Exercise during menopause is much more than a way to balance everyday life – it is one of several effective measures to maintain health, performance, and wellbeing in the long term. When used correctly, movement can help alleviate common symptoms such as hot flashes and help women feel more confident and stronger in their own bodies again.
To understand which types of training are truly beneficial, we spoke with Ann-Sophie Mante, founder of Miracle. She focuses on women’s health, hormones, social freezing, and longevity – and explains why targeted training during menopause is crucial and how women can start taking preventive measures as early as their thirties.
Tip: As a corporate member of Urban Sports Club, you can use Miracle for free via the App Catalog! Your company doesn’t offer Urban Sports Club yet? Learn more and recommend us to your company.
| What Is Miracle? Miracle supports women across Europe in making informed decisions about fertility, social freezing, or (peri-)menopause at the right time. With clear guidance, scientifically grounded information, and easy-to-use tools, reproductive health becomes more accessible and easier to plan. Ann-Sophie Mante is a fintech lawyer and is using Miracle to provide easier access to social freezing, reproductive medicine, and women’s health. Learn more about Miracle here. |
What Happens in the Body During Menopause – Beyond Hot Flashes
Menopause officially begins after twelve months without a menstrual period, usually around age 51. However, perimenopause typically begins in the mid-to-late 40s, though hormonal shifts – such as a declining egg reserve and fluctuating cycles – can often start in the mid-30s. During this time, estrogen levels fluctuate and decline – with noticeable and invisible effects on the entire body:
Egg Cells and Fertility
Women are born with all the eggs they will ever have: around one to two million. By age 30, the egg reserve decreases to about 12%, by 40 to about 3%, and by 50 to less than 1%. Eventually, hormonal activity is no longer sufficient to maintain the menstrual cycle – and estrogen production drops significantly.
Bone Health
In the first 5–7 years after menopause, up to 20% of bone density can be lost – particularly in the spine, hips, and femoral neck. This dramatically increases the risk of fractures.
Muscles
Type II muscle fibers, which are important for strength and quick reactions, become weaker. At the same time, muscle mass decreases (sarcopenia), increasing the risk of falls and frailty.
Joint Health
Estrogen keeps blood vessels elastic. Without this protection, the risk of heart attacks rises significantly. Cardiovascular diseases become the most common cause of death among postmenopausal women.
Cardiovascular System
Östrogen hält Blutgefäße elastisch. Ohne diesen Schutz steigt das Risiko für Herzinfarkt stark an. Herz-Kreislauf-Erkrankungen werden zur häufigsten Todesursache postmenopausaler Frauen.
Brain & Mood
Concentration and memory can decline, and mood swings or depressive episodes occur about 40% more often – according to a 2024 meta-analysis of over 9,000 women published in the Journal of Affective Disorders. Estrogen receptors are densely located in brain areas responsible for thinking and mood – when the hormone declines, these networks can slow down.
Other Symptoms
Additional symptoms may include sleep problems, hot flashes, brain fog, loss of libido, or joint discomfort.
Many women first notice subtle signals: cycle irregularities, mild mood fluctuations, or a vague feeling of not quite feeling like themselves anymore. “Whether you experience hot flashes or not – being symptom-free does not mean there are no consequences. Bones, muscles, heart, and brain decline even if you don’t feel it,” explains Ann-Sophie.
Why Exercise During Menopause Is So Crucial
Exercise is no longer a nice-to-have. It is a very effective intervention to slow down or slightly improve the decline caused by reduced estrogen levels.
Heart Protection
Endurance training lowers blood pressure, improves vascular elasticity, and reduces the risk of heart attacks. In this way, exercise takes over part of the protective function that estrogen previously provided.
Bone Protection
Not every sport protects your bones equally. Swimming strengthens the heart but has little impact on bones. Bones respond to mechanical load – meaning the pulling and pressure created when muscles pull tendons against bones. This pulling creates electrical signals that activate osteoblasts – the cells responsible for building new bone tissue. This process, called mechanotransduction, follows Wolff’s law: bones adapt to the load placed on them, becoming stronger with activity and weaker with inactivity.
