And beyond! Be in it for the long haul!
Whether we experience menopausal symptoms or not, or even if we think we've come through the other side, the fact remains that our bodies undergo tremendous change during his time. Just because symptoms may decline in intensity and for some lucky ones disappear altogether, the effects of what goes on in the body will remain beyond this time. It is therefore the perfect time to reassess and consider setting ourselves up for the future. If you want to keep fit and well for as long as possible then I would strongly recommend you 'keep moving' and focus on movement for long term health.
We can't always see and feel what is going on with our bodies (we clearly feel hot flushes, joint aches, anxiety,weight gain etc). But what's happening to those things we cant see - our bones, our muscles, our heart, our brain..... ?
Hormonal shifts can play havoc with our bodies (there are a plethora of hormones involved, we mainly talk about fluctuating and declining estrogen, progesterone and testosterone) and in most cases we continue to add fuel to the fire, such as stress. Consider work/life balance, family responsibilities (looking after family both parents and children) and putting our own needs behind everyone elses. We may also be poor wrong dietary and nutritional choices and not creating time for the all important exercise.
It is well documented that physical activity is a great tool for health promotion (physical and mental) as well as disease prevention in all ages. Without movement and exercise our mobility is affected, we lose strength, our aerobic capacity declines, our balance becomes impaired, our risk of injury and falls increases....., not a complete list by any means!
So let's consider:
Our bones - the International Osteoperosis Foundation state that 1 in 3 women over the age of 50 will develop osteoperosis due to the lower levels of hormones. We know that estrogen plays a part in bone remodelling and declining levels impair this process. Peak bone mass occurs in our 30s and is followed by gradual bone loss. It is believed that bone loss accelerates a few years before menopause and continues post menopause although at a slower rate. Most cases of osteoporosis occur in postmenopausal women, and the prevalence increases with age. Associated lifestyle risks include poor nutrition and insufficient physical activity although, of course, genetics, certain medications and cancer treatments may also play a part.
Our muscles - loss of skeletal muscle mass and strength (sarcopenia) is believed to mostly affect older individuals but can clearly occur at any age in response to factors such as lifestyle, medical conditions and as a response to declining hormonal (in particular estrogen, again!) levels. Sarcopenia increases the risks of falls, fractures, disability and functional impairments. Loss of strength is often part of inactivity which in turn means it is also linked to weight gain and the presence of increased fat mass. Remember muscle works harder than fat so the more active muscle you have the better!
Our heart - according to ONS heart disease is one of the top causes of death in women under 75 in the UK. Whilst there are a number of risk factors contributing to heart disease (particularly lifestyle choices), declining levels of estrogen also play a part. It is thought that estrogen helps protect the heart. Falling levels during menopause mean that we should do what we can to keep our hearts strong and healthy. Alongside this, a lot of women will not be aware that menopause is associated with an increase in cholesterol levels and notably 'low density lipoprotein' (LDL) and tryglycerides and a decrease in high density lipoprotein (HDL). Top tip: get cholesterol levels checked at this time and beware of foods high in saturated fat as research suggests that it is these that can result in the build up of cholesterol in the blood. (In other words, think nutrtion.)
Our brain - I suppose we can 'feel' this one as brain fog and cognitive impairment is constantly referred to during the menopause journey. But what is happening that we can't see? Think of the menoapuse as a neuro-endocrine (brain+hormones) driven event. A study in 2021 by Mosconie et al showed that the menopause is a dynamic neurological transition and significantly impacts brain structure, connectivity, and metabolic profile and is representative of endocrine ageing rather than chronogological aging. The latter point is good new as 'recalibration' usually occurs! Yet again good old estrogen has a big part to play as there are estrogen receptors in ALL centres of the brain involved with cognitive function. Check out an earlier post on menopause and the brain here.
All of the above we can influence - remember we don't have to just accept our 'lot'! We can't beat ageing but we can challenge it, as we can the menopause journey. It is not compulsory to put on a few pounds, or to stop doing things because they seem a bit more difficult. Neither is it compulsory that we develop unwanted (and mostly unavoidable) medical conditions, nor that we coninue to put others first and soak up the stress that life brings our way. What should be compulsory though is finding time for ourselves and doing what's right for us!
