Menopause & Movement: The Missing Link to Staying Strong
Perimenopause is a chaotic train ride! You start to feel the shift into perimenopause with random aches and pains, sleep difficulties, mood swings, hot flashes, and irregular cycles. This unpredictable bridge between your fertile years and menopause (12 months after your last period) looks different for every woman. Once menopause settles in, however, things start to feel less chaotic but more… real.
If you’re going through the chaos of perimenopause right now, know this: now is an important time to take action to maintain good balance, osteoporosis prevention, injury prevention, and strength training for menopause. The physical therapy team here at A Life in Balance can help guide you through this transition and into a strong, balanced menopause.
What Actually Changes After Menopause
The perimenopause train can last anywhere from 4 to 14 years! The average shift into menopause after that is somewhere around ages 51–52, but again, that average can vary widely between individuals. Overall, a lot of things slow down and settle in the body as perimenopause shifts into a more "stable" menopause, where these conditions persist:
Estrogen drops throughout perimenopause, but reaches a lower, long-term baseline once you’re in menopause.
Natural bone loss, which starts during perimenopause, continues through menopause, although there are ways to slow it down and maintain bone density, as we discussed in our osteoporosis prevention blog.
Muscle mass and strength decline noticeably; maintaining or building muscles requires a little more effort and strategy.
And, oh, the metabolism. It starts to slow down and takes a lot longer to respond. But it still responds!
"During perimenopause, things are more unpredictable, and symptoms and clinical presentation can fluctuate a lot across this stage,” explains Dr. Aurora. “Once people reach menopause, the body is adjusting to lower levels of estrogen long-term, and things begin to level out. The body is now adjusting to a new baseline. This can make changes in strength, bone density, and metabolism more noticeable and fitness progress feel a bit slower—but it’s still attainable."
Just remember: Nothing is broken. You are not broken. Your body is just changing and adapting, so it requires a different approach to stay strong and balanced.
The Slide from Perimenopause into Menopause: When Movement Becomes Non-Negotiable
The first step in adapting to these changes is to be aware of what’s happening in your body and to adjust your lifestyle and habits in ways that empower you through this phase of life. Although you can’t force your body to keep making estrogen, you can actually replace many of its beneficial effects through consistent, strategic movement. Movement is literally medicine during this phase of life! Movement supports:
Bone density and osteoporosis prevention
Muscle mass
Connective tissue health
“Movement isn’t optional anymore, ladies—it’s necessary and protective,” says Dr. Aurora. “It’s critical to find smart ways to work it into your daily routine, because effective exercise can help to support these elements and make up for some of the loss of estrogen.”
At this stage, knowing what to do—and how to do it safely—can make all the difference. If you’re unsure how to build strength or where to begin, working with a physical therapist can help you create a plan that supports your body through this transition.
Why Muscle Matters More Than You Think
Muscles matter, especially as you’re going through perimenopause and all the way through menopause, too. This makes adding strength training to your routine an absolute must because muscles can:
Improve bone health: Bones respond to strength training, even through menopause, by bolstering bone density, which counteracts the bone loss associated with lower estrogen levels.
Help you maintain stability and balance: Good muscle tone supports your whole body, especially in the core, where stability and balance are centered. This can help with injury prevention by bolstering balance and stability. The ALIB team works with many women on individualized physical therapy for balance programs.
Protect your joints: Maintaining good muscle tone also provides additional support to joints, which typically suffer from lower estrogen levels. Stronger muscles, however, support joint health throughout menopause.
“If you’re noticing decreased muscle mass and feeling less strong, know that this slide directly impacts joint stability and bone density,” says Dr. Aurora. “You can still build muscle mass, however! Muscles help pull on the bone, causing mechanical loading, which stimulates bone growth. They also attach to different points on the bones and surrounding joints, providing structure and stability to joints throughout the body.”
So, keeping your muscle mass up not only keeps you strong and moving, it actually protects your whole system!
Myth-Busting: Not All Exercise Works the Same Anymore
Yes, cardio is still important for your health, and we would never tell you not to take your daily walk. Walking, however, isn’t enough anymore, and we’ve noticed that many women in the perimenopause-to-menopause transition are exercising based on old information. For example, some “play it safe” with only light weights and don’t challenge themselves enough with the weight training their bones, joints, and muscles really need right now. It’s actually time to kick it up a notch to fulfill your new needs.
You can exercise safely while still challenging your muscles in ways that bolster your muscle, bone, and joint health while improving your strength and balance. Smart, progressive muscle challenges can bring tangible results. Getting personalized guidance on where to start is important, which is why we focus on that with each individual in both of our physical therapy Flemington NJ, and physical therapy Manchester VT, locations.
What Strength Training for Menopause Actually Looks Like
The most effective strength training for menopause progressively increases resistance training, weight-bearing movement, balance training, and functional, full-body exercises tailored to your individual needs.
