Mend Physical Therapy Blog and Injury Information

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

April 23, 2023

Women can experience a lot of undesirable symptoms during perimenopause, including reduced energy levels, dramatic mood changes, and incredibly uncomfortable hot flashes. Many also notice changes in their body composition, including the loss of lean muscle mass and increased abdominal fat. Put another way, perimenopause is stressful for everyone; however, it can be especially frustrating for athletes.

During perimenopause, women who work out may experience excessive fatigue and muscle soreness following more intense sessions. They may also take longer to recover and struggle to max out at high-intensity intervals. All of these symptoms can be linked to fluctuating estrogen levels, which make the progesterone balance out of whack, too.

Many women assume menopausal hormone therapy (MHT) is their only option to mitigate these symptoms; however, evidence shows adjusting exercise habits can not only reduce perimenopausal symptoms but also boost declining hormones. This is because the physiologic responses to exercise can stimulate some of the same functions of estrogen. One example of this is improved insulin sensitivity (a desirable response to exercise that helps control blood sugar and prevent diabetes).

At our Boulder and Lafayette Physical Therapy practice, we specialize in women’s health, and evidence-based exercise prescription is a cornerstone of our practice.

If you want to use exercise for perimenopause symptoms, here are our top three recommendations to reap the most benefits:

1. Lift Heavy Weights (MEND recommendation 2-3x/week)

Muscle mass declines at a rapid rate during the 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 the bone loss that accelerates during this period.

2. Incorporate HIIT into Your Fitness Routine (MEND recommendation 2-3x/week)

The benefits of High Intensity Interval Training (HIIT) include increased muscle mass and reduced cortisol levels. The right perimenopause exercise program can also help reduce abdominal and visceral fat (i.e., the types of fat that are linked to negative health outcomes). Even athletes who focus primarily on endurance can benefit from SIT as it’s been shown to improve VO2 max and power at your lactate threshold.

  • 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-second sprints followed by 12 seconds of slow pedaling for 60 total sprint intervals. Cool down for three to five minutes.

3. Listen to Your Body.

Make your hard days hard and your easy days easy.  Stop spending time in no-man’s land, where you push a little too hard (think running with someone who is a little too fast for you to keep up with). This will only leave you feeling rundown without any of the benefits that are supposed to come with sprint interval training.

For help designing an exercise program appropriate for your goals and stage in life, click here to schedule an appointment 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.