Best Exercises for Menopause Symptoms and to Keep Your Heart Healthy

Posted on November 20, 2023 by Sally-Anne Turner

The aim of this year's World Menopause Day on 18th October is to raise awareness of the links between menopause and the potential risk of cardiovascular disease (CVD) in women. Given that around 13 million women in the UK, or a third of the female population, are currently in the perimenopause or menopause stage, and that CVD is responsible for 35% of deaths in women each year, it's an issue that really can't be ignored. Understanding the connection between hormonal changes during menopause and heart health is crucial for every woman approaching or experiencing this natural life transition. The good news is that with the right exercise programme, proper support, and expert guidance, women can significantly reduce their cardiovascular risks whilst managing menopause symptoms effectively.

Here's what you need to know about protecting your heart health during menopause and the specific exercises that can make a real difference to your wellbeing during this transformative stage of life.

Breast cancer is widely believed to be the biggest threat to women's health but, according to the World Heart Federation, CVD, including heart attacks, coronary artery disease, heart failure and stroke, kills more women every year than all the cancers combined, despite advances in both diagnosis and treatment. This startling statistic highlights a significant gap in public awareness about women's health risks. Many women spend considerable time and energy worrying about cancer screening and prevention, which is absolutely important, but often overlook the cardiovascular changes that occur during menopause and the steps they can take to protect their heart health during this critical period.

Reproductive milestones in a woman's life, including menopause, have now been linked to increased cardiovascular risks, with hormonal changes affecting the heart as oestrogen levels drop, cholesterol levels rise and fatty plaque builds up in the arteries. The protective effect that oestrogen has on the cardiovascular system throughout a woman's reproductive years diminishes during menopause, leaving women more vulnerable to heart disease. This hormonal shift can lead to changes in blood vessel function, increased inflammation, and alterations in how the body processes cholesterol and fat. Understanding these physiological changes is the first step in taking proactive measures to maintain cardiovascular health through the menopause transition and beyond.

The menopause is a natural transition period in a woman's life when the oestrogen levels produced by the ovaries decline and she no longer releases an egg each month. Menopause usually occurs between the ages of 45 and 55 and lasts around 7 years. In the UK, the average age for a woman to reach menopause is 51, although symptoms can start in the mid-30s with perimenopause and continue well into the mid-50s. Menopause is reached when a woman hasn't had a period for 12 consecutive months and is no longer able to get pregnant naturally. During this time, women may experience a wide range of symptoms, including hot flushes, night sweats, mood changes, sleep disturbances, weight gain, joint pain, and reduced energy levels. These symptoms can vary dramatically from woman to woman, with some experiencing mild discomfort whilst others find their daily life significantly impacted by the severity of their symptoms.

The menopause transition provides an opportunity to take positive steps towards a healthier lifestyle and a proactive approach to a healthy heart through balanced diet, weight management, quality sleep, not smoking and regular exercise. Rather than viewing menopause as simply something to endure, women can embrace this life stage as a catalyst for positive change. Many women report that the menopause prompted them to finally prioritise their own health and wellbeing after years of putting others first. By focusing on heart-healthy habits now, women can set themselves up for decades of good health and vitality in their post-menopausal years. At Bodyline Clinic, we specialise in supporting women through the menopause with personalised treatment plans that address both symptoms and long-term health concerns.

Get Moving

As women move into midlife, a healthy body is key to supporting a healthy heart, undoubtedly the most important muscle in the body. The stronger your body and the more freely you're able to move it, the more your inner body - digestion, cortisol levels and detoxification process - can work effectively. Movement is medicine during menopause, helping to counteract many of the physiological changes that occur during this transition. Regular physical activity helps maintain healthy blood pressure, improves cholesterol levels, supports healthy blood sugar regulation, and reduces inflammation throughout the body. Beyond the cardiovascular benefits, exercise also helps manage weight gain, which is a common concern during menopause as metabolic rate naturally slows down and body composition changes.

Experts recommend a minimum 2.5 hours of moderate exercise a week – think a brisk walk, a round of golf or a swim five times a week – or around 1.5 to 2.5 hours of energetic exercise like jogging, fast cycling or playing an energetic team sport. You should also ideally aim to add in a couple of sessions of strength or resistance training every week. These guidelines might seem daunting if you're not currently active, but the key is to start where you are and gradually build up your activity levels. Even small increases in physical activity can yield significant health benefits. If you're currently sedentary, starting with just 10 minutes of walking per day and gradually increasing the duration and intensity can make a meaningful difference to your cardiovascular health and menopause symptoms.

