Menopause - Exercise & Eating Advice

As a personal trainer who's a qualified menopause coach, I am constantly approached by women in my Portsmouth based training studio about help and support regarding fitness and nutrition advice, particularly for those clients who are approaching or going through the menopause. It's surprising how little is known and much less taught, even with the the medical and fitness industries. I hear from clients all the time how they're just being 'hormonal' in terms of mood swings or simply don't understand that low energy levels, low libido and insomnia can actually be the first signs that the peri-menopause has started.

Photo Credit: The 48 Symptoms of Menopause, Bethan Thomas

Early Menopause (between the ages of 40 and 45)

Early menopause occurs when the final menstrual period happens sometime between 40 and 45 years. This could be naturally occurring or as a sudden onset because of surgery or an illness.

Perimenopause

Perimenopause is a more widely used word now. It's the stage before menopause when all the symptoms begin to appear. This stage usually starts a few months or years before periods stop, and it can persist for quite some time. On average, women start to experience symptoms from around the age of 45 onwards, with the average age being about 51, but women may not recognize the underlying cause of these symptoms, confusing external life factors with internal physiological causes. You can generally take it that these symptoms mean that the train has left the station and the woman is on her perimenopause journey where her final destination is menopause.

Menopause

As I said, menopause is the day a woman has gone 12 consecutive months without a period, and on that day they can throw a menopause party, as beyond that day they are post-menopause, and this is for the rest of their life. And let's face it, most women may live half of their life in this post-room, so it's important that they stay healthy and well as women are living and working longer.

Menopause is caused by changes in hormone levels which take place as a woman gets older. There are three driving hormones: estrogen, progesterone, and testosterone. These make women unique, keep them fertile, curvaceous. These hormones combined are what distinguish women for their fertility, their hearts, their bones, and helping to keep tissue taut, tight, and vibrant. They also provide protective factors for women to maintain their health and their fertility. But as these hormones begin to disappear, the body opens up to more challenges and menopause symptoms begin to develop. Simply put, post-purity, young women are coursing with hormones, the fertility switch is on. With menopause, the switch turns off, bringing a range of unexpected symptoms. Post-menopausal women are at a higher risk of developing osteoporosis, the bone loss condition known as the silent killer as it doesn't have any symptoms. They develop cardiovascular disease, which is the biggest killer of women in the UK, as well as a number of other conditions which may be less serious, but which have a detrimental impact on women's lives. Preventive health measures become even more significant for women at this stage. Women need to be really proactive in protecting their health. Gynecologist Dr. Karen Morton is going to take you through a more detailed explanation of women's hormones that impact on reproductive systems in section three.

Menopause Symptoms

There isn't a part of the body that isn't affected by menopause. Over time, women can develop a range of really challenging physical symptoms that they need to manage in order to function on a day-to-day basis. There are around 34 recognised symptoms and women don't get to pick and mix their selection in perimenopause as hormones begin to fluctuate. Women have estrogen receptors all over their body. So when supplies of estrogen decline, symptoms can be felt almost anywhere, bringing a variety of unexpected symptoms including the following most common ones:

• Loss of hair

• Vaginal dryness/lack of interest in sex (pain during sex)

• Itchy Skin

• Hot Flushes

• Anxiety

• Mood Swings

• Depression

• Aching Joints

• Osteoporosis

• Night Sweats

• Weight Gain

• Digestive Issues

• Fatigue

• Sleepless Nights

• Fatigue

• Brain Fog

Whilst some women don't notice the symptoms, in others it's more pronounced, but on average women in general tend to have to manage the symptoms of menopause for around 4 years although saying that, many experience the symptoms for much longer; there's no single answer!

Taking Control Of Menopause - Diet & Exercise

Resistance Training, HIIT & Cardio

Recent studies have shown that there is a clinically significant decrease in hot flushes of at least 50% for menopausal women who undertake regular weight/resistance training, two or three times per week. In addition, in 2017 there was a an Australian study conducted with osteoporotic women over 8 months with twice weekly, supervised training sessions. The group did deadlifts, overhead press, back squats, jumping chin ups with drop landings. It was high intensity, 5 sets of 5 repetitions, over 85% of their RM, their repetition maximum.

The results showed this approach was both safe and effective over the course of over 2,600 sessions. It showed increase in bone density and in some cases reversed some of the stress fractures.

Similarly, in 2015 studies showed that resistance training, combined with HIIT & cardio saw a reduction and avoidance of obesity and its related comorbidities (hypertension, glucose intolerance, dyslipidemia, and heart disease), reduced rates of cancer, dementia and cognitive decline, adverse mood and anxiety symptoms, and reduction of osteoporosis, osteopenia, falls, and fractures.

Finally, and most recently, a meta-study condducted in 2023 that specifically looked at strength training, found that when undertaken regularly the following benefits were observed in terms of improving menopausal symptoms:

• Improvement in bone density

• Improviement in mood

• Improvement in blood pressure

• Reduction in hot flushes

• Increase in muscle mass

• Reduction in BMI (body fat)

• Increase in metabolism (helps burn fat quicker)

Diet - Taking Back Control

For many women, the menopause is a bit of a mind bender.....what has worked in the past as far as your diet is concerned may well have little effect when the menopause hits, or at the very least will have far less of an effect than it previously did.

As your oestrogen levels fall, the metabolic rate also begins to slow down. This process starts even before perimenopause as a natural part of aging, leading to muscle loss in both men and women. However, the decline in oestrogen accelerates muscle loss in women, further slowing the metabolic rate. It's a double whammy: an increased propensity to lay down fat around the tummy and a generally higher tendency to gain fat unless subtle changes are made to diet and physical activity levels. It's really important to explain this to women because by the time they hit their mid-forties or early fifties, most will have dieted at some point. They need to understand that the approach required to lose menopausal weight or to maintain a healthy weight must change.

Women have to get used to the fact that the body you have to manage from the menopoause if very differnt to the one you hand in your 20's, 30's and 40's. You're going to have to adjust not only your diet, but your choice of exercise and your lifestyle as you begin with wrestling with this beast.......and that's where I can help......you're not on your own.

Even if you're taking HRT, this only takes the edge of symptoms, it doesn't fix the whole problem, particularly from a physical perspective.

So what supplements should I take and what foot should I eat?.....

Supplements:

• Vitamin D3 (min 5,000 iu)

• Vitamin B - full spectrum

• Magnesium

• Zinc

• Creatine (5g per day)

• Protein Isolate - particularly if you're not hitting your protein targets.

• Selenium

• Collagen

• Black Cohosh

• Calcium (if you take this you must take D3)

What Diet & What Foods?

Much of what's best to eat is characterised by eating low glyceminc carbs (not smoothies but real fruit), keeping to mainly to root and green veg, fruit (like apples, kiwi fruit, berries - all kinds, and good fats like olive oil, coconut oil, and oil containing foods like avocado).

The main take away is a low carb, high protein, moderate fat based diet, which is something that can still provide delicious, satisfying meals and avoid you feeling hungry.

I'm afraid out will go alcohol, sweets, crisps, chips and all processed foods. For many of my clients there is also a huge change in their metabolism so whereas before the onset of the menopause they could get away with the odd snack or two, they now find that the occasional snack over the year results on putting on significant weight. You often read about menopause and having to make 'lifestyle choices' the biggest of these being diet and exercise. The most sucessful of my clients embrace the change in their lives, rather than miss what they had. If you need any help or support, please contact me on the link above.

Thank you, Tina xx