What Is The Best Exercise For Menopause
We know exercise is good for health and that we should be doing it on a regular basis. But can exercise help with menopause and which type of exercise is recommended? Read on to find out.
In this blog, you will learn:
- Can exercise help with menopause?
- How does exercise help with menopause?
- What is the best exercise to do for menopause?
In menopause, the drop in estrogen causes several factors that can lead to poor health. Visceral fat increases, glucose tolerance decreases, hypertension develops and cholesterol increases. These can lead to insulin resistance, overweight, pre-diabetes/diabetes, high cholesterol and high blood pressure (Gersh F, 2024). Risk of cardiovascular disease (CVD), bone loss, breast cancer and even dementia increase after menopause.
These are all worrying negative changes in health but they are not destiny. There are many things you can do to counteract these risks and issues.
Can Exercise Help with Menopause?
In a word, yes!
Exercise reduces menopause symptoms and improves health in menopause. As you know from following our blog, diet can help tremendously. There are supplements to manage menopause. BHRT reduces symptoms and health risks. Lastly, exercise can help too!
Exercise can counteract these issues of excess fat, high blood sugar, high cholesterol, high blood pressure (BP), high body mass index (BMI), insulin resistance and the risk of developing CVD, bone loss, breast cancer, dementia or other chronic and serious illness. It is also a key factor in increasing longevity.
How Much Exercise?
The CDC’s official recommendation is that adults need at least 150 minutes (2.5 hours) of moderate physical activity per week or 75 minutes (1.25 hours) of vigorous intensity activity (CDC, 2023). Moderate physical activity is walking, weightlifting, dancing, gardening and low-intensity exercise. Vigorous exercise is activities like running, biking, skiing, hiking, swimming and others.
In this case, more is better. Doing more than the recommended amount of exercise lowers the risk of death (Hoon Lee D, 2022). People who did 2-4 times more than the recommended moderate physical activity had:
- 26%-31% lower all-cause mortality (or risk of death)
- 28%-38% lower risk of cardiovascular disease mortality
- 25%-27% lower risk of non-cardiovascular disease mortality (Hoon Lee D, 2022)
What is the Best Exercise for Menopause?
It is clear that exercise will help in menopause. Now the question is what type of exercise is best for menopause, managing symptoms and decreasing disease risk.
Let’s start with the honest truth: any exercise you will actually do is the best exercise for you. If you don’t exercise because you don’t like it, it doesn’t matter which is recommended as the best type.
The same benefits can be achieved through various types of exercises (Capel-Alcaraz AM, 2023). So do what you love! Find a physical activity, or two or three, that you love and do them often.
Cardiovascular Exercise Reduces Hot Flashes & CVD Risk
Cardio or aerobic exercise is running, swimming, cycling, dancing, jumping rope and other exercises that get the heart pumping. Cardio/aerobic exercise raises heart rate and breathing, improving cardiovascular health. Cardio enhances thermoregulatory control of sweating, skin and brain blood flow (Bailey TG, 2016). It decreases basal core temperature.
Cardiovascular disease is a leading cause of morbidity (having a disease) and mortality (dying from a disease) for menopausal women. Vasomotor symptoms (VMS), or hot flashes/night sweats, are common during the menopausal transition. These symptoms are associated with high blood pressure and increased CVD risk. High BP contributes to higher CVD risk in general and in menopausal women with VMS (Lee E, 2022).
More frequent VMS are associated with elevated BP. Women with VMS have significantly higher BP compared to women without VMS (Lee E, 2022). The mechanisms linking VMS to CVD risk include factors like autonomic nervous system dysfunction, inflammation and changes in vascular function (Lee E, 2022).
Greater thermoregulatory control helps reduce hot flashes. Exercise brings on higher core temperature and enhanced vascular function, training the body to better control temperature (Bailey TG, 2016). In one study, women who did 16 weeks of cardio exercise had better cardiorespiratory fitness and less frequent hot flashes (Bailey TG, 2016).