Strength or resistance training slows this process and can even moderately increase bone density – particularly in the spine and hips, the critical areas for fractures. High-intensity training with weights or machines can significantly improve bone mineral density. Important: if you stop training, gains in bone density and muscle mass can begin to reverse – research on detraining suggests meaningful losses can occur within a few months.
Muscle Health & Metabolism
Muscles are not only responsible for strength – they are metabolically active tissue. The more muscle mass you have, the more calories your body burns at rest and the better your blood sugar regulation becomes.
During menopause, body composition often shifts: muscle mass decreases while visceral fat increases – fat that accumulates around internal organs and can increase the risk of insulin resistance and type 2 diabetes.
Regular strength training directly counteracts this process. It maintains and builds muscle mass, improves insulin sensitivity, and keeps metabolism active. Additionally, it creates a so-called afterburn effect: your body continues to burn energy for hours after training while muscle tissue repairs and builds.
Mental Health
Regular exercise has measurable positive effects on mental health. Women who train consistently report fewer mood swings, fewer symptoms of depression, and better resilience to stress. Exercise promotes the formation of proteins that are crucial for learning, memory, and neural adaptability. At the same time, movement can reduce inflammatory processes in the body that are associated with depression.
Hot Flashes & Sleep
Research results are not entirely clear, but they suggest that endurance training may reduce the frequency and intensity of hot flashes. Yoga has been shown to improve sleep quality and can reduce irritability and mood swings. Strength training may additionally stabilize thermoregulation and promote deep sleep phases. Even though exercise does not reduce all symptoms in every woman, many report noticeable relief when they train regularly and intentionally.
The Best Types of Exercise During Menopause
1. Strength Training: Heavy Lifting for Muscles & Bones
Strength training is the most important tool for preventing muscle loss and bone density decline during menopause. As estrogen levels drop, the body needs stronger mechanical stimuli: weights that truly challenge muscles, tendons, and bones. This load activates bone-building cells (osteoblasts) and preserves type II muscle fibers, which are crucial for stability, reaction speed, and fall prevention. Properly dosed strength training makes you stronger and more defined – not “bulky.”
Quick & Practical Training Tips:
- 2–3 sessions per week
- 7–10 challenging repetitions (about 70–80% of maximum weight)
- Progressive overload: gradually increase weight or resistance (without overdoing it)
2. Endurance Training: Heart Health & Stress Regulation
Endurance training protects the heart and blood vessels and helps regulate the stress and nervous systems. Running, cycling, brisk walking, dancing, or swimming improve circulation, lower blood pressure, and help regulate cortisol. At the same time, endurance training improves insulin sensitivity and can – for many women – reduce hot flashes, sleep problems, and mood swings. It does not replace strength training but is essential for cardiovascular health and mental stability.
Quick & Practical Training Tips:
- 150 minutes of moderate activity per week, or
- 75 minutes of intense training
- Ideally: a combination of steady pace and short, more intense intervals
3. Complementary Movement: Mobility & Wellbeing
Yoga, Pilates, mobility exercises, balance work, or everyday movement improve body awareness, flexibility, and overall quality of life. They support stress reduction and can positively affect sleep and wellbeing, but they do not replace strength or endurance training when it comes to protecting bones, muscles, and the heart.
Strength Training vs. Endurance – Which Is More Effective?
Both are important, but they have clearly different effects. For long-term health during menopause, a combination is crucial, with priority given to strength training.
| Benefit | Strength Training | Cardio |
| Heart health | Moderate | High |
| Bone health | High | Low |
| Muscle & metabolism | High | Moderate |
| Injury prevention | High | Moderate |
| Mood & brain fog | Moderate | High |
In short: cardio protects the cardiovascular system, while strength training protects muscles and bones.
Hormone Replacement Therapy (HRT) as a Complement to Exercise During Menopause
Hormone replacement therapy replaces the estrogen (and depending on the situation progesterone) that the ovaries no longer produce during menopause. The goal is not to stop aging but to relieve symptoms and reduce long-term risks associated with estrogen deficiency.
Important: HRT is not a one-size-fits-all approach. Whether it makes sense for you should be decided together with your gynecologist, taking into account your symptoms, risk factors, and personal health goals.