It's about making sensible choices and finding activities that you enjoy. The more you move your body, the more calories you'll burn. A good goal is to stay on your feet for as much of the day as you can, so meet a friend for a walk in the park instead of for coffee, take regular breaks away from your desk (sitting still for lengthy periods has been linked to increased abdominal fat) and try to increase your step count whenever and whatever you are doing. Incidental exercise – the movement you do as part of your daily life rather than structured workouts – can contribute significantly to your overall activity levels. Taking the stairs instead of the lift, parking further away from your destination, doing housework or gardening with more vigour, or playing actively with grandchildren all count towards your daily movement goals. Many women find that tracking their steps with a fitness watch or smartphone app provides motivation and helps them stay accountable to their movement goals.

Take quality time out for yourself with mindful meditation, Tai Chi yoga and mobility stretching are all highly beneficial to mental wellbeing, relaxing both mind and body and reducing stress levels. Chronic stress can exacerbate menopause symptoms and negatively impact cardiovascular health by keeping cortisol levels elevated. Mind-body exercises that combine gentle movement with breath work and meditation can help activate the parasympathetic nervous system, promoting relaxation and recovery. These practices are particularly valuable during menopause when sleep quality often deteriorates and stress levels may increase due to the physical and emotional challenges of this transition. Incorporating even just 10-15 minutes of gentle stretching or meditation into your daily routine can help improve sleep quality, reduce anxiety, and enhance your overall sense of wellbeing during menopause.

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Resistance: Weight Training

Andy McGlynn of NAPTP, a clinical nutritionist, coach and mentor to other PTs, is excited about the massive benefits of weight training in menopause. Weight training, also known as resistance training or strength training, has emerged as one of the most powerful interventions for managing menopause symptoms and protecting long-term health. For many years, women were discouraged from lifting weights due to misconceptions about becoming "bulky" or masculine. However, research has consistently shown that resistance training offers unique benefits for menopausal women that cannot be replicated through aerobic exercise alone. The hormonal changes during menopause make strength training more important than ever, as declining oestrogen levels directly impact muscle mass, bone density, and metabolic rate.

A recent 2023 study referenced weight training as being more effective than aerobic training in reducing menopausal hot flushes. Apart from the general benefits of weight training – improved body composition, enhanced strength of the entire body and increased bone density and health – there are also very specific added benefits to incorporating resistance training into your weekly regime when going through menopause and the associated symptoms. Hot flushes are one of the most common and disruptive menopause symptoms, affecting up to 80% of women during the transition. The fact that resistance training can help reduce the frequency and severity of hot flushes represents a significant breakthrough in non-pharmacological management of menopause symptoms. The mechanisms behind this effect are thought to relate to improved thermoregulation, better stress hormone management, and positive changes in body composition that occur with regular strength training.

A well-balanced weight training programme three times a week is optimum for combatting menopause symptoms and the associated cardiovascular risks. Research shows that training with weights not only increases muscle mass but also improves everything from cognitive function and health to glucose control and insulin sensitivity, while preserving metabolic rate and leading to better hormonal balance in the body. The cognitive benefits of resistance training are particularly relevant during menopause, when many women report experiencing "brain fog", memory difficulties, and reduced concentration. Studies have shown that regular strength training can improve executive function, processing speed, and memory in middle-aged and older women. The improvements in glucose control and insulin sensitivity are crucial for preventing type 2 diabetes, which becomes more common after menopause. By maintaining or building muscle mass through resistance training, women can keep their metabolism more active, making it easier to maintain a healthy weight during and after the menopause transition.

Andy advises keeping it simple to start with by splitting the movement patterns of the body in to two workouts, prioritising compound exercises that work multiple muscle groups at the same time. Workout one, for example, could be lower body incorporating lunges, squats and some form of bending pattern exercise, with workout two including 'push' and 'pull' exercises like deadlifts and incline bench presses and ideally a form of rotating movement. When first starting out, he recommends repetitions in the 15-25 rep range to condition the stabilising muscles, but without over-thinking it too much, rather rely on intuition and listen to your own body. To progress, you can gradually increase the weight and start to bring the rep range a little lower, thereby increasing the load and switching the focus between different muscle fibre groups. This approach to programming ensures that you're working all the major muscle groups throughout the week whilst allowing adequate recovery time between sessions targeting the same muscles.

