Hormonal changes affect multiple body systems, including the brain, bone, and cardiovascular. For menopausal women, these changes can have a significant impact on health and well-being. Declines in estrogen contribute to increased bone loss relative to bone building and decreased muscle mass in favor of fat accumulation. In particular, early menopause is associated with a greater risk of cardiovascular disease (CVD) and osteoporosis. These changes increase the risk of other age-related conditions that can affect lifestyle and longevity.
Despite these changes, it is possible to age gracefully while maintaining strength and your current activity routine. Muscle and bone are adaptive, so regular exercise can stimulate muscle and bone to preserve mass and strength. And specific exercises such as pilates, dance, and pelvic floor therapy are associated with additional benefits that support healthy aging.
This article will discuss changes to muscle during menopause and how exercise can alleviate menopausal symptoms to help you feel your best.
Key takeaways
- Hormonal changes that accompany aging can affect muscle mass and strength. Regular exercise may improve menopausal symptoms and preserve muscle mass and strength.
- Exercises like pilates, dance, aquatic exercise, and balance training support healthy aging and may mitigate menopausal symptoms.
- InsideTracker’s platform is designed to help women navigate menopause by explaining the transition and then connecting the biological changes to symptoms women may be experiencing.
What happens to muscle during menopause?
Muscle mass gradually decreases after the age of 30, with loss accelerating after 50 years of age. [1] Some research suggests muscle mass decreases by 0.6% yearly following menopause. [2] Likewise, declines in muscle strength occur between 50 and 60 years of age.
But whether these changes in muscle mass and strength are due to hormonal shifts or aging is unclear. Some evidence suggests a link between lower circulating levels of estrogen and decreased muscle strength, though the exact mechanism is not yet understood. And levels of Dehydroepiandrosterone (DHEA)—a precursor that converts sex hormones like estrogen and testosterone—decline with aging, particularly in the period between perimenopause and postmenopause. Lower levels of DHEA are associated with reduced muscle mass and physical performance. [1]
Oxidative stress may also influence muscle composition and function. Oxidative stress accompanies menopause, potentially contributing to muscle fiber death and increases in circulating inflammatory biomarkers. These effects can then lead to the accumulation of fat mass while negatively affecting muscle function. [1,3]
How does exercise help manage menopausal symptoms?
Some research has yielded mixed results on the benefits of exercise for managing menopausal symptoms, specifically vasomotor symptoms. [4,5] However, studies have suggested a link between higher levels of physical activity before menopause and reduced menopausal symptoms. And participating in exercise throughout menopause may mitigate a variety of symptoms. [6]
Exercise can also help manage menopausal symptoms related to changes in bone and muscle mass. [7] Physical activity supports bone mineral density and reduces the risk of other age-related conditions like cardiovascular disease.
5 exercises for menopause
1. Pelvic floor muscle training
Pelvic floor muscle (PFM) training involves exercises to strengthen the muscles of the pelvic floor, located along the bottom of the pelvis and used to support pelvic organs like the bladder, bowels, and uterus.
PFM training can improve bladder and bowel control, pelvic floor strength, blood flow to the vulvovaginal tissues, and sexual function—common concerns during menopause. [8,9,10]
You can practice PFM contractions in isolation as an initial step to training these muscles. Active exercises are another option and can include:
- 10 quick flicks: Quick squeeze and release tension 10 times.
- 10-second pelvic floor holds: Breathe out when contracting and then regularly throughout the holds. Repeat three times.
- Three elevated lifts: Imagine your pelvic floor is an elevator. Squeeze and lift your pelvic floor from the ground to the tenth floor. Then, release and gently descend from the tenth to the ground floor.
Aim for 14 to 20 minutes of PFM training daily. It can be challenging to identify the pelvic floor muscles initially, so consult a physical therapist or other healthcare professional for guidance. Consult your healthcare provider if you have any signs of pelvic floor dysfunction (prolapse, urinary incontinence, lower back pain, discomfort during sex, or pain or pressure in the pelvic region or rectum), as PFM training can exacerbate pelvic floor dysfunction.
2. Dance
Dance is a multifaceted activity that activates the physical body and mind by incorporating creative elements that challenge memory. Research suggests that dance improves muscular and cardiovascular function in menopausal women.
Dancing—jazz, ballroom, ballet, square, Zumba—incorporates multi-directional movement that challenges balance, relying on core and lower body muscles for support. Regular dance can improve balance and increase lower limb strength in menopausal women, helping to retain functional fitness through aging. [11,12]
Additionally, regularly practicing dance may benefit cardiorespiratory fitness. Dancing at a moderate intensity with noticeable increases in heart rate may help improve cardiovascular health.
