Exercise and the menopause
Dr Louise Newson, a GP and menopause expert, worked with Liz Earle on her book Healthy Menopause: How to Best Manage Your Symptoms and Feel Better Than Ever.
Fitness for women in their forties is a really important area. One of my aims is to try to engage women in exercise when they are perimenopausal or before because once they are menopausal, a lot of women have less energy, less self-esteem and are really tired. To encourage them to exercise is hard. Even though many of my patients do exercise professionally or have been motivated in the past, they still find it hard. So, to ask your average Brit to do yoga three times a week? It’s not going to happen. You’re more likely to continue exercising if you’re in a good routine before you start having menopausal symptoms – and we know that exercise helps all sorts of things, not just the menopause.
As we age, there are changes to our muscle strength and mass which can be related to our hormones. I’m interested in the benefits of getting your hormones right, so it’s not just about improving your symptoms but lowering your future risk of heart disease, osteoporosis, osteoarthritis – arthritis is more common as people go through the menopause. I see a lot of women who have muscle and joint pains and it’s all related to their changing oestrogen levels. A lot of people don’t realise that, and it’s hard to treat a physical symptom unless you treat the underlying cause. After all, we’re not designed to have 30 years of being postmenopausal; in Victorian times we died two years after our menopause, on average, whereas now we have, hopefully, 30 more years.
While exercise can help with menopausal symptoms and hormones, the problem with the menopause is that it’s physiological – it’s something that just happens. So exercise won’t always help improve symptoms because you’re not treating the main cause. Women often don’t realise that a lot of the symptoms they have are related to menopause, but it’s certain they will feel better from exercising and will reduce their risk of cardiovascular disease.
Exercise can also help build bone – osteoporosis is a huge problem, especially in women, and exercising can help. And anything that’s going to help with our weight is important. As for what type of exercise is best, do what works for you – anything that gets your heart rate up, whether that’s mowing the lawn or running up the stairs. Also anything that helps core and pelvic-floor strength; urinary incontinence is a taboo that no one talks about. I do ashtanga yoga because it works for me, I can do it at home and I like the mental side of it. But if you said I had to do step aerobics three times a week, I’d say forget it!
So although exercise is really important, without the right balance of hormones it’s hard for a middle-aged woman’s body to reach equilibrium. You can’t always do it without hormones. I know what my yoga practice was like before I took HRT – my joints were stiff and my headstands weren’t as easy – and my practice is so much more fluid now I’ve got my balance of hormones back. When I see overweight women walking down the street, I often think, “Why don’t more of them take HRT?” Because being overweight increases their risk of heart disease and also breast cancer, which they may not realise.
However, the menopause is not just about HRT, it’s about exercise, diet, your whole lifestyle – it’s all so important.
See menopausedoctor.co.uk for more on health, fitness and HRT during the menopause