Best exercises for menopause: 5 types and how they help

Your periods are wacky, your mood is all over the place, and your hips and shoulders ache out of nowhere. Welcome to menopause. Inside, muscle mass and bone density may be changing. On the outside, you can’t help but notice an increase in belly fat. It’s all linked to the hormone changes that happen during menopause. But there are steps you can take to help ease the effects and feel more like yourself again — starting with exercise. 

Whether you've always been active or are looking to start a new exercise routine now, there are some important things to know about how to exercise in menopause and plan your menopause workouts for optimal health benefits. 

Here, learn more about how exercise helps improve menopause symptoms and the best menopause exercises and tips from Hinge Health physical therapists.

Symptoms and effects of menopause

Perimenopause — or the time leading up to menopause — typically begins in your late 40s and lasts an average of four years. (Menopause officially means that it’s been a year since your last period.) During this transition, hormone levels fluctuate and estrogen drops, which can lead to such symptoms as:

• Irregular periods

• Hot flashes and night sweats

• Sleep problems

• Brain fog and fatigue

• Mood changes

Changing hormones also impact your musculoskeletal system. Estrogen helps maintain bone structure, improve muscle mass and strength, and increase the collagen content of connective tissues in your joints. It also helps prevent inflammation that may contribute to osteoarthritis.

Lower levels of estrogen during menopause can lead to changes in your bones, muscles and joints, known as musculoskeletal syndrome of menopause (MSM). MSM can cause pain, inflammation, loss of bone density and muscle mass, and speed up the onset of arthritis (cartilage changes and narrower joint spaces).

Menopause is also linked to an increased risk of cardiovascular disease. 

Decreasing estrogen levels change how your body stores fat, leading to more fat around your belly (aka “menopause belly”) and internal organs. Extra belly fat can increase your risk of several health issues, such as high blood pressure, heart disease, diabetes, and certain cancers (like breast and colon cancer). It can lead to arthritis, inflammation, and make it harder to manage blood sugar levels. It can also worsen menopause symptoms like hot flashes, urinary issues, and vaginal discomfort. 

Benefits of exercise during menopause

When your joints and muscles ache, or you feel menopause-related fatigue or brain fog, you’re more likely to avoid movement. But being active can help you feel better. “Movement and exercise play a crucial role in managing joint pain, muscle aches, and other symptoms and effects of menopause,” says Heidi Austin, PT, DPT, a physical therapist at Hinge Health. Menopause exercise can help:

• Ease joint pain and stiffness. Your joints contain synovial fluid, which is rich in nutrients. Exercise helps circulate the fluid to keep joints healthy and lubricated and improve range of motion to help relieve pain.

• Keep bones strong. Lower estrogen leads to more bone breakdown. Bone loss can lead to osteoporosis, a condition where bones become weak and are more likely to break. Exercise stimulates bone-forming cells and encourages bone remodeling, which helps maintain bone density. It also promotes calcium deposition and collagen formation to make bones stronger and less likely to break. Regular weight-bearing exercise can prevent or reverse bone loss during and after menopause.

• Maintain and build muscle mass. Just like your bones, your muscles are constantly breaking down and repairing. Estrogen has protective effects on muscles, so when hormone levels drop, it can speed up muscle loss. Exercise can increase lean muscle mass and improve muscle structure. Plus, strengthening muscles around your joints can provide better support and stability to take pressure off painful joints.

• Promote better sleep. Research shows regular physical activity can improve sleep quality and help manage insomnia, which can reduce fatigue.

• Boost your metabolism. During perimenopause, it’s common for metabolism to slow down, leading to weight gain for many people. Regular physical activity can help counteract this.

• Improve fatigue and mood. Exercise causes cellular changes that increase your body’s energy levels. It also boosts endorphins, which are natural mood-lifting chemicals that help with stress, anxiety, and depression.

• Protect your heart health. Menopause-related body changes — like increases in body weight and blood pressure — can raise your risk of heart disease. Regular exercise can help prevent and even reverse many of the heart health risk factors associated with menopause and inactivity.

