Training considerations for peri-menopause and menopause by kelly kortik from newcastle performance physio

The older and the wiser doesn’t come without the fun of hormonal changes and consequential hot flashes, irritability, sleep disturbances, body composition changes, cognitive changes and mood disorders – just to name a few.

The good news is, we are finally starting to understand this time of our lives better and put some strategies into place to better manage these symptoms. The bad news, we are only starting to understand this all in recent years, and women have been going through menopause for millions of years without answers or help. Time to change that now!

In regards to training, traditional methods of training are not adequate for improving bone, muscle or make body composition changes in peri-menopausal and menopausal athletes. Specific training considerations are going to best suit female physiology as females move through this time of their lives. With the changes of estrogen and progesterone, our body needs exercise stress to make up for the responses the hormones used to have – as menopausal women no longer have the same anabolic stimulus.

So what happens from a hormonal level and how can training help?

Estrogen in pre-menopause is a stimulus for anabolic growth (muscle repair, strength, speed and power). How training can help? When hormones begin to flatline, females need to use external drivers to facilitate this anabolic stimulus.
Increased total body inflammation due to a lack of hormones which would moderate our immune function. How training can help? Specific training can help to downgrade inflammation in the body.
Increased insulin sensitivity due to interaction between estrogen and progesterone and how they moderate blood sugar. How training can help? We can counter this with the types of exercise and timing of carbohydrates.
Reduced stimulus for bone turnover without estrogen.
Hormones affecting neurotransmitters in the brain leading to cognitive changes and mood disorders can be managed with exercise and nutritional interventions.
Decreased lipid removal rate (fat cells) resulting in storing excess fat. Again, this can be addressed through specific exercise interventions.

The list goes on.

So, what is the best training then?

Strength training

Strength is defined as a maximum force a muscle can produce in a single effort irrespective of time. Strength is so important as we age as we lose the ability to synthesise muscles and need to develop a strong contraction to maintain muscle integrity. You want to be working through a repetition range of 1-6 reps, over 4-5 sets. Anything above 6-8 repetitions starts to move into muscle hypertrophy which is not the priority anymore. If you can do more than 6 reps safely, time to go heavier. Future you will thank you for it!

Why strength training?

We have less power production and muscle synthesis with menopause. This means we need to train for power not for endurance! Neuromuscular training focuses on performing exercises that train the nerves and muscles to react and communicate; accomplished through controlled resistance training. Plus the additional benefits of increased cross sectional area of muscle, bone mineral density and metabolism, and improved strength, immune status and cardiovascular health.

High Intensity Interval Training (HIIT)

HIIT is defined as short periods of hard anaerobic work with less intense recovery periods, working at 85-90% of max heart rate with 70% heart rate in the recovery period. The maximum session duration is 30 mins, if you can go for longer it isn’t hard enough!

Why HIIT?

HIIT is effective for changing body composition, improving blood glucose control and CV function.

Plyometric training

Plyometrics are exercises in which muscles exert maximum force in short intervals of time, with the

goal of increasing power and speed. Plyometrics can be integrated into HIIT.

Why plyometrics?

Plyometric training causes gene transcriptional changes to improve metabolic function of the muscle

cells and improve the rapid nerve firing for the strong contraction – better mitochondrial function to

fuel better and utilise glucose or carbohydrate to improve insulin sensitivity.

What about endurance/aerobic training?

There are inherit sex differences at birth that make women better and more efficient at using, burning and storing fat i.e. women are inherently primed at developing a strong aerobic system through our natural physiology. The idea of long slow or aerobic work is to develop more fat stores, which women inherently already have – therefore more of this work results in a response to store more fat. Longer duration results in an elevation of cortisol resulting in more stimulus to save and store fat. In saying this there is still a place for the long, slow stuff in endurance athletes. Endurance sessions should be incorporated on the weekends and in the deload training weeks, but otherwise the focus should be on power and high intensity.

How to actually apply and integrate this into training?

First things first, if we don’t recover, we don’t get the adaptations. As we get older, recovery becomes just as important as the training itself. We typically recommend 2 hard weeks, followed by a deload week. During the hard weeks, aim for 3 gym sessions including HIIT and/or plyometric training, with low to moderate activity on alternate days and one complete rest day. During the deload week, the focus needs to be on sleep and recovery. Reduce the intensity of gym sessions to 50%, and continue low to moderate intensity activities as you please.

A lot to take in?

It’s new, it might be different, and kind of exciting! If this sounds like something you want to explore more and better understand how to adapt your training with your life stage and physiology give us a call at Newcastle Performance Physiotherapy, we would love to help!