Brain & Mood
Estrogen has neuroprotective effects and supports concentration, memory, and emotional stability. If HRT begins early in (peri-)menopause, some research suggests it may help reduce the risk of cognitive decline later in life – though the evidence is still evolving and timing appears to be a key factor. Timing is crucial.
Bone Health
HRT is considered one of the most effective measures against osteoporosis. It inhibits bone-degrading cells and supports bone formation. Studies show a significant reduction in vertebral fractures and overall fracture risk.
Cardiovascular System
Estrogen keeps blood vessels elastic. If HRT is started within ten years after menopause or before age 60, it can significantly reduce the risk of coronary heart disease.
Sleep, Energy & Quality of Life
Many women report better sleep, more stable moods, and higher energy levels.
Sexual Health
HRT can relieve vaginal dryness and improve libido – sometimes complemented by testosterone therapy.
| Your Peri- & Menopause Toolkit Exercise and movement: Use strength and endurance training strategically to directly counteract the physiological changes caused by estrogen loss. Anti-inflammatory diet: A diet low in added sugar and harmful fats but rich in protein and fiber helps reduce systemic inflammation and supports metabolic health during hormonal transitions. Good sleep: Seven to nine hours of restorative sleep support hormone regulation, mental function, and tissue repair while the body undergoes major hormonal changes. Stress management: Reducing both environmental and interpersonal chronic stress protects the cardiovascular system and helps maintain hormonal balance. Chronic stress intensifies the challenges your body faces. Hormone replacement therapy (HRT): When appropriate and started at the right time, HRT can replace what your body no longer produces and protect multiple organ systems. |
Menopause is not an end but a biological transition – and one you can actively influence. The muscle strength you build now, the cardiovascular fitness you maintain, and the hormonal decisions you make largely determine how mobile, clear-minded, and healthy you will feel in your 60s, 70s, and beyond.
Exercise during menopause is crucial. Prioritize strength training that truly challenges muscles and bones, and complement it with endurance training for heart and circulation.
Note: Miracle’s content and this article are for informational purposes only and do not replace medical advice. Miracle does not provide medical services, diagnoses, or treatments. For medical questions, please consult your gynecologist.
FAQ: Exercise During Menopause – Explained Briefly
What are the benefits of exercise during menopause?
Exercise during menopause helps protect muscles, bones, the heart, and the brain, relieve symptoms, and maintain daily performance. Regular training can also improve mood, sleep, and metabolism – regardless of age or menopausal stage.
Which symptoms can exercise help relieve during menopause?
Exercise can help with:
Fatigue
Hot flashes
Sleep problems
Mood swings
Joint pain
Weight gain
How often should you exercise during menopause?
3–5 exercise sessions per week are recommended. Ideally a combination of 2–3 strength training sessions and additional endurance training. What matters most is consistent exercise that can be sustainably integrated into daily life.
Is strength training important during menopause?
Yes, strength training is particularly important during menopause. It protects against muscle loss, maintains bone density, and reduces the risk of falls. Without strength training, women lose muscle strength and stability faster during menopause.
Can women still build muscle at 50?
Yes. Women can build muscle at 50 and beyond. Studies show that targeted strength training improves muscle mass, strength, and bone density even at older ages – including during and after menopause.
At what age should training be adapted for menopause?
Adjusting training often becomes useful from the mid-30s onward. The hormonal changes associated with menopause frequently begin earlier than expected. Starting training early helps better prevent muscle and bone loss later.
How can you reduce belly fat during menopause?
Belly fat during menopause often develops due to declining estrogen, muscle loss, and stress. Strength training, regular daily movement, a protein-rich diet, and HRT can be effective strategies to counteract this.
Is yoga alone enough during menopause?
Yoga supports flexibility, stress reduction, and sleep but is not sufficient on its own. Muscles, bones, and metabolism also require strength training. Yoga is a valuable addition but does not replace targeted exercise.
What role does nutrition play during menopause?
Nutrition strongly influences symptoms, body composition, and energy levels during menopause. A protein- and fiber-rich, anti-inflammatory diet with little added sugar supports muscle growth, recovery, and helps maintain training results in the long term.
Can exercise compensate for hormonal changes with age?
Exercise cannot fully replace hormonal changes with age, but it can significantly reduce their effects. Regular training protects many organ systems that are affected by declining estrogen during menopause.