Compound exercises are particularly efficient for busy women because they work multiple muscle groups simultaneously, giving you more benefit in less time. A squat, for example, works the quadriceps, hamstrings, glutes, and core all at once, whilst also improving balance and functional movement patterns that translate to daily activities. Deadlifts strengthen the entire posterior chain including the back, glutes, and hamstrings, which can help prevent back pain and improve posture. Push exercises like chest presses and shoulder presses build upper body strength, whilst pull exercises like rows strengthen the back muscles that are often weak from desk work and poor posture. Including rotational movements helps maintain spinal mobility and core strength, which are essential for preventing injury and maintaining independence as we age.

Resistance training has been consistently shown to improve insulin sensitivity, especially in older women, meaning that the body is better able to process and soak up carbohydrates rather than storing them as body fat. Weight training also increases metabolic rate by increasing fat-free mass, which typically drops after menopause. This is one of the key reasons why many women find it increasingly difficult to maintain their weight during and after menopause. As muscle mass decreases, the number of calories your body burns at rest also decreases, making it easier to gain weight even if your eating habits haven't changed. By building and maintaining muscle through regular resistance training, you can counteract this metabolic slowdown and make weight management more achievable. The metabolic benefits of strength training extend beyond the workout itself – muscle tissue is metabolically active, meaning it burns calories even when you're resting, unlike fat tissue which is relatively inert.

For women who are new to weight training, working with a qualified personal trainer or attending beginner classes can be invaluable for learning proper form and technique. Poor form not only reduces the effectiveness of exercises but also increases the risk of injury. Many gyms and fitness centres offer women-only sessions or classes specifically designed for midlife women, which can feel less intimidating than mixed or younger-focused environments. Starting with bodyweight exercises or light dumbbells allows you to master movement patterns before progressing to heavier weights. Remember that you don't need to lift extremely heavy weights to benefit from resistance training – the key is to challenge your muscles progressively over time, gradually increasing the resistance as your strength improves. At Bodyline, we can support your weight management goals alongside your exercise programme with personalised advice and treatment options.

Aerobic: Rebounding

Rebounding, or exercising aerobically on a mini-trampoline, can be a game-changer for women experiencing menopause symptoms, as well as being a fun form of cardio. Rebounding has gained popularity in recent years as more women discover its unique benefits, particularly during the menopause transition. Unlike high-impact activities like running, which can be hard on joints that may already be experiencing menopause-related pain and stiffness, rebounding provides an effective cardiovascular workout whilst being gentle on the joints. The bouncing motion creates a unique form of resistance as your body works against gravity with each bounce, engaging muscles throughout the body whilst the trampoline surface absorbs much of the impact that would otherwise stress the joints.

Kimberlee Perry CEO of Bouncefitbody, the UK's leading resistance-based fitness brand specialising in mini trampoline fitness, advises that rebounding during menopause offers an enormous range of benefits including improving muscle mass, bone density and pelvic floor strength, as well as stimulating the lymphatic system, aiding detoxification and hormone balance. It's also fantastic for enhancing balance and coordination, whilst also boosting oxygen levels and therefore optimising cell function and contributing to an overall sense of well-being. The pelvic floor benefits are particularly significant for menopausal women, many of whom experience weakening of the pelvic floor muscles leading to stress incontinence or pelvic organ prolapse. The gentle bouncing motion of rebounding helps strengthen these muscles without the high impact of activities like running or jumping on a hard surface.

Research carried out by NASA found that rebounding helped astronauts to regain their muscle mass and bone density after returning from space, proving to be around 68% more effective than jogging. This research has important implications for menopausal women, who face similar challenges to astronauts in terms of bone density loss, albeit for different reasons. Whilst astronauts experience bone loss due to the lack of gravity in space, menopausal women experience it due to declining oestrogen levels. The fact that rebounding was so effective at rebuilding bone density in astronauts suggests it can be equally beneficial for women going through menopause. The vertical acceleration and deceleration that occurs with each bounce creates a unique stimulus for bone-building cells, encouraging them to lay down new bone tissue and maintain existing bone density.