Best exercise for menopause

Regular physical activity and movement can help manage symptoms and effects of menopause. Aim for at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise each week. (Always consult with your healthcare provider before starting a new exercise program.) Some of the best types of exercise for menopause include:

1. Strength training

Resistance exercise (aka strength training) is the gold standard for improving muscle health and strength in menopause. This involves lifting or pushing against an external resistance like weights, resistance bands, weight machines, or your own body weight. Aim for two to three strength training sessions per week targeting major muscle groups (e.g., upper body, lower body, core, etc.). “Try to incorporate a variety of exercises that involve movement in different directions, like forward and backward and side to side,” suggests Dr. Austin. 

Strength training helps build lean muscle, which burns more calories and boosts your metabolism. Bonus: Resistance exercise is also key for bone health in menopause. 

2. Aerobic exercise 

This type of physical activity — such as walking, jogging, swimming, and cycling — strengthens your heart and lungs to help improve cardiovascular health. Aerobic exercise can also boost your metabolism, improve your mood, and enhance brain function, including mental sharpness and memory. Weight-bearing aerobic exercise, such as walking or jogging, can help promote bone growth. Aim for 30 minutes of aerobic exercise most days to maintain overall health and well-being.

High-intensity interval training (HIIT) is a type of aerobic activity that involves short bursts of intense effort (30 to 60 seconds) followed by 1 to 2 minutes of rest or low-intensity activity. Research shows that HIIT can help women in menopause lose fat and improve their body composition. You can incorporate HIIT into activities like walking, running, cycling, or bodyweight exercises. 

3. Balance and flexibility exercises

Both are important during menopause: Balance exercises help improve your stability and prevent falls, reducing fracture risk. Flexibility movements work to lengthen and strengthen muscles and tendons to improve range of motion in your joints.   

4. Pelvic floor exercises

Your pelvic floor is a group of muscles and tissues that stretch like a hammock from your pubic bone in front of your body back to your tailbone, supporting your bladder, bowel, and sexual organs. Just as you can strengthen the muscles in your arms or legs, you can exercise your pelvic floor muscles and help treat menopause-related pelvic issues like leaks, urgency, and pelvic pain.

5. Relaxation exercises

Activities like deep breathing and yoga can help improve focus and mental clarity, improve pelvic floor health, and help reduce stress and anxiety.

You can exercise on your own to manage the symptoms and effects of menopause, but working with a physical therapist (PT) can be valuable. A PT can do a full assessment and help tailor a comprehensive treatment plan to manage menopause symptoms and improve overall function. A PT can help you choose the best strength training exercises for menopause. They may recommend low-impact exercises and stretches to prevent stiffness and tightness, as well as exercises to strengthen your core, pelvic floor, low, mid-, and upper back muscles. They can make sure your plan includes weight-bearing exercises to help prevent osteoporosis. 

You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

Incorporating these exercises into your routine can help improve your overall strength, flexibility, and balance in menopause. A physical therapist can guide you in performing these exercises safely and effectively.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Exercise tips for menopause

“Any physical activity can have a positive impact on your health during menopause,” says Dr. Austin. Some tips to help you get started:   

• Move every day. You don't need a long workout. Taking a short walk or doing a gentle Hinge Health exercise therapy session can provide benefits. “Even a 5- to 10-minute walk after a meal is a great way to rev up your metabolism,” says Dr. Austin. Then slowly increase the intensity and duration of your workouts. This helps you maintain momentum and build confidence.

• Balance your exercises. Aim for 30 minutes of aerobic exercise most days, strength training two to three times a week (targeting each major muscle group), and at least one session focused on balance and flexibility.

• Stay hydrated. Drink plenty of water to keep your body hydrated and help lubricate your joints.

• Seek expert care, when needed. “If you have risk factors for osteoporosis, for example, or cardiovascular disease, or if you have specific conditions like pelvic floor weakness, work with a physical therapist who can create an exercise plan that’s safe and effective for you,” says Dr. Austin.

PT tip: Movement is medicine for menopause

“Think of physical activity and exercise as a form of therapy for your menopause symptoms,” says Dr. Austin. Reframing it that way may help you prioritize it. Menopause can be a tough period of transition, but you can thrive if you arm yourself with the right tools and support.

“If moderate intensity cardio has been your only go-to, it might be time to add something new,” says Dr. Austin. She suggests adding new types of exercise to your menopause workout, like strength training and high-intensity interval training (HIIT).

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

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