Choose a dance type and class you enjoy. Aim to dance two to three times weekly to help preserve functional fitness and cardiovascular health.
3. Pilates
Pilates is a low-impact exercise focused on controlled movements that engage and strengthen the core muscles. Pilates increases strength, stability, and flexibility, and studies show that it may benefit functional fitness in postmenopausal women. [13,14] Moreover, pilates may improve menopausal vasomotor symptoms, such as night sweats and hot flashes.
Pilates improves balance by improving core strength and flexibility. Balance declines with age, and both balance and flexibility are vital for maintaining health through aging.
Besides its benefits on strength, flexibility, and balance, research suggests pilates may also improve sleep outcomes in postmenopausal women. Adding pilates to your exercise routine can assist you with falling asleep faster and improving sleep quality. [15]
Try incorporating two 45 to 60-minute pilates sessions weekly, slowly building the intensity as the movements become more familiar. Pilates can be done on a mat in a studio or at home, or on a reformer machine.
4. Balance training
Balance declines with aging, leading to greater risk of falls and injury. Balance training focuses on strengthening muscles in your core and lower limbs that help you stay upright and engage in activities of daily living, such as carrying objects in one hand or using the stairs. Research shows that engaging in balance exercises during peri- and postmenopausal years can help maintain functional fitness with age. [16,17]
Balance training refers to exercises that move your body off equilibrium to encourage it to return to its center of balance. Balance training includes:
- Forward-backward stepping
- Wide-stance gait
- Standing marches
- Heel lifts
- Toe presses
- Standing on one leg
Increase the difficulty of balance training by standing on uneven or unsupportive surfaces like a foam mat or grass. Aim for two balance training sessions weekly, gradually building up to 6 to 10 repetitions of 5 to 8 exercises per session. Start balance training under supervision if you have a history of instability or falls.
5. Aquatic exercise
Aquatic exercise is a workout done in the water to provide resistance with minimal stress to bones and joints. Aquatic exercise uses the natural resistance of water density to help increase your strength. It is often performed in a class setting, where an instructor guides you through resistance, cardio, and flexibility exercises. Walking, running, strength circuits, and tai chi can all be done as aquatic exercise.
Studies show a link between two to three weekly aquatic exercise sessions and increased strength and flexibility among older adults. Improving strength and flexibility benefits and preserves functional fitness and prevents falls and injury. [18]
Aquatic exercise incorporates cardio and strength. Research demonstrates improved aerobic capacity and cardiovascular health in menopausal adults participating in water-based activities that increase heart rate and stress the cardiovascular system. [19]
Aim for 45 to 60 minutes of aquatic exercise three times weekly. Perform aquatic exercises in waist to chest-deep water. As aquatic exercise puts minimal stress on your bones, it is essential to incorporate some land exercise to enhance bone mineral density.
Need help navigating menopause? InsideTracker can help.
Managing menopausal symptoms can be tricky, and understanding the changes happening during this time can empower you to make the best decisions for your health. InsideTracker explains the biological changes happening in the body and connects them to the symptoms women may be experiencing. Women in this stage receive information, personalized recommendations, and an Action Plan from InsideTracker using factors like body mass index (BMI), sex hormone levels (estradiol and progesterone), cholesterol, and more. InsideTracker looks at age, menopause status, and hormone use (like birth control or menopause hormone therapy) when analyzing your blood results.
Check out this article to learn more about the menopause-specific updates of the platform, and click here to explore InsideTracker plans.
References:
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- https://pubmed.ncbi.nlm.nih.gov/17389732/
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- https://pubmed.ncbi.nlm.nih.gov/32017473/
- https://pubmed.ncbi.nlm.nih.gov/25862491/
- https://pubmed.ncbi.nlm.nih.gov/32105155/
- https://pubmed.ncbi.nlm.nih.gov/28508398/
- https://pubmed.ncbi.nlm.nih.gov/34284435/
- https://pubmed.ncbi.nlm.nih.gov/27433865/
- https://pubmed.ncbi.nlm.nih.gov/32443744/
- https://pubmed.ncbi.nlm.nih.gov/27419122/
- https://pubmed.ncbi.nlm.nih.gov/31097181/
- https://pubmed.ncbi.nlm.nih.gov/26802006/
- https://pubmed.ncbi.nlm.nih.gov/28422544/
- https://pubmed.ncbi.nlm.nih.gov/27182389/
- https://pubmed.ncbi.nlm.nih.gov/11880822/