The lymphatic system benefits of rebounding are another important consideration during menopause. Unlike the cardiovascular system, which has the heart to pump blood around the body, the lymphatic system relies on muscle contractions and body movement to circulate lymph fluid. This fluid carries waste products and toxins away from tissues for elimination. The rhythmic bouncing motion of rebounding creates a pumping action that stimulates lymphatic flow throughout the body, supporting detoxification and immune function. Many women report feeling less bloated and more energised after incorporating regular rebounding sessions into their routine. The lymphatic stimulation may also help with the fluid retention that some women experience during menopause.

Balance and coordination naturally decline with age, increasing the risk of falls and injury. Rebounding requires constant small adjustments to maintain balance on the unstable surface of the trampoline, which trains the proprioceptive system and improves overall balance and coordination. This can translate to better balance in daily life, reducing the risk of falls. The improved oxygen circulation that occurs during rebounding sessions benefits every cell in the body, including brain cells. Many women report improved mental clarity and mood after rebounding, which may be due to the combination of increased oxygen delivery, endorphin release, and the simple joy of bouncing. Rebounding can be done at home with a mini trampoline, making it a convenient option for women who prefer to exercise in privacy or who have limited time to travel to a gym or fitness class.

Holistic: Pilates

A holistic exercise like Pilates works wonders for menopause symptoms like joint pain and stress, when combined with aerobic workouts and weight training. Pilates focuses on balance, posture and flexibility, mobilising the body, building muscle strength to aid joint support and improving weaknesses in the core, deep abdominals and pelvic floor, which can lead to the dreaded 'meno-belly' muffin top. Pilates was developed by Joseph Pilates in the early 20th century and has evolved into one of the most popular forms of exercise for women of all ages, but it's particularly beneficial during the menopause transition. The emphasis on controlled, precise movements performed with proper alignment makes Pilates an excellent choice for women who may be experiencing joint pain or stiffness, as it strengthens the muscles that support the joints without placing excessive stress on them.

Pilates increases muscle and bone mineral density at a time when women need it most as the metabolism naturally slows down, muscle mass decreases and oestrogen levels decline resulting in reduced bone strength and density. The conscious breathing patterns used in Pilates help to calm the nervous system by forcing you to focus on your body and clearing your mind of other distractions. This mindful aspect of Pilates makes it more than just physical exercise – it becomes a form of moving meditation that can help manage the stress, anxiety, and mood changes that many women experience during menopause. The breath work in Pilates typically involves deep, controlled breathing that activates the parasympathetic nervous system, promoting relaxation and reducing cortisol levels. This can be particularly helpful for managing hot flushes, as stress and anxiety are common triggers for these uncomfortable symptoms.

Depending on the type of class you choose, Pilates uses a combination of spring-loaded resistance machines with mat-based exercises where the body works against gravity like planks, knee hovers and pelvic tilts. Reformer Pilates, which uses the specialised equipment with springs and pulleys, provides adjustable resistance that can be tailored to your fitness level and gradually increased as you become stronger. Mat Pilates requires no equipment beyond a mat and uses your body weight as resistance, making it accessible for home practice. Both forms of Pilates are effective for building core strength, improving posture, and enhancing flexibility. The core strengthening aspect of Pilates is particularly important during menopause, as a strong core helps support the spine, improves balance, and can help prevent the forward-hunched posture that becomes more common with age.

The pelvic floor focus in Pilates is invaluable for menopausal women. Many Pilates exercises specifically engage the pelvic floor muscles, helping to strengthen them and improve their function. A strong pelvic floor is essential for preventing or managing stress incontinence, which becomes more common during and after menopause due to weakening of these muscles. Pilates also helps address the abdominal changes that occur during menopause. Many women notice an increase in abdominal fat during this time, often described as "meno-belly," which occurs due to hormonal changes that shift fat storage from the hips and thighs to the abdomen. Whilst spot reduction isn't possible, strengthening the core muscles through Pilates can help create a stronger, more toned midsection and improve posture, which can make the abdomen appear flatter. The deep core work in Pilates targets the transverse abdominis, the deepest layer of abdominal muscles that acts like a natural corset around the midsection.

Pilates is also excellent for improving flexibility and joint mobility, both of which tend to decrease during menopause. The flowing movements and stretches incorporated into Pilates classes help maintain range of motion in the joints and length in the muscles, reducing stiffness and improving overall movement quality. This can make daily activities easier and more comfortable, from bending down to tie your shoes to reaching overhead to get something from a high shelf. The improved body awareness that develops through regular Pilates practice can also help you move more efficiently and with better alignment throughout your day, reducing the risk of injury and strain. Many women find that Pilates helps them reconnect with their bodies during a time when physical changes can feel alienating or distressing. Book a consultation at Bodyline Clinic to discuss how our menopause support programmes can complement your exercise routine.

