Exercise during menopause: what actually helps now

Your jeans fit tighter even though you eat exactly the same as always. The workout feels like it did at 35, but recovery takes longer the next day, and sleep has turned into a lottery. If you are in your mid-forties or beyond, there is a very solid explanation for all of this - and the phase even has a name: the menopause transition does not start when your final period disappears; on average it begins around seven years earlier.

The good news in that: it is not a diagnosis, it is a phase. And this particular phase responds remarkably well to training - just not to any training. Here is what the research actually shows on muscle, bone, abdominal fat, hot flushes and sleep.

The mineral part of this programme runs in my evening: a glass of FitLine Restorate Citrus, which combines calcium, magnesium and vitamin D in one drink - exactly the three building blocks that gain new weight in this phase of life. Why that is, below.

What actually happens in this phase

Strictly speaking, "menopause" only names the final period - in Germany, on average at about 52 years of age. The years before, when oestrogen levels first swing and then fall, are called perimenopause. During this time, review papers report that around 80 per cent of women experience symptoms, for an average of about four years, with peaks of up to twelve (BMC Women's Health 2024).

Muscle. The withdrawal of oestrogen hits exactly where you need it. Studies across the menopause transition show lower muscle, respectively fat-free, mass: perimenopausal women average around 2.5 per cent below premenopausal levels, postmenopausal women 5.7 per cent (review, menopause & muscle mass). After menopause, muscle mass declines by roughly 0.6 per cent per year without training (review, oestrogen deficiency & sarcopenia). This does not run unopposed by itself - but it can be slowed, as follows.

Abdominal fat. The most underestimated part. In a four-year longitudinal study, visceral fat rose significantly only in those women who entered menopause during the study; at the same time their overnight energy expenditure fell around 1.5 times more than in equally aged women without this shift (-7.9 versus -5.3 per cent), and fat oxidation dropped by about a third (Lovejoy et al., International Journal of Obesity 2008). In numbers from the same study: daily energy expenditure fell by roughly 200 kilocalories on average. So the counting error is not on your plate - the body quietly burns less, and it starts doing so before anything in your routine has changed.

Bone. During the transition the spine loses on average around 2 per cent of its density per year, the hip a little over 1 per cent - and that accelerated phase lasts for years (SWAN study). Details and countermeasures are gathered in Keeping your bones strong.

Then come hot flushes, night sweats, joints that suddenly grumble. Not for everyone, but for many - which is exactly why the next question is worth asking: what can training really do here?

Why strength training is the foundation now

The clearest answer comes from training research. A meta-analysis of 27 randomised trials with nearly 2,000 women aged 40 to 60 showed: training programmes improved fat-free mass, handgrip strength and leg strength - most effectively resistance training at three sessions per week, 20 to 90 minutes each, for at least six weeks (meta-analysis, RCTs in menopausal women). Handgrip strength, a classic marker of general fitness, responded particularly clearly.

Bone responds too - but only to enough stimulus. Analyses of 17 randomised trials in postmenopausal women found improved bone density at the lumbar spine, femoral neck and hip, especially at high intensity from around 70 per cent of the one-repetition maximum, three times per week, over longer periods (Zhao et al. 2025). Combinations of resistance training and impact loading - jumps, rope skipping - outperformed resistance training alone in earlier analyses (Zhao et al. 2015). If you have pelvic floor issues, move impact work into the water or onto a stepper.

In practice that means: twice a week, 45 minutes of full-body training with weights that genuinely get heavy after eight to twelve repetitions. Pure bodyweight workouts rarely deliver this stimulus - you need dumbbells, machines or bands with enough resistance. First noticeable results show up after around eight weeks; in studies at the German Sport University Cologne, women increased their strength by up to 80 per cent this way (NDR). And starting pays off even after menopause: in a Danish study, postmenopausal women improved insulin sensitivity and muscle metabolism as strongly as premenopausal women after three months of high-intensity training (Mandrup et al. 2018, Menopause).

An honest note for regular runners: more is not automatically better now. A chronically excessive training frequency can push cortisol upwards - stressing sleep and blood pressure, which already have plenty to do in this phase (Apotheken Umschau). Scaling back is allowed.

Endurance and intensity: dose it, do not force it

The guardrails are unspectacular: 150 minutes of moderate aerobic activity per week plus at least two days of strength training is the recommendation of the International Menopause Society (IMS factsheet 2025). Combinations of endurance and strength - including high-intensity intervals if you enjoy them - delivered the best results across the reviews for heart, inflammation markers, strength and body fat.

Concretely: twice a week, 35 to 40 minutes of brisk walking, Nordic walking, running or cycling at an intensity where you can just about hold a conversation. More is not needed for the cardiovascular effect, advises sports physician Patrick Diel (NDR). The rest is daily life: stairs instead of the lift, short walks between long sitting periods. How much everyday movement counts at all, I have broken down in Ten thousand steps.

Hot flushes and sleep: what sport really can do - and what it cannot

Now the honest part that no advertising poster will tell you: strength training is not a remedy for hot flushes. The large Cochrane review found no reliable effect of exercise on the frequency or severity of flushes and night sweats (Cochrane 2014); a newer meta-analysis of 21 studies saw at most a small effect on symptom severity, not on frequency (Liu et al. 2022, assessed by the IMS). For sleep the balance is similarly sober: physical activity improved measured sleep problems only minimally, with no significant effect on sleep quality or insomnia (Maturitas 2025).

So why train at all? Because the gains sit elsewhere: strength, muscle mass, bone density, insulin sensitivity, blood pressure - and mood. Mental wellbeing in particular reliably benefits, as the International Menopause Society factsheet also stresses (IMS factsheet 2025). If you train to banish flushes, you will be disappointed. If you train to go through this phase strong, steady and clear-headed, you get exactly that.

For training days with flushes, the practicalities help: train cool, wear breathable clothing, go early in the morning in summer, and take a short shower afterwards. And if symptoms dominate your daily life, the right move is seeing your GP or gynaecologist - hormone replacement therapy is a medical decision, not part of your training plan.

Protein and minerals: the underestimated part

From your mid-forties you need more protein than before, not less. Professional bodies recommend 1.0 to 1.2 grams of protein per kilogram of body weight per day for older adults, more for those who train - spread over meals of 25 to 30 grams each (PROT-AGE Study Group; ESPEN Expert Group). A remarkable detail from the same menopause study: protein intake actually fell once the transition began - the worst possible timing (Lovejoy 2008).

For bones, the mineral arithmetic matters next: the recommended intake for women aged 51 and over is 1,200 milligrams of calcium per day, plus 600 International Units of vitamin D (Institute of Medicine 2011). Calcium and vitamin D contribute to the maintenance of normal bones - and that is exactly where FitLine Restorate Citrus fits into my evening: a glass after strength training or before bed, with calcium, magnesium and vitamin D in one drink. It replaces neither meals nor medical advice - it closes a gap that would otherwise stay open all day.

How to start this week

1. Two strength sessions. Full body, six to eight exercises, eight to twelve repetitions, with a weight where the last two truly count. Technique first, then progression. The basics are explained in Strength training for women - the principles apply at any age.
2. Two endurance sessions. 35 to 40 minutes at a brisk pace, just barely able to talk. Consistency beats breathlessness.
3. Count