What is menopause and why is it an issue?
Menopause is the period of time 12 months after the last menstrual cycle, signifying the end of reproductive period1. The age of onset is typically between 40-60 years old and the average length of changes is 7.4 years, with some cases lasting up to 11.8 years2. The natural decline of female hormones, most importantly Estrogen, sets off a cascade of biological changes and has significant deleterious effects all across the body’s tissues and organs.
Symptoms can have a major impact on quality of life and influence the lifestyles and behaviour of women experiencing them. Common symptoms include:
- hot flushes
- fat mass gain
- muscle loss
- anxiety and mood changes
- sleeping issues and increased
- joint pain
- Decreased libido & sexual dysfunction
Some of the more serious side-effects don’t necessarily come with symptoms however, with morbidities such as diabetes, osteopenia and risk of coronary artery diseases often being ‘silent’ and asymptomatic conditions that are only found through regular screening1.
How can strength training help?
Note for Readers: Clinical studies often use the term ‘resistance training’ and ‘strength training’ interchangeably.
Exercise interventions are becoming one of the go-to alternative treatments to Hormone Replacement Therapy (HRT) for treating symptoms and reducing health impacts of menopause. In fact, there is evidence to suggest pairing HRT with resistance training can increase the effectiveness of both interventions3.
Resistance training has been growing in popularity due to its efficacy and positive results with several pathologies associated with the initiation of menopause, such as osteopenia, sarcopenia, metabolic syndrome, diabetes and cardiovascular disease. As well as being a protective behaviour to guard against future morbidity and illness, strength training also has the capacity to improve symptoms in a short-term time frame4.
Dealing with ‘hot flushes’ can be enough to put menopausal women off exercising just to avoid bringing them on. However, there is research suggesting that resistance exercise can help via the release of endogenous opioids (self-producing hormones) into the blood that can alter the thermoregulatory centre and reduce the frequency of symptoms.
15 weeks of resistance exercise, performed twice a week, was shown to halve (44%) hot flushes when compared to matched controls who were sedentary5. Interesting to note that low-intensity exercise such as walking, Pilates and yoga have been shown to be less effective at reducing hot flush symptoms than moderate-high intensity exercise.
By improving the capacity of the muscles to tolerate more load, movement becomes more efficient and takes less effort. As such, improving strength has great transfer to other important qualities like walking efficiency, social sport performance and reducing risk of injury. Muscle strength naturally declines with age as muscle tissue deteriorates and taking an active approach to retaining it becomes a very important factor in falls prevention for older adults.
Regular resistance exercise has been shown to increase muscle strength in menopausal women in several studies3,6-8. These changes in strength can come even without changes in muscle mass or body composition.
Bone structures naturally break down as part of the ageing process and are accelerated by periods of non-weight bearing or inactivity. Strength training and weight-bearing exercise is gold-standard treatment for conditions such as osteopenia and osteoporosis, as they cause micro-fissures in the bone in order to create the all-important ‘repair’ stimulus for the body to build new bone in its place. Done regularly, this reinforces bone density – making them stronger and healthier than before.
8 months of twice weekly sessions of high-intensity resistance training and weight-bearing exercise improved bone density scores at all sites of the body and improved physical performance scores in menopausal women with osteopenia when compared to controls who completed a low-intensity home exercise program8.
Lean Muscle, Fat Loss & Weight Control
The mechanism behind resistance exercise and fat loss is two-fold. Besides the obvious reason of burning calories from actually doing the exercise, resistance exercise works to increase the calories burnt at while resting – our basal metabolism. This occurs over time as you slowly increase the amount of lean muscle tissue in the body because, like other living organs in the body, muscles have their own energy demand in order to be sustained.
The effect of strength training on body composition and weight control in menopausal women has been studied by numerous groups and different methods3,6, 8-10. Longer term approaches (>6 months) had more consistent effects but positive results were found in interventions lasting only 8-12 weeks. Higher intensity exercise was shown to have greater effectiveness at facilitating fat loss than lower intensity exercise. In many of the long-term studies, the control groups (who didn’t strength train) lost muscle tissue and gained fat mass so simply maintaining baseline level composition is also considered progress.
