The Perimenopause: What’s Happening and the Importance of Exercise and Strength Training

Dr. Andrew Chappell PhD, & Ms Stephanie Noble

The Perimenopause, What’s Happening?

The peri-menopause is a transitional period that occurs before menopause, usually beginning in a woman’s late 30s or early 40s. During this time, a woman’s body undergoes significant changes both physiologically and psychologically. These changes can affect a woman’s health, well-being, and quality of life. In this article, we will discuss the changes that occur during the peri-menopause and the importance of exercise and strength training in maintaining health and well-being. Prior to discussing the menopause though it’s important to first understand the menstrual cycle.

Menstrual Cycle: A Brief Overview

The menstrual cycle is a series of physiological changes that occur in a woman’s body, typically over a 28-day period. The cycle is regulated by a complex interplay of hormones, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), oestrogen, and progesterone. These hormones work together to prepare the uterus for pregnancy each month. During the first half of the menstrual cycle, oestrogen levels rise, causing the lining of the uterus to thicken in preparation for a potential pregnancy. At the same time, FSH and LH stimulate the growth and maturation of a follicle in one of the ovaries. The follicle contains an egg, which is released during ovulation. If the egg is fertilized by sperm, it will implant in the thickened uterine lining and a pregnancy will begin. If the egg is not fertilized, the levels of oestrogen and progesterone drop, causing the uterine lining to shed. This shedding of the uterine lining is what causes menstruation, which marks the beginning of a new menstrual cycle. The figure below illustrates the complex hormonal interactions that take place during the menstrual cycle between and how this can affect a females metabolism and water balance.

	PRE OVULATION		POST OVULATION
	EARLY FOLICULAR	LATE FOLICULAR	EARLY LUTEAL	LATE LUTEAL
DOMINANT HORMONES	OESTROGEN / FSH	OESTROGEN / LH	PROGESTERONE	PROGESTERONE
WATER RETENTION/ BLOAT	LOW	SLIGHT INCREASE	SMALL DECREASE	HIGHEST
INFLAMMATION	LOW	SLIGHT INCREASE	SMALL DECREASE	HIGHEST
BODYWEIGHT	LOWEST	SLIGHTLY HIGHER	SLIGHTLY LOWER	HEAVIEST

Peri-Menopause and Menopause: Changes in the Menstrual Cycle

During the peri-menopause, the menstrual cycle becomes irregular and unpredictable as a result of fluctuating hormone levels. This can include changes in the length of the menstrual cycle, as well as changes in the amount and duration of bleeding. As women approach menopause, oestrogen and progesterone levels continue to decline, eventually leading to the cessation of menstruation. Menopause is defined as the absence of a menstrual period for 12 consecutive months and marks the end of a woman’s reproductive years. As the figure below demonstrates the decline in oestrogen and progesterone is gradual with compensatory peaks and troughs. As a result this can lead to fluctuations in the symptoms that a female is likely to experience.

As Women move through the different stages of their life the hormones released fluctuate until they pass through the menopause

Oestrogen and progesterone levels decline in a linear fashion with peaks and troughs in hormone production as they move through the perimenopause

Physiological Changes

The peri-menopause is characterized by changes in hormone levels, particularly oestrogen and progesterone. These changes can cause a variety of physiological symptoms, including:

1. Irregular menstrual cycles: women may experience irregular periods, heavier or lighter periods, or shorter or longer menstrual cycles.
2. Hot flashes and night sweats: these are common symptoms of the peri-menopause and can be uncomfortable and disruptive to sleep.
3. Vaginal dryness: as oestrogen levels decrease, the vaginal tissues may become drier and less elastic, leading to discomfort during sex.
4. Decreased bone density: oestrogen plays a key role in maintaining bone density, and as levels decrease, women may be at an increased risk of osteoporosis and fractures.
5. Changes in metabolism: women may experience weight gain, particularly around the abdomen, as well as a decrease in muscle mass and an increase in body fat percentage.

Psychological Changes

The peri-menopause can also have psychological effects on women, including:

1. Mood changes: women may experience mood swings, irritability, anxiety, and depression.
2. Sleep disturbances: hot flashes and night sweats can disrupt sleep, leading to fatigue and irritability.
3. Decreased libido: changes in hormone levels can lead to a decrease in sex drive.
4. Cognitive changes: some women may experience changes in memory and concentration during the peri-menopause.

The Importance of Exercise and Strength Training

Regular exercise and strength training can help women manage the physical and psychological changes of the peri-menopause. Some of the benefits of exercise during this time:

1. Improved bone density: weight-bearing exercise can help maintain bone density and reduce the risk of osteoporosis.
2. Weight management: exercise can help women maintain a healthy weight and reduce the risk of metabolic changes associated with the peri-menopause.
3. Improved mood: exercise has been shown to reduce symptoms of anxiety and depression and improve overall mood.
4. Better sleep: regular exercise can improve sleep quality and reduce the frequency and severity of hot flashes and night sweats.
5. Increased strength and muscle mass: strength training can help women maintain muscle mass and improve overall strength and fitness.

Recommended Exercises for Women in the Peri-Menopause

Exercise Type	Description	Recommended Frequency
Aerobic Exercise	Activities that increase heart rate and breathing, such as brisk walking, cycling, swimming, or dancing	150 minutes per week
Strength Training	Resistance exercises that target major muscle groups, such as squats, lunges, push-ups, or weightlifting	2-3 times per week
Flexibility Exercises	Stretches that help maintain flexibility and range of motion, such as yoga or Pilates	2-3 times per week

The peri-menopause is a time of significant change for women, both physiologically and psychologically. Regular exercise and strength training can help women maintain their health and well-being during this time by reducing the risk of metabolic changes, and improving mood. The peri-menopause also doesn’t mean you have to give up on your fitness goals, and with the right guidance and support it’s still possible to get in the shape of your life. If you found this article useful and you think we can help you at ProPrepCoaching, then hit that sign up button today (https://proprepcoaching.com/sign-up/)