Sally-Ann Turner, MD and Founder of Bodyline Medical Wellness Clinics, has this to say:

"The menopause can be a daunting time with severely debilitating symptoms impacting all parts of a woman's life. Ensuring optimised health and wellbeing through this changing stage of life is key, especially with regards to cardiovascular health. At Bodyline, we've been supporting women through menopause for over 18 years, and we understand that every woman's experience is unique. That's why we offer personalised treatment plans that address your individual symptoms and health concerns. Our approach combines medical expertise with holistic support, recognising that managing menopause effectively requires attention to both physical and emotional wellbeing.

Finding an activity that you enjoy makes it so much easier to maintain. Create a virtuous circle where exercise lifts your mood, therefore making you both feel better and sleep better so you are more likely to exercise the following day. As you gain muscle, your body will burn calories more efficiently, helping you to lose or maintain weight and keep your heart healthy. The psychological benefits of regular exercise during menopause cannot be overstated. Exercise releases endorphins, the body's natural mood elevators, which can help counteract the mood swings and low mood that many women experience during this transition. Regular physical activity has also been shown to improve sleep quality, which is often disrupted during menopause due to night sweats and hormonal fluctuations. Better sleep, in turn, improves mood, energy levels, and motivation to continue exercising, creating that positive cycle of wellbeing."

The journey through menopause is different for every woman, but one thing remains constant: regular exercise is one of the most powerful tools available for managing symptoms and protecting long-term health. By incorporating a combination of aerobic exercise, resistance training, and holistic movement practices like Pilates into your weekly routine, you can address multiple aspects of menopausal health simultaneously. Cardiovascular exercise strengthens your heart and improves circulation, resistance training builds muscle and bone density, and practices like Pilates enhance flexibility, balance, and core strength whilst calming the nervous system. Together, these different forms of exercise create a comprehensive approach to health and wellbeing during menopause and beyond.

It's important to remember that it's never too late to start exercising, even if you've been sedentary for years. The benefits of physical activity begin to accrue as soon as you start moving more, regardless of your starting point. If you're new to exercise or returning after a long break, start slowly and gradually build up your activity levels. Listen to your body and respect its limits, but also challenge yourself to do a little more each week. Consider working with a qualified fitness professional who understands the specific needs and concerns of menopausal women – they can help you design a safe, effective exercise programme tailored to your goals and current fitness level. Many women find that exercising with friends or joining a class provides motivation, accountability, and social connection, all of which enhance adherence to an exercise programme.

At Bodyline Medical Wellness Clinics, we recognise that exercise is just one component of comprehensive menopause care. Our specialist menopause services include hormone replacement therapy (HRT), nutritional guidance, and lifestyle advice, all delivered by experienced healthcare professionals who understand the complexities of this life stage. We offer bespoke hormone replacement therapy treatments tailored to your individual needs, helping to alleviate symptoms whilst protecting your long-term health. Our approach is personalised, taking into account your symptoms, medical history, lifestyle, and personal preferences to create a treatment plan that works for you.

If you're struggling with menopause symptoms or concerned about your cardiovascular health during this transition, we encourage you to reach out for support. You don't have to navigate this journey alone. Our team of dedicated healthcare professionals has supported thousands of women through menopause, helping them not just manage symptoms but thrive during this stage of life. With the right combination of exercise, medical support when needed, and lifestyle modifications, menopause can be a time of positive transformation rather than something to simply endure. Book a consultation at Bodyline Clinic to discuss how we can support your health and wellbeing during menopause and beyond. Together, we can create a personalised plan that addresses your concerns, manages your symptoms, and protects your cardiovascular health for the years ahead.

Whether you're just beginning to experience perimenopausal symptoms, are in the midst of the menopause transition, or are post-menopausal and looking to optimise your health, the combination of regular exercise and appropriate medical support can make a profound difference to your quality of life. Don't let menopause hold you back from living your best life. With the right support, information, and treatment, you can navigate this transition with confidence and emerge stronger, healthier, and more vibrant than ever. Your heart health matters, your symptoms matter, and you matter. Take the first step towards better health today by incorporating more movement into your daily life and seeking expert support when you need it. Contact Bodyline today to learn more about our comprehensive menopause support services and start your journey towards optimal health and wellbeing.