Mend Physical Therapy Blog and Injury Information

3 Ways You Should Change Your Exercise Routine During Your Perimenopausal and Menopausal Years

April 23, 2023

Many women are aware of the multitude of undesirable symptoms that occur in the perimenopausal period (the menopausal transition where you go from a regular menstrual cycle to a very irregular cycle) including reduced energy level, mood changes,hot flashes, and body composition changes including loss of lean muscle mass and increased abdominal fat. For the female athlete, notable changes in the perimenopausal period might include: poor ability to recover, inability to lean down with training/exercise as you previously had been, excessive muscle soreness and fatigue following workouts and inability to push to high intensity like you used to be able to do.

In short and oversimplified terms, these symptoms are related to declining or fluctuating levels of estrogen (and how estrogen and progesterone balance gets out of whack)

Women typically think that menopausal hormone therapy (MHT) is their only option to mitigate these symptoms but high quality evidence shows us that adjusting our exercise habits can not only reduce our perimenopausal symptoms but also provide our declining hormones a boost as our physiologic responses to exercise can stimulate some of the same functions as estrogen did in our premenopausal years. One example of this is improved insulin sensitivity (a desirable response to exercise that helps us control our blood sugar and prevent the development of diabetes).

In our Boulder and Lafayette Physical Therapy practice – serving Boulder, Lafayette, Louisville, Longmont, Erie, Broomfield and beyond- we specialize in Women’s Health physical therapy and help with managing women’s concerns through the lifespan. Evidence-based exercise prescription is a cornerstone of our practice. Here are our top 3 recommendations on exercise as you make the transition through menopause:

  1. Lift heavy weights (MEND recommendation 2-3x/week): muscle mass declines at a much more rapid rate in our perimenopausal years making strength training even more important over the age of 40. Increasing your lean mass boosts your basal metabolic rate and helps prevent weight gain. Lifting heavy weights can also offset bone loss that is also accelerating during this period.

  2. Incorporate high intensity interval or sprint interval training (SIT) into your fitness routine (MEND recommendation 2-3x/week). Benefits of sprint interval training include increases in lean muscle mass, reduced fat mass (both abdominal fat and visceral fat – the type we worry about due to negative health outcomes), reduced cortisol levels and increased cardiovascular health to name just a few benefits. Even if you are a focused endurance athlete, sprint training has been shown to improve VO2 max and power at your lactate threshold. Sprint training can actually help you go longer!

    • More from Mend: A 2020 review article (Dupuit et al) indicated that cycling intervals were more effective than running intervals. You can use your sprint interval training to boost your running performance while reducing joint loading! An exercise bike such as an Airbike (Echo, Assault, Airdyne) works wonderfully for sprint training.

    • Suggested workout: After a 5 minute warm up, perform 20 minutes of 8 sec sprints followed by 12 sec of slow pedaling (60 total sprint intervals). Cool down 3-5 minutes.

  3. Make your hard days hard and your easy days truly easy. Stop spending time in no-man’s land where we push a little bit hard (think running with someone that is just a little too fast for you to keep up with), get run down but don’t experience the same positive training response as with sprint interval training and easy endurance training.

For assistance in designing an exercise program appropriate for your goals and stage in life, click here to schedule with one of the Women’s Health experts at MEND.


1.  DUPUIT M, RANCE M, MOREL C, et al. Moderate-Intensity Continuous Training or High-Intensity Interval Training with or without Resistance Training for Altering Body Composition in Postmenopausal Women. Medicine Sci Sports Exerc. 2019;52(3):736-745. doi:10.1249/mss.0000000000002162
2.  Dupuit M, Maillard F, Pereira B, Marquezi ML, Lancha AH, Boisseau N. Effect of high intensity interval training on body composition in women before and after menopause: a meta‐analysis. Exp Physiol. 2020;105(9):1470-1490. doi:10.1113/ep088654

3. Sims S T. Next Level. Your Guide to Kicking Ass, Feeling Great, and Crushing Goals Through Menopause and Beyond. New York: Rodale Books; 2022.

Other helpful resources for female athletes:

5 Things Every Athlete Should Know About the Pelvic Floor

Planning Your Workout To Optimize Your Menstrual Cycle