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PHYSICAL ACTIVITY AT THE MENOPAUSE

The many benefits of physical exercise are well-researched and plentiful, with physical inactivity ranked second only to smoking in how bad it is for good health. Your heart, like any other muscle, needs physical activity to keep it in the best possible condition. Physical activity can help to improve many long term health conditions, such as high blood pressure, high cholesterol levels and diabetes, as well as benefiting your overall heart health.

This article was included in issue 90 ( Autumn 2021) of The Menopause Exchange newsletter.

As well as lowering your risk of diabetes, physical activity can help to control your weight alongside a balanced diet. Exercise increases your bone strength, so not being active leads to a loss of bone mass, which creates a “use it or lose it” type of situation. Regular exercise can help to maintain bone mass and reduce age-related bone loss. It also improves your muscle strength, balance and coordination, which all help to prevent falls when you get older. Some research has shown that regular physical activity can reduce how often you get hot flushes, reduce symptoms of depression and anxiety and improve sleep.

Beneficial types of exercise
Hate the idea of exercise? You’re not alone! But many different types of activity provide the benefits of exercise, so there’s lots to choose from when you get started. You can choose between aerobic exercise, resistance training and impact exercise. Walking, gardening and dancing all count as exercise but make sure to choose something you enjoy; the most effective exercise is the one you’ll stick to.

You can also make simple changes to your day-to-day life. Why not take the stairs rather than the lift? You could also make sure to go for a walk each day or increase your step goal. Small changes can add up quickly – could you park your car slightly further from where you work so you have a longer walk in? Perhaps now is the time to join the dance class you’ve been interested in, or to try something completely different. The Chartered Society of Physiotherapists have created a campaign titled “Love Activity, Hate Exercise?” filled with resources to support people wanting to be more active.

How to get started
It’s common to feel anxious when you start something new or are increasing the amount of activity you’re doing. Take your time, set some goals and make sure to celebrate when you reach them. You could try a new exercise class with a friend, explore a new walking route or create a new feature in your garden – it all counts! There are many resources online to help you find local clubs and groups. If you’re nervous, why not take a friend with you?

How much exercise should I do?
The NHS recommends that adults should try to do some form of activity every day, whether it’s a structured exercise class or a short walk, because any activity is better than none. The current guidelines are 150 minutes of moderate intensity exercise or 75 minutes of vigorous exercise each week.

Moderate intensity exercise is classed as anything that makes you breathe quicker than normal but still means you can talk; for example, swimming, a brisk walk or cycling. Vigorous intensity exercise means you’re breathing fast and talking would be difficult; for example, taking part in sport, running or walking up several flights of stairs. The guidelines also recommend taking part in balance exercises to reduce the risk of falls as you get older.

Exercise for bone health
Some bone loss with age is normal for everyone, but women in particular lose bone rapidly in the first few years after the menopause, which can lead to osteoporosis. Osteoporosis is a health condition that causes bones to become more fragile and puts them at a higher risk of fractures (broken bones). Osteopenia is the stage before this and indicates that you have lower bone mineral density than normal but it doesn’t always lead to osteoporosis. Taking part regularly in some form of physical activity has been shown in research studies to reduce the risk of osteoporosis by increasing bone density and how well muscles repair and regrow.

Decreases in bone mineral density are more common in women after the menopause, most likely due to their lowered oestrogen levels. However, regular walking can improve your bone mineral density and reduce your risk of osteoporosis. Weight bearing exercises (anything where you’re having to work against gravity, such as, for example, running, squats and step-ups) have been shown to increase bone density in people with osteoporosis and significantly boost their quality of life.

Cautions with exercise
With some medical conditions, you’ll need medical approval (e.g. from a doctor) before you take part in certain types of exercise. These conditions include high blood pressure, heart problems and uncontrolled metabolic disease. However, some of these conditions can actually improve if you increase the amount of exercise you’re doing. Make sure to seek advice from a medical professional if you have any pre-existing health conditions.

Effects of too much exercise
Whichever stage of exercise you’re at, make sure you’re getting enough rest periods too. Overtraining can lead to fatigue, muscle aches and difficulty sleeping, so please seek advice from a healthcare professional if you’re struggling with any of these issues. It’s important to increase your activity levels slowly and in a way that means you can keep doing the exercise safely over a long period of time.

Conclusion
Exercise doesn’t have to be scary – it’s just about increasing the amount of physical activity you’re getting each day to boost your overall health. You can find many helpful resources about how to increase your activity levels on the Chartered Society of Physiotherapy website, www.csp.org.uk.

About the author
Eleanor Boyce is a senior physiotherapist at the Norfolk and Norwich University Hospital. She is a member of the Chartered Society of Physiotherapists and has a keen interest in research.

Created Autumn 2021
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