“One go-to exercise that hits all the marks is controlled step-ups,” says Dr. Aurora. “These involve controlling your posture as you step up onto a raised step or bench while holding weights.”
Step 1: Add Weight for Strength Training
As you work with a trainer or physical therapist on an individualized training regimen, you’ll want to add weight to provide the resistance necessary to bolster muscle strength, bone density, and joint protection. In the case of step-ups, Dr. Aurora explains that: “You can progressively add weights (either ankle weights or hand-held) to a step-up to turn it into resistance training.”
Step 2: Speed Up for Increased Impact
If you’re doing step-ups or other exercises, you can notch up your speed to increase the impact… the force with which your feet hit the surface, triggering the bones to increase density for effective osteoporosis prevention. This also boosts your cardio workout!
Step 3: Slow Down for Balance
“After a speed run, slow down a step, and you can work on your balance by trying to maintain the single-leg phase,” says Dr. Aurora. The ALIB team can coach you through different physical therapy for balance moves that will keep your movements stable, safe, and balanced, yet still appropriately challenging.
Good form matters at every stage. Make sure your alignment is solid and the movement is pain-free before adding weight, speed, or balance challenges. “You can also use handrail support as needed to facilitate safety," adds Dr. Aurora.
If this all sounds like a lot to fit into your already busy schedule, keep in mind that it’s not really about doing more or taking more time out of your day. It’s about doing the right things progressively; letting go of old habits that aren’t helping, and trading them in for exercises that build your strength and balance.
But What If I’m Dealing with Pain, Injuries, or Feel “Out of Shape”?
Yes, let’s face those inevitable worries: everyone goes through these things. Perimenopause is known for triggering random aches and pains. Old injuries remind you they’re still there—or were never quite dealt with properly. And who hasn’t been so busy in life that workouts ended up on the back burner for… a while? All of those feelings, hesitations, worries, and questions are valid and real. The good news? You don’t have to start from anywhere but where you are right now. It’s never too late. With the right support and guidance, you can start where you are, improve, and build up to where you want to be, and beyond. The important thing is to start!
The ALIB team can help you get a smart start with physical therapy for balance, injury prevention, strength training for menopause, and osteoporosis prevention for better bone density.
"The great thing about using a physical-therapy-based approach towards better fitness through perimenopause and menopause, especially here at ALIB, is that we don’t treat a single body part or condition,” explains Dr. Aurora. “We treat each individual as a unique, whole person with all the layers they bring with them. We meet each person where they are at and develop a specific plan of care to not just work around pain, injuries, or general conditioning, but to address these things directly with exercises and other physical therapy modalities to decrease any barriers that might hinder the ability to partake in a more rigorous exercise program for osteoporosis prevention."
Small Shifts Make a Big Difference
Small, simple additions to your lifestyle to improve your health don’t have to be a big production. Our physical therapy team recommends:
Getting two or three strength training sessions every week.
Paying close attention to alignment and posture with each exercise.
Gradually increasing the weight load.
Being intentional by adding more everyday movement.
Again, keeping it simple and realistic is the key, and Dr. Aurora has an easy suggestion to incorporate into your daily routine: "One of my favorite go-to exercises and a gateway exercise to strength training is the sit-to-stand move,” she says. “One small change you can make today would be to add a little more control and repetition when you go from sitting on a chair to standing. Try to be more intentional with this movement. Go slow and try to keep your legs lined up, hip width apart, and keep breathing as you go. See if you can do at least 5 extra sit-to-stand repetitions when you go to stand once or twice throughout your day. Stop if there is any pain with this. But this is a great habit to start to pave the way towards strength training and improved physical function."
Once again, you don’t have to overhaul your entire life—just start moving differently, on purpose. Instead of getting up from your chair once, do it 5 times, with intention and control. Add movement here and there throughout the day. It will add up, and you'll feel better.
Menopause: It’s Not Too Late—You Just Need a New Approach
The first step in this new approach is to stop thinking about perimenopause and menopause as a “decline”. Think of it instead as a shift—one that simply calls for smarter, more intentional movement. Progress may feel slower at times, but it is absolutely possible and achievable for everyone on this journey! You really can still build strength, balance, and bone health!
“It is never too late to make meaningful health changes,” insists Dr. Aurora. “It might be challenging, and progress might feel slow, but it is never too late to start an exercise program to help build strength, improve bone health, and even improve balance, especially when you have one-on-one personalized guidance that can help make a program specifically for you."
If you’re ready to feel stronger, more stable, and supported through this transition, we’re here to help. Contact our physical therapy Flemington NJ, or physical therapy Manchester VT center to get the guidance and support you deserve to boost your muscle, bone, and joint health at any age!
