Exercise and Menopause

Menopause is usually a natural process defined as the permanent end of menstruation. It can also be the result of surgery (e.g. hysterectomy) or a side effect from cancer treatment as the ovaries cease the production of oestrogen.

The initial stage of menopause consists of variation in oestrogen and progesterone levels. This stage is known as perimenopause and can last from 1 to 10 years and has a standard duration of 4 to 6 years. During this time, symptoms of hot flushes, disrupted sleep and mood disturbances begin.

Early onset menopause is defined as when a woman undergoes her final menstrual cycle prior to the age of 45. Premature menopause occurs before the age of 40. These can happen naturally or from surgery and pharmacotherapies. 


Hormonal changes such as a loss of protective hormones can increase the reduction in bone mineral density, tendon degeneration and loss of muscle. Resistance and pelvic floor exercises can help load the bones, muscles and tendons to reduce risk of osteoporosis, osteopenia, fractures and pelvic floor dysfunction.


The cardiovascular effects of menopause include endothelial dysfunction, increased systolic blood pressure (SBP), increased LDL (bad) cholesterol and triglyerides, and decreased HDL (good) cholesterol. Aerobic exercise is recommended as it can assist in improving these health markers and reduce the risk of potential atherosclerotic changes.


Menopause increase the risk of metabolic syndrome as hormonal changes lead to insulin resistance. Population groups at higher risk include Indiginous Australians, Polynesian and South Pacific Islanders and Indian women. Insulin sensitivity can be improved by participating in moderate intensity aerobic exercise. 

How does exercise help?

Exercise can help with menopause related symptoms and long-term optimal health. Exercise can help with the management of:

  • Hot flushes and night sweats
  • Psychological symptoms (depression, anxiety and impaired memory & concentration)
  • Joint pain, headaches and dizziness
  • Incontinence 

Exercise in post-menopausal and perimenopausal women can result in:

  • Maintenance of bone mineral density
  • Reduced risk of developing cardiovascular disease
  • Improved endothelial function therefore reducing the risk of atherosclerotic changes and high blood pressure
  • Improved quality of sleep
  • Improved insulin sensitivity therefore reducing the risk of developing diabetes
  • Improved mental health and quality of life

What exercise is best?

An exercise program should meet the physical activity recommendations of 150 minutes per week of moderate intensity aerobic exercise or 75 mins of vigorous exercise and 2 non consecutive days of resistance exercise. 

The following should be taken into consideration when prescribing exercise:

  • Exercise history
  • Individual goals
  • Exercise that is enjoyable
  • Chronic health conditions and/or injuries

Before beginning an exercise program, all post-menopausal women should have their pelvic floor strength assessed. If pelvic floor dysfunction is suspected, exercise should aim to reduce increases in intra-abdominal pressure and avoid strain being placed upon the pelvic floor organs and muscles. 


Exercise Right. 2022. How exercise can help during Menopause. [online] Available at: <>