Strength training in the perimenopause

Hot flashes, sleep disturbances, weight gain, and the loss of muscle and bone mass are typical accompanying symptoms of perimenopause. But research shows: strength training is an effective strategy to actively counteract these symptoms.

Menopause marks the permanent cessation of menstruation – diagnosed when no bleeding has occurred for over 12 months and no other cause is present. Typically, it occurs between the ages of 45 and 55, when the hormonal activity of the ovaries comes to a halt: oestrogen production decreases because the follicle reserve is exhausted. With the hormonal withdrawal, complaints arise that are summarised under the term "climacteric syndrome."

About three-quarters of all women experience hot flashes for several years—sometimes for more than a decade. At the same time, bone mass diminishes, increasing the risk of osteoporosis and later fractures. What sounds abstract has concrete consequences for body composition and metabolism: Muscle mass decreases by about 0.5 to 0.7 percent each year, while fat percentage – especially in the abdominal area – increases.

These changes are at least partially due to hormonal adjustments, where increased androgen levels occur in relation to oestradiol after menopause. In a large US cohort study, fat mass increased by an average of 1.6 kg during the menopausal transition phase within 3.5 years.

In a six-year longitudinal study, women in natural postmenopause lost more muscle mass than age-matched premenopausal women; at the same time, they showed a greater increase in central fat mass and a reduced resting energy expenditure of about 100 to 200 kilocalories per day.

As we age, we lose muscle mass, which reduces the basal metabolic rate (the energy expenditure of the body at rest). Since the metabolic rate of muscles is more than three times higher than that of fat tissue, the loss of muscle during menopause leads to a decrease in energy expenditure.

Medically, there are effective therapies, such as hormone replacement therapy with oestrogens or in combination with progestogens. But those who have a strong, resilient body can actively counter many symptoms of perimenopause.

Targeted training offers significant advantages:

• Increases muscle strength and bone density
• Improves balance, coordination, and motor control
• Reduces the risk of falls
• Improves the quality of life

Progressive strength training has been proven to increase muscle mass and performance even in advanced age.

The analysis of various clinical studies involving a total of 817 postmenopausal women confirms these findings. It revealed significant improvements in strength, physical activity, bone density, as well as hormonal and metabolic parameters compared to inactivity or placebo (the administration of dummy drugs). Compared to unsupervised home exercises, the difference was even more pronounced. The women in the strength training group had more fat-free mass, higher bone density in the thigh bones, and less pronounced "widow's hump" (kyphosis).

Another study from 2019 showed that the fracture rate in the strength training group remained stable. Such findings demonstrate that the Kieser principle is also ideal for women in menopause: Twice a week, targeted, intense – it pays off. Already four months of training can positively influence strength and bone health and have a beneficial effect on hormonal and metabolic processes. Furthermore, it has been demonstrated that heart rate variability increases and the level of stress hormones decreases, while parasympathetic activity is strengthened and the temperature center is regulated, which can alleviate hot flashes.

Strength training is a powerful remedy against physical discomfort during perimenopause because it strengthens muscles, bones, and metabolism. It not only shapes the body but also protects it. Those who build strength can positively influence the symptoms of perimenopause, prevent further complaints, and significantly improve their well-being.