Quality of Life & Psychological Factors
Exercise is a known treatment for depression and anxiety11. The explanation for this is quite complex but biochemistry studies have found the release of anti-depressant hormones such as serotonin and dopamine as part of the natural ‘endorphin’ release from exercise can have strong positive effects on mood.
Short-term (8 weeks) resistance exercise training significantly improved quality of life, Menopause Symptom Checklist scores and depression symptoms in menopausal women4. Not surprisingly, improvement in other symptoms was strongly related with higher quality of life scores.
How Do I Incorporate Strength Training?
Exercise Sport Science Australia (ESSA) guidelines for moderate-high intensity resistance training are below:
- 2 sessions per week
- 6-10 exercises targeting all major muscle groups
- Lifting weights at a minimum of 60% of your maximum capacity
- 2-4 sets of each exercise, for 6-15 repetitions
This can be difficult to plan and execute without some professional guidance. Engaging with an accredited exercise physiologist or accredited exercise scientist will help ensure that technique, loads and exercise selection are individualised to be safe and appropriate. It is worth noting no injuries or health issues were reported in any of the studies mentioned in this blog – this should provide ample reassurance that lifting heavier weights and training at higher intensities while supervised is not only safe: It is recommended!
Whether it’s to begin your strength training journey, or optimise what you are currently doing, contact Absolute Health & Performance today to book in a consultation with one of our expert coaches today.
Written by Sean Van Velsen, Accredited Exercise Physiologist (AEP)
- Leite, R., Prestes, J., Pereira, G., Shiguemoto, G. and Perez, S., 2010. Menopause: Highlighting the Effects of Resistance Training. International Journal of Sports Medicine, 31(11), pp.761-767.
- Avis, N., Crawford, S., Greendale, G., Bromberger, J., Everson-Rose, S., Gold, E., Hess, R., Joffe, H., Kravitz, H., Tepper, P. and Thurston, R., 2015. Duration of Menopausal Vasomotor Symptoms Over the Menopause Transition. JAMA Internal Medicine, 175(4), p.531.
- Teixeira, P., Going, S., Houtkooper, L., Metcalfe, L., Blew, R., Flint-Wagner, H., Cussler, E., Sardinha, L. And Lohman, T., 2003. Resistance Training in Postmenopausal Women with and without Hormone Therapy. Medicine & Science in Sports & Exercise, 35(4), pp.555-562.
- Ağıl, A., Abıke, F., Daşkapan, A., Alaca, R. and Tüzün, H., 2010. Short-Term Exercise Approaches on Menopausal Symptoms, Psychological Health, and Quality of Life in Postmenopausal Women. Obstetrics and Gynecology International, 2010, pp.1-7.
- Berin, E., Hammar, M., Lindblom, H., Lindh-Åstrand, L. and Spetz Holm, A., 2016. Resistance training for hot flushes in postmenopausal women: Randomized controlled trial protocol. Maturitas, 85, pp.96-103.
- Park, K., Park, S. and Kang, S., 2019. Effects of resistance exercise on adipokine factors and body composition in pre- and postmenopausal women. Journal of Exercise Rehabilitation, 15(5), pp.676-682.
- Manfredi, T., Monteiro, M., Lamont, L., Singh, M., Foldvari, M., White, S., Cosmas, A. and Urso, M., 2013. Postmenopausal Effects of Resistance Training on Muscle Damage and Mitochondria. Journal of Strength and Conditioning Research, 27(2), pp.556-561.
- Watson, S., Weeks, B., Weis, L., Harding, A., Horan, S. and Beck, B., 2019. High‐Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial. Journal of Bone and Mineral Research, 34(3), pp.572-572.
- BEA, J., CUSSLER, E., GOING, S., BLEW, R., METCALFE, L. and LOHMAN, T., 2010. Resistance Training Predicts 6-yr Body Composition Change in Postmenopausal Women. Medicine & Science in Sports & Exercise, 42(7), pp.1286-1295.
- Son, W., Pekas, E. and Park, S., 2020. Twelve weeks of resistance band exercise training improves age-associated hormonal decline, blood pressure, and body composition in postmenopausal women with stage 1 hypertension. Menopause, 27(2), pp.199-207.
- Blake, H., 2012. Physical activity and exercise in the treatment of depression. Frontiers in Psychiatry, 3.