Physical activity and menopause: a natural ally against symptoms

Menopause occurs on average around age 51 in France, but its effects often begin 2 to 5 years before, during perimenopause. Hot flashes, sleep disturbances, weight gain, bone loss, unstable mood, low energy: these symptoms are real, biologically documentable, and can strongly impact quality of life and performance at work.

In this context, physical activity is not vague additional advice, it is a health intervention in its own right, validated by hundreds of randomized studies. It acts on almost all the symptoms of menopause, protects the most vulnerable organs during this period (bones, heart, brain) and contributes to a transition experienced with more vitality and serenity.

1. What changes at menopause and how exercise can help

2. The most effective exercises according to the objectives

At menopause, the three types of exercise recommended by the WHO remain relevant, but some deserve to be particularly prioritized:

• ●Muscle strengthening (priority no. 1): this is the most important exercise during menopause and in the years that follow. It combats sarcopenia, maintains bone density, improves insulin sensitivity and reduces visceral fat. 2 to 3 sessions per week are recommended, working all major muscle groups.

• ●Moderate aerobic endurance: brisk walking, cycling, swimming, dancing, 150 minutes per week. It protects the heart, improves mood, regulates weight and blood sugar.

• ●Activities with impact: light running, step, gentle jumps, team sports, specifically beneficial for bone density via mechanical constraints. To be adapted according to possible joint pain.

• ●Yoga, Pilates and tai chi: particularly suitable for managing stress, improving sleep, working on balance and posture. Their mindfulness components also help to go through the transition with more serenity.

3. Physical activity and hot flashes: important nuances

The relationship between exercise and hot flashes is the most nuanced and most frequently misinterpreted. It is important to be precise:

• ●In the short term during intense exercise: intense exercise can temporarily increase the frequency of hot flashes, the rise in body temperature during exercise can trigger episodes. This is not a harmful effect but a transient phenomenon.

• ●In the medium term (regular practice): a 2014 meta-analysis (Daley et al.) concludes that women who regularly practice physical activity report a reduction in the frequency of hot flashes. The effect is moderate but real, especially for moderate intensity exercises.

• ●Thermoregulation and sport: exercise improves central thermal regulation in the long term, which is the probable protective mechanism. Avoiding very hot periods and hydrating yourself abundantly helps reduce the occurrence of puffiness during exercise.

4. Bone and cardiovascular health: absolute priorities

The two biggest health risks of menopause are bone loss and increased cardiovascular risk. Physical activity is the more effective preventive intervention of the two:

• ●For bones: at the first signs of perimenopause, combine muscle strengthening and impact activities. The intervention window is particularly important in the first 5 years post-menopause, during which bone loss is the most rapid (up to 5% per year).- For the heart: regular aerobic physical activity partly compensates for the loss of the cardioprotective protection of estrogens. It maintains the elasticity of the arteries, reduces blood pressure, improves the lipid profile and reduces vascular inflammation.

• ●The combination of bodybuilding + cardio is synergistic: several studies show that the combination is more effective than each modality alone for post-menopausal metabolic and cardiovascular health.

5. Start or adapt your practice to perimenopause

Perimenopause is the ideal time to evaluate and adapt your sporting practice, before hormonal changes have produced all their effects. It is a period of transition that can also be an opportunity to take care of your health in a more intentional way.

• ●For beginners: start with 3 brisk walking sessions of 30 minutes per week + 1 gentle strengthening session (yoga, Pilates, gentle gym). Increase gradually over 6 to 8 weeks.

• ●For women who are already active: increase the weight training part of your routine, add impact activities if not practiced, and integrate balance and proprioception work.

• ●Specific precautions: in the event of joint pain (common during menopause), favor discharge activities (swimming, cycling, elliptical). A poorly managed injury can interrupt a sporting routine for several months.

A complete health check-up at perimenopause makes it possible to assess bone density, cardiovascular and metabolic assessment, and to establish a personalized physical activity program, adapted to the symptoms and risk factors specific to this period.