Flow-mediated dilation (FMD) is a marker of CVD. It is the ability of arteries to dilate or widen in response to increased blood flow and reflects endothelial function. Blood pressure and cardiovascular fitness significantly predict FMD (Brislane A, 2022). FMD significantly improves with aerobic exercise training in postmenopausal women (Brislane A, 2022).
Resistance Training Reduces Hot Flashes
Resistance training, or strength training, involves exercising muscles against resistance. Weights, bands, machines or your own body weight can be used to create resistance and build muscle strength. Examples are squats, lunges, push-ups, plank, sit ups and pull ups.
Resistance training significantly lessens hot flashes, reducing both severity and frequency of hot flashes in postmenopausal women (Choudhry DN, 2024). In one study, VMS were more common in those who did no exercise and decreased significantly in those who did resistance training (Choudhry DN, 2024).
- Postmenopausal women with moderate/severe hot flashes or night sweats did 15 weeks of resistance training 3 times/ week (Berin E, 2019).
- The key outcome was a decrease in moderate/severe hot flashes per day (Berin E, 2019).
- Women had 7.1 moderate/severe hot flashes per day which dropped in frequency by -43.6% after 15 weeks of resistance training (Berin E, 2019).
Strength Training Increases Mood & Muscle Mass
After age 30, muscle mass declines by 3-5% per decade (US Dept. of Health, 2025). This is called sarcopenia. Falling estrogen levels during peri and menopause speed up this process, especially after age 50. Maintaining muscle mass helps to stay healthy and mobile into older age. Strength training helps stimulate muscle growth, offset sarcopenia and maintain bone density, mobility and overall good health (Capel-Alcaraz AM, 2023).
A higher muscle to fat mass ratio reduces risk of disease (arthritis, diabetes, osteoporosis, high blood pressure, heart disease and obesity). Muscle is more metabolically active than fat, helping to maintain a healthy metabolism (Capel-Alcaraz AM, 2023). It burns energy, keeps blood sugar stable and reduces risk of type 2 diabetes.
Strength exercises can be beneficial for menopause symptoms. It improves muscle performance, bone density, hot flashes and metabolic issues like heart rate and blood pressure (Capel-Alcaraz AM, 2023). Strength training increases lean muscle mass, bone density and reduces the ‘hunch back’ neck often seen in older people (Capel-Alcaraz AM, 2023).
Not surprisingly, high-volume strength exercises get better results than low-volume exercises (Capel-Alcaraz AM, 2023):
- It helps lower cholesterol, build muscle performance and lean mass, decrease heart rate and hot flashes (Capel-Alcaraz AM, 2023).
- It increases hormones; estradiol, growth hormone, insulin-like growth factor 1 and DHEA-s levels.
It decreases blood pressure, total body mass, BMI, body fat percentage and increases quality of life (Capel-Alcaraz AM, 2023).
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Exercise Improves Mental Health
- A 12-week period of exercise led to positive changes in vitality and mental health in women (Dąbrowska J, 2016).
- Exercising women exercised for 60 minutes 3 times/ week (Dąbrowska J, 2016).
- These women had a statistically significant higher quality of life, vitality and mental health compared to non-exercisers after 12 weeks (Dąbrowska J, 2016).
Mindful Exercises (Yoga, Pilates, Tai Chi, etc.) Reduce Anxiety & Improve Sleep
Mind-body exercises include tai chi, yoga, Pilates, qigong and mindfulness-based stress reduction. These types of mind-body exercise significantly enhance sleep quality, reduce anxiety, depression and fatigue in peri and postmenopausal women (Hong X, 2024). Mind-body exercise also improves bone mineral density (Hong X, 2024).
12 weeks of Pilates exercise improves sleep quality, anxiety, depression and fatigue in postmenopausal women (Aibar-Almazán A, 2019). Sleep duration, sleep disturbance, fatigue, depression and anxiety improved (Aibar-Almazán A, 2019).
