More than one third of women living in the Western world have been through menopause and nowadays most women will spend a third of their lives in or beyond menopause. For those of us involved in the fitness industry, this is a large section of our clientele – often the group with the time and the financial ability to exercise and take care of their health..
Like the beginning of puberty, timing varies from individual to individual. After menopause the ovaries decrease their output of estrogen (consisting of Estradial, Estrone and Estriol). After menopause women tend to lose 2/3 of their estrogen and 50-60% of their testosterone. The estrogen loss happens much quicker than the testosterone allowing the influence of testosterone to surface. This often means a shift in fat gains to the abdomen as opposed to the hips and thighs and blood pressure and cholesterol rise.
It seems oestrogen helps to decide the body fat distribution. It is the female sex hormone responsible for ovulation and women of child bearing age tend to store fat in the lower body (hence the ‘pear’ shaped body shape) while men and postmenopausal women store fat around the abdomen. Animal studies have shown that a lack of oestrogen leads to excessive weight gain although the exact mechanisms are not yet understood.
Visible changes of these inevitable hormone rebalance may include a thickening of the waist, loss of muscle mass and an increase in fat tissue, or a thinning or loss of stretchiness of the skin.
Between the ages of 35 and 55 a woman’s body is also likely to change in a similar way due to lifestyle changes. The metabolism slows down and lean mass decreases. Muscle burns calories so the less muscle you have the fewer calories you burn. A lower metabolic rate will therefore lead to an increase in body fat But in addition to this women in their 40s onwards are also experiencing changes due to hormones and not just external factors –so for many of us it is a double whammy!
The Woman’s Health Study investigating pre-menopausal women aged 42-50 years found that after the first three years of this study each woman had gained an average of 5 pounds. 20% had gained 10 lbs or more and only 3% had lost that amount of weight.
It has also been found that women who have undergone menopause have higher levels of body fat and central fat distribution .In a 6 year study of 543 premenopausal women or early perimenopausal (showing the first signs of menopause) there was an average increase of 7 1/2 lbs of fat mass and an increase in 5 1/2 cm of waist circumference. If weight is gained during menopause it will be most likely gained around the waist or abdominal area. Women may turn from the safer ‘pear’ shape to an ‘apple’ – which is a risk factor for heart disease.
In the Postmenopausal Estrogen/Progestin Interventions (PEPI) study, women who were more active at baseline (whether pre, or post menopausal or currently experiencing it at the start of the study) gained less weight during the study. Women who decreased their physical activity by 300 calories daily (one half hour walk a week) over 3 years gained over 5 lbs while those who increased their physical activity by 300 calories weekly (added one half hour walk) only gained 3 1/2 lbs.
Studies show that while exercise will have no effect on the timing of menopause, active women appear to have fewer and milder symptoms (hot flashes, sweating, dizziness, sleeplessness etc) than those who are more sedentary and this reduction may be linked to the endorphin-like compounds involved.
Weight gain after menopause is more likely in sedentary women than active women so a comprehensive exercise program can offset weight gain (which can also lead to an increase in blood pressure and cholesterol and heart disease) as a result of hormonal changes.
Studies have shown that exercising also contributed to a significant decrease in intra-abdominal fat, total body fat and body weight in exercising women compared to non exercising women. This answers the question “How do I get rid of my tummy?”!
Exercise guidelines broadly (but this depends from one individual to the next so see an experienced qualified personal trainer or fitness consultant) recommend cardiovascular exercise 3-5 days weekly of 20 -60 minutes (acceptable in 10 minutes sessions split up if necessary). It should be a combination of moderate and vigorous exercise. Resistance training should be performed 2-3 days per week.This group of women should choose exercises which involve using many muscles in one exercise and that are largely ‘functional’ (movements that are useful to their everyday lifestyle). Perimenopausal, menopausal and post-menopausal women MUST exercise in order to maintain muscle mass and prevent their metabolisms from dropping.
