Exercise During Menopause

US guidance recommends at least 150 minutes of moderate aerobic activity a week, or 75 minutes of vigorous activity, or an equivalent mixture. It also recommends muscle-strengthening activity on at least two days, covering the major muscle groups. These recommendations apply to adults generally, including the menopause years.

You can accumulate aerobic activity in short sessions. A brisk walk before work and another after lunch can contribute to the same weekly total. If you have been inactive, begin with a comfortable amount and increase it over time. Some activity provides health benefits even before you reach the recommended total.

Aerobic activity and muscle strengthening serve different purposes. A walking routine can improve endurance, while exercises against resistance help maintain strength for lifting, climbing stairs, and getting up from a chair. Include both in the plan, with flexibility or balance work when useful.

Moderate activity makes you breathe harder while still allowing conversation. CDC's talk test describes this as being able to talk but finding singing difficult. During vigorous activity, you can say only a few words before pausing for breath. The same walking speed can feel different to people with different fitness levels.

A watch can help track time, but a heart-rate target is not necessary to begin. Breathing, comfort, and the ability to recover give useful information. Ask for an individualized plan if a medical condition or medication changes how you should monitor effort.

Body composition changes around the menopause transition. SWAN research found faster fat gain and a decline in lean soft tissue around the final period. Lean tissue includes muscle and other nonfat tissue, so that result cannot quantify a person's muscle loss. It provides context for paying attention to strength and daily function.

Resistance activity asks muscles to work against a load: weights, bands, a machine, or your body weight. The load needs to be challenging enough to require a rest after a set. Increase difficulty gradually as the movement becomes easier, keeping control of the exercise.

Osteoporosis changes the choice of exercise. NIAMS advises avoiding sudden or excessive strain and high-impact activity when osteoporosis is present. A physical therapist can teach suitable exercises, safer movement, and balance work. Discuss an existing fragility fracture or diagnosis before starting an unfamiliar program.

The following example reaches 150 minutes of moderate aerobic activity and includes two strength sessions. It assumes you can already tolerate this amount. If that is a large increase, reduce the starting duration and build toward it over several weeks.

The aerobic sessions can be divided into shorter periods. Strength sessions need exercises for the major muscle groups; their duration depends on the routine and rests. A chair sit-to-stand or wall press-up can be a starting movement, with guidance if technique or balance is uncertain.

Sleep and fatigue

If night sweats or insomnia are leaving you exhausted, discuss treatment while adjusting the activity to what you can manage. Menopause treatment may reduce heat-related waking; persistent insomnia can benefit from CBT-I. A severe new decline in exercise tolerance needs assessment.

Pain and recovery

Choose comfortable movements and build gradually. Persistent pain, an injury, balance problems, or osteoporosis may call for a physical therapist's help. The aim is a routine you can continue and progress, with movements adapted to your circumstances.

• Record minutes of aerobic activity and the strength sessions you complete.
• Notice whether stairs, walking, and carrying everyday items become easier.
• Adjust the next week according to recovery and symptoms.
• For weight management, review food, activity, and health outcomes together with the clinician or dietitian.