So what do we do?
Focus on movement and exercise that provides you with the ability to keep moving well, retain strength, challenge the brain and get the heart rate up. Choice of exercise will depend on what you are trying to achieve - weight loss, run a 5k, improve mobility, manage a medical condition, etc. Find something you enjoy, are prepared to find time for and can fit into your life, make it challenging both physically and mentally. Go for variety to provide the following benefits:
increased aerobic capacity - start with low impact/low intensity and endurance and work to include higher intensity for greater gains. Benefits include a healthy heart and improved respiratory function, reduced metabolic risk associated with declining estrogen, improved cholesterol levels, reduced risk of high blood pressure. Walking, jogging, cycling, swimming, dancing (kitchen disco!), even try a bit of skipping. Movements that take you from a low to high eg squats to raising arms overhead or movement on the spot like jogging, high knees, step jacks (no jumping involved unless you want to).
increased muscle strength and endurance. Weight bearing exercise will help maintain and increase muscle mass and promote good bone health. During weight-bearing activity, the muscles and tendons apply tension to the bones, which stimulates the bones to produce more bone tissue. Squats, lunges, push ups (bodyweight). Use specific equipment (dumbbells, reistance bands, medicine balls) or household items (tin cans, plastic bottles, loaded bags) to create a varied home workout and add to bodyweight exercises.
improved flexibilty and mobility. Generally I would suggest taking a whole body approach and work towards increasing range of joint movement. Go beyond the old favourties of hips, hamstrings, glutes, lower back (these come up time and again due to sitting too long either at the laptop or on the sofa!!) and pay attention to hands, fingers, wrists - more mobility you have in these the greater grip strength for everyday tasks like getting lids off jars, carrying and pushing ability. Think about taking 10 minutes a day (or a few times a week) to practise a dynamic stretching and flexibilty workout. You can split between lower and upper body if you don't want to do all at once.
improved balance - this is a real biggie! Balance exercises improve our ability to control and stabilize our body's position. It is really important to keep challenging ourselves here (as my clients well know!). Ageing brings a worsening of our ability to know where you are in space, (proprioception) and this contributes to a decline in balance. Working on your balance not only improves stregthening of leg muslces but will also leads to improved posture. This helps to reduce pain associated with muscle imbalances and will reduce the risk of falls as we get older. Exercises that you can fit into your day eg balancing on one leg whilst waiting for kettle to boil or cleaning your teeth. Try and hold for as long as you can but build up to at least 30 seconds. You can increase the challenge by adding weight or movement.
maintenance of a healthy and energised brain, improving mood and self esteem. Any new activity will challenge our cognitive ability and we can certainly manipulate our movement and exercise to do just this. Any movment that you are not used to will challenge the brain. Think variety, once you have mastered one exercise, move onto something different. Put together a simple home workout, the challenge is memorising the moves as well as keeping correct form. Include some agility training which involves quicker movement and change of direction eg use a couple of markers on the floor in front and behind you (or numbered post it notes on the wall) and get a friend to call out which one to touch next. Check out this post on physical activity and mental well being here.
Exercise can help regulate our response to stress - stress being one of the biggest issues at this timewhether a busy life and/or hormonal influences. As well as challenging the brain to learn new skills, exercise creates 'me time' which is really important to help reduce stress and release the natural feel good hormones.
If you're unsure where to start then I would strongly advise Walking!
I'm a great advocate of walking especially with friends in the fabulous Surrey countryside! It's brilliant and ticks so many boxes improving cardiac health, muscular strength and endurance as well as helping to strengthen bones. It also helps alleviate depression, anxiety, fatigue, improves mood, creates less stress on joints, can prevent weight gain, improve circulation and posture.... I could go on! If you want to challenge yourself then add in some bodyweight exercises such as squats, lunges. Find some steps and incorporate them into your walk along with a variety of inclines. You can basically make a walk to be any level of activity you want or need it to be!
If you need any help then please do get in touch, always happy to chat
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