Pumping Iron For Perimenopause

Eye on London - Edition 19 - 13th Dec 2023 - 7th Feb 2024

The past few years have seen a welcome surge menopause awareness. Previously women’s health has been under-researched, misunderstood, and dismissed. It was only in 1993 that women were allowed to participate in clinical trials, even for products specifically meant for them!

Times are changing. Where menopause is concerned, information is no longer non existent or just a paragraph in the medical textbooks. It can be found in prime time documentaries, the press and social media.

It is now widely accepted that regular exercise and a healthy diet can help manage symptoms of menopause. However, what if you already do that?

According to the Pure Gym UK fitness report, around 10 million people are currently a member of a gym. This is predicted to increase over the next decade. Why then do countless women, who workout regularly and eat healthily still suffer with the fatigue and weight gain associated with this phase of life. The move more, eat less tactic associated with weight loss that worked so well in their 20s, is now leaving them exhausted, undernourished and thick round the middle. As hormones change in the peri-menopause, so training methods must too.

There are three main types of estrogen, estrone (E1), estradiol (E2) and estriol (E3). E1 is the only estrogen your body makes after menopause. E2 is the most common type in women of child bearing age. E3 is the main estrogen in pregnancy. Estradiol (E2) is an anabolic hormone, essential in muscle growth and repair. As this hormone decreases in peri-menopause, women find it increasingly harder to maintain lean metabolically active muscle. With less muscle, these women have less energy for training and burn less calories at rest, which can in turn result in the well known middle aged spread.

The best way to attenuate this is to turn up the intensity. Think strength, power and HIIT (high intensity interval training). Lifting weights that are heavy enough to fatigue the muscle after only 3-8 repetitions, will build strength and increase metabolic rate even in the absence of E2. Unfortunately there is still a general trend among women to do lighter weights for higher repetitions out of fear of bulking up. This mindset must change. Both men and women naturally loose muscle as they age. In fact we loose about 8% each decade after age 30 and this decline accelerates during the peri-menopause and after age 60 in men.

Heavy lifting sends a signal to the brain to activate all the available muscle fibres possible in order to get the job done. This mind muscle connection works on a neurological level to create a really strong contraction and produce explosive power. On a cellular level, it stimulates the production of mitochondria, the powerhouses of the cells. The more of these, the greater the resting metabolic rate and the less chance of that middle aged spread. Combine these intense workouts with adequate rest, sleep and enough protein to really reap the benefits. For those women out there who fear they will end up looking like Arnie, you can rest assure, you won’t even come close! In fact, testosterone, one of the main anabolic hormones in both men and women, is significantly lower in women than in men. This makes it incredibly hard for women of any age to gain muscle size, even when they want to. In fact men’s levels are around 200-1200ng/dl, compared to just 15-70ng/dl in women of reproductive age. Even men at the lower end of the range (200nd/dl), will still have more than twice the amount as a women at the higher end of the women’s normal range (70nd/dl). Therefore focusing on nutrition and training to maintain as much metabolically active lean muscle mass is essential at this stage of life.

Now you may think it sounds counterintuitive to up the intensity when already exhausted. It doesn’t have to be. By truly recovering you will be ready to push to your max in each session. If you are battling through long endurance sessions several times a week, it will be worth lowering the duration on a couple of days and do a shorter but more intense HIIT. This style of training can boost your VO2 max (how much oxygen you can use) by as much as 46%, raise your power at lactate threshold and significantly lower your resting heart rate. It also stimulates the body to increase your mitochondria content, allowing you to burn more fat for energy when you are not exercising. It is as if your body knows it is going to need energy for these workouts and causes your liver and muscle cells to absorb glucose from your blood and store it as glycogen ready to fuel your next session. A task previously preformed by E2 in your reproductive years. This is an excellent way to balance blood sugar and improve insulin sensitivity, therefore improving cardiovascular and metabolic health for years to come.

Too many long medium intensity workouts can not only cause extreme fatigue but also result in increased levels of the stress hormone, cortisol. This hormone increases during menopause anyway and encourages the body to store fat round the middle. To counter this effect, consider swapping out one of these draining sessions for yoga, a walk in nature or a leisurely swim. These actives calm the sympathetic nervous system, a branch of the nervous system, that is responsible for that stressful flight or fight feeling, doing wonders for your energy levels.

Another important factor to consider is nutrition. There are so many conflicting nuggets of wisdom out there, it is hard to know what is best. Like most things in life, the answer is nuanced. Everyone is different and there is no one size fits all answer. However, there are some non-negotiables for active women. The most important of which is to eat a protein rich meal before and after exercise. Don’t cut carbs, instead choose nutrient dense options from wholegrains, root vegetables, pulses and fruit. Don’t go down the low fat route, get plenty of omega 3 rich seafood, nuts and seeds. Eat plenty of fibre from whole food sources and have a wide variety of fruit and vegetables in every meal.

There are a host of other health benefits associated with strength training. These include stronger bones, younger looking skin, improved cognition and it is one of the most important things you can do to reduce the risk of neurodegenerative disorders as you age.

Natalie Shanahan