves using external resistance, such as weights, resistance bands, or weight machines, to challenge your muscles. Examples of resistance training exercises include weightlifting, squats, lunges, push-ups, and overhead presses. Resistance training not only builds muscle strength but also stimulates bone remodeling and increases bone density.

Plyometric exercises: Plyometric exercises involve quick, explosive movements that combine strength and speed. Examples include box jumps, medicine ball throws, and jumping lunges. These exercises can help improve bone density by subjecting the bones to rapid and forceful loading, stimulating bone remodeling.

 

Beneficial Exercises During Menopause

During menopause, engaging in various types of exercises can offer numerous benefits. Here are some exercises that are particularly beneficial during this stage:

  • Aerobic exercises: Aerobic or cardiovascular exercises, such as walking, jogging, cycling, swimming, or dancing, are great for overall health during menopause. These exercises improve cardiovascular fitness, promote weight management, boost mood, and support bone health.
  • Strength training: Strength training exercises, including weightlifting, resistance band workouts, or bodyweight exercises, help maintain muscle mass and strength, increase bone density, and enhance metabolism. They also improve joint stability, which can be beneficial as hormonal changes during menopause may lead to joint discomfort.
  • Yoga and Pilates: Yoga and Pilates focus on flexibility, balance, and core strength. These exercises can help alleviate menopause-related symptoms like hot flashes, reduce stress, improve posture, and enhance overall body awareness and relaxation.
  • High-impact exercises: For women who are capable and comfortable with high-impact exercises, activities like jumping jacks, running, or high-intensity interval training (HIIT) can be beneficial for cardiovascular fitness and bone health. However, it’s important to consider individual capabilities and any pre-existing health conditions.
  • Balance and stability exercises: As women may experience changes in balance and stability during menopause, exercises that target these areas are essential. Examples include tai chi, balance exercises, or specific yoga poses that focus on stability and mindfulness.
  • Flexibility exercises: Stretching exercises like static stretches or dynamic movements can improve flexibility, and joint range of motion, and relieve muscle tension. Incorporating stretching into your routine can help counteract the effects of reduced flexibility that can occur with age.