Jumping Improves Bone Health
It’s very important to maintain bone mass and density. Up to 50% of women aged 50+ will break a bone due to osteoporosis (Clissold TL, 2022).
BMD, or bone mineral density, in peri-menopausal women can be improved with bone-stimulating jumping exercises (Clissold TL, 2022). Regularly doing jumping exercises for a 12-month period significantly improves bone health and BMD and improves jump performance. It significantly increases muscle reactivity and vertical jump performance (Clissold TL, 2022). If no jumping were done, these physical abilities decline over time (Clissold TL, 2022).
All it takes is just 3-5 minutes of per day (Clissold TL, 2022). Premenopausal women who did jumping-landing exercises up to 5 times/ week for 12 months saw significant benefits. They jumped 2-3 mins/day 4-5 times a week and saw (Clissold TL, 2022):
- Improved bone strength at relevant body sites linked to osteoporosis in premenopausal women
- Bone changes of +3.5 – +5% a year in the hip and lumbar spine
- Increase in bone mineral density and bone mineral content at the femoral neck, total hip and lumbar spine
- Significant increase in cortical thickness
For How Long should you Exercise?
It is recommended to follow the CDC guidelines of exercising at least 150 minutes (2.5 hours) of moderate physical activity per week or 75 minutes (1.25 hours) of vigorous intensity activity (CDC, 2023).
Plus, you have to keep exercising over time to maintain the benefits of exercise. Exercise must be a long-term habit. Muscles atrophy and the benefits of exercise are not maintained over time if you don’t continue to exercise on a regular basis (Capel-Alcaraz AM, 2023).
Can Exercise Balance Hormones?
Exercise helps regulate hormonal fluctuations during menopause. It supports and enhances estrogen sensitivity, reduces cortisol and increases testosterone and growth hormone. It increases endorphins, the ‘feel-good’ hormones that boost mood and energy and reduce pain.
Estrogen
It seems that exercise modulates estrogen. Some studies show that it raises estrogen and some show that it reduces estrogen (Razzak ZA, 2019). Although confusing at first glance, it seems that exercise modulates or manages levels of estrogen. Exercise improves estrogen metabolism and estrogen sensitivity. It decreases excess estrogen which decreases risks associated with estrogen imbalances or estrogen dominance. Exercise helps keep to a healthy weight and reduces excess body fat which is a source of estrogen.
- Estrogen Metabolism: Aerobic exercise affects how the body processes estrogen, shifting towards more beneficial, less toxic types of estrogen metabolites. Decreasing the toxic estrogen metabolites reduces the risk of breast cancer (Razzak ZA, 2019).
- Estrogen Receptor Sensitivity: Physical activity can increase the sensitivity of estrogen receptors, which means cells will respond more effectively to estrogen signals. Better estrogen sensitivity makes cells recognize the estrogen that is present and reduce symptoms of low estrogen such as hot flashes and night sweats. Aerobic and strength training helps the body adapt to lower estrogen levels without raising estrogen directly.
Progesterone
Regular physical activity can help balance progesterone levels. While exercise doesn’t directly boost progesterone levels, it can help regulate other hormones, like cortisol (a stress hormone), which can indirectly impact and modulate progesterone levels.
Testosterone
Strength training can stimulate testosterone production, improving energy, muscle mass and libido, all of which tend to decrease with age.
Cortisol
Exercise reduces levels of cortisol. This helps manage stress and prevent cortisol-related symptoms such as anxiety and sleep disturbances. Yoga and moderate aerobic exercise are particularly effective in lowering cortisol.
Insulin
Exercise helps balance blood sugar and improve insulin sensitivity, which supports overall hormone balance, metabolic health and healthy weight.
Exercise is clearly incredibly beneficial for managing menopause and for overall health. We recommend finding a few activities that you love to do and doing them often to reap the benefits!
If you are suffering from menopause symptoms, then get in touch with us at the Medicine with Heart clinic. We can help you to best manage and optimize your menopause experience!
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