In addition to the thickening of the waist and change is body shape from ”pear” to ”apple, osteoporosis is another long term effect of the estrogen deficiency of menopause and in the western world 50% of women are expected to develop it or be at risk of developing it after the age of 50. It is thinning of bone tissue and a loss of bone density over time. Bones become brittle and prone to fracture. It has become a major cause of disability and death in the elderly as fractures occur after relatively minor falls or accidents and recovery may involve a long period of bed rest.
Petite light women are actually at greater risk of osteoporosis, especially those who have been underweight during much of their adult life as they have not carried enough body weight to be ‘weight bearing’ and it is weight bearing exercise which helps to build bone mass. The older we get the more likely we are to develop osteoporosis and women are five times more likely to develop it than men.
Genetics of course also play a role and the amount of peak bone mass at maturity. Bone mass reaches it peak between 20 and 30 years so the more we have at bone maturity the more we can afford to lose as we age. Get your teenage daughters exercising as osteoporosis may happen to you after menopause but you need to do something about it from your teens. Studies show that developing bone mass in teenagers is more effective than increasing calcium intake later. Remember to that vitamin D intake is essential for calcium absorption .Along with these supplements and other pharmacology interventions, exercise is part of the usual treatment for osteoporosis!
The time during which women enter menopause often coincides with other family or life changes. Children may be leaving home or social support networks may change due to divorce or moves. Parents, spouses, close relatives or friends may fall ill or die. So many women may be coping with their own aging in addition to other problems within their lives. This can mean a change in eating or exercise habits as their routines alter or as a result of stress, further compounding the problems of weight gain and change in body shape.
The benefits of exercise in the prevention and management of stress and depression is well documented. Exercise releases the body’s mood elevating compounds which heighten the mood and reduce the depression hormone cortisol. Getting plenty of sleep and keeping the sleep cycle regular will also help as inadequate sleep can worsen depression. Maintaining a regular meal schedule and eating a well balanced healthy diet is also important.
This all indicates that perimenopausal, menopausal and post-menopausal women MUST exercise including adding resistance or weight training to their regime in order to maintain muscle mass, bone density, relieve stress and prevent their metabolisms from dropping. As I have already mentioned, midlife is also a time where lifestyle can become more sedentary. So this age group may already be experiencing decreased physical activity in addition to the body wanting to create more fat deposits around the waistline!
I mentioned before that while studies show that exercise will have no effect on the timing of menopause, active women appear to have fewer and milder symptoms than those who are more sedentary and this reduction may be linked to the endorphin-like compounds involved. Exercise can help to ease tension and anxiety as it has a positive impact on mood.
Any type of weight bearing exercise is good for offsetting osteoporosis. Walking is good for weak hips, legs and the spine but remember can’t help the shoulder or wrist! Swimming and cycling don’t count as there is not enough weight bearing.
Exercise guidelines generally (but depending on the individual so see an experienced qualified personal trainer or fitness consultant especially if you are looking for an osteoporosis related program or have any other concerns that may have an impact on your exercise such as joint or heart issues) recommend cardiovascular exercise 3-5 days weekly of 20 -60 minutes (acceptable in 10 minutes sessions split up if necessary). It should be a combination of moderate and vigorous exercise. Resistance training should be performed 2-3 days per week and for those already diagnosed with osteoporosis there are more specific guidelines as to the nature of exercises. This includes strength training though the long axis of the bone to build up bone strength, lots of spinal extension style exercise (hyperextension) rather than spinal flexion (a sit up or crunching movement) and no aerobic activity that might risk a fall. Balance training and all this involves will also help to prevent future accidents. This group of women should choose exercises which involve using many muscles in one exercise and that are largely ‘functional’ (movements that are useful to their everyday lifestyle). The exercises need to direct force through the spine and hip.
If you have never worked with weights and want to start but are not sure how, or if you are not comfortable working out in a large public gym, then Body By Design has private fully equipped gyms where you can work one-on-one with an internationally qualified instructor guiding you through your specifically designed program.