The Cardio Conundrum
We explore effective cardio approaches for women during perimenopause
Welcome to perimenopause! Come on in and join us in navigating this time in life where your mood fluctuations are strong and your ability to grab a particular word is weak, where your weight is steadily rising but your muscles are diminishing, where the exhaustion is omnipresent but uninterrupted sleep is hard to come by. Fun times for all!
If you have children, do you remember those sheets we received at their check-ups that detailed developmental milestones and explained emotional, physical, and cognitive changes at each age? I have often wished for a similar resource for this stage of life. Why does this straightforward, easily accessible information not exist? Menopause is universal in half the population and yet it is still understudied and quite often misunderstood.
Perimenopause and menopause may be a natural timeframe, but natural doesn't mean easy or simple or straightforward. Menopause is actually a single day marked by the cessation of ovulation. It signifies the end of menstrual cycles and is confirmed after 12 consecutive months without a period. This milestone is preceded by perimenopause, a transitional phase that can last several years and is characterized by hormonal fluctuations that manifest and present uniquely in each of us. And while the research is evolving and communication lines between practitioners and patients and amongst women themselves are improving, the perimenopause into menopause years are still marked by confusion for many of us, particularly when it comes to the topic of fitness.
The U.S. Department of Health and Human Services recommends that adults engage in at least 150 minutes of moderate-intensity or 75 minutes of vigorous intensity aerobic activity per week, or a combination of both. Additionally, muscle strengthening activities involving all major muscle groups are advised for two or more days per week. For added health benefits, adults are encouraged to exceed these minimum guidelines and reduce sedentary behavior. Older adults should include exercises to improve balance and flexibility to reduce fall risk.
Strong Muscles and Bones
As we grow older, women (and men) naturally lose muscle mass and bone density. Humans of both sexes lose approximately 3-8% of our strength per decade after the age of 30. Bone mass also decreases after around 30 years of age. This decrease is relatively small until menopause with its decrease in estrogen when the bone loss rises more dramatically. In short, menopausal hormonal shifts can accelerate both bone and muscle loss. While we cannot entirely halt this process—professional athletes also experience muscle and bone mass loss with age—we can preserve muscle and bone strength and stimulate new muscle and bone production through weight bearing activities and strength training.
Over the past decade there have been many studies that show a positive relationship between resistance training and bone density. The 2017 LiftMOR (Lifting Intervention for Training Muscle and Osteoporosis Rehabilitation) study investigated the effects of high intensity resistance training on postmenopausal women with low bone mass. The findings underscore the benefits of resistance training for improving bone health, muscle strength, and overall physical function in postmenopausal women.
As a personal trainer, I am constantly telling my clients that resistance training is key. And it is. Lifting weights or adding similar resistance in an amount that is challenging for you is essential to keeping and building muscle as well as fortifying our bones to protect against osteoporosis. Strong muscles can help prevent falls and strong bones can prevent fractures when we do fall.
Strong Heart and Blood Vessels
But what about cardio? You may have heard advice to slow down and opt for walks to avoid potential injury from too much intensity. Conversely, concerns may arise about too little cardio negatively impacting cardiovascular health—a significant concern during menopause, as cardiovascular disease is the leading cause of death among women, claiming a life every minute.
As women go through the menopause journey our estrogen levels decrease which may cause stiffness in the arteries. In the first 5 decades or so of life, estrogen is a heart protector for women. But post menopause, cardiovascular health is a critical concern. It is imperative that women understand and recognize the symptoms of cardiovascular disease in women and are screened by their doctor regularly. Some of the most common symptoms for women (extreme fatigue and anxiousness) are different from the warning signs typically seen in men and can also be mistaken for other more common menopause symptoms. Exercise and a healthy diet can be important prevention strategies to reduce cardiovascular disease. A 2020 study published in the Journal of Clinical Hypertension titled “The Cardiometabolic Benefits of Exercise in Postmenopausal Women” demonstrated that exercise provides substantial benefits for postmenopausal women, improving both cardiovascular health and metabolic function.
A 2019 study published in Medicine and Science in Sports and Exercise titled "The Effect of Sprint Interval Training on Body Composition of Postmenopausal Women" found that short bursts of intense exercise followed by adequate recovery significantly improved body composition and lean mass. Additionally the 2019 study published in the Menopause journal, titled "Menopause and High-Intensity Interval Training: Effects on Body Composition and Physical Performance," investigated the impact of high intensity interval training on body composition and physical performance in menopausal women. The study found that high intensity interval training led to significant improvements in body composition, including reduced fat mass and increased lean muscle mass. Participants also showed enhanced physical performance, such as better cardiovascular fitness and strength. Together, these studies suggest that interval training is an effective exercise approach for improving both body composition and physical performance during menopause.
So, if you hate cardio, you might find this information reassuring. No more long cardio sessions needed. You can do short (yet intense) high intensity sprint Intervals a few times a week and improve your cardiovascular fitness and body composition. But what about the Cardio Queens or those training for (and loving) half marathons or marathons? Do you need to say goodbye to the exercise you love? The short answer is NO. The longer answer is NO, definitely not-engaging in exercise that brings joy and consistency has benefits that are important and significant. Women are naturally built for endurance and you should continue to train for marathons and half marathons and even ultras but perhaps now with less volume and more intensity. Less training time needed- what’s not to love about that.
My Recommendations:
If there is a type of cardio exercise that gives you joy, do it. All exercise has value and by finding something you enjoy and will stay committed to, your body and overall health will reap the benefits of your increased movement.
Incorporate interval training into your routine a few times per week. Push yourself and challenge your heart and lungs for a short burst and then give yourself adequate time to recover before you do another burst or sprint again. This can be done with running, cycling, bodyweight jumping or plyometric moves or using cardio equipment.
Try to sneak in outdoor walks during the day or a power walk after dinner. Being outdoors in nature and walking is a low entry, low impact way to reduce stress, clear your mind, and improve your health.
If your preferred approach stops working for you and your goals or you stop enjoying it, reevaluate. There are very few inherently bad exercises or exercise modalities, but there might be a different way that is more effective for your goals, your interests, your availability, or your health situation so be open to making a change if needed.
By approaching fitness in general and particularly cardio fitness with flexibility and an open mind, you can navigate menopause with an exercise routine that supports your health and well-being.
Diane Pokorny Wilson, founder of Power Within Fitness + Coaching, has been a certified personal trainer and running coach for over 20 years and loves training and supporting women. She believes training should be safe, effective, goal oriented, and FUN. She will encourage and supervise you every step of the way as you push past your comfort zone and towards a stronger and healthier you. YOU GOT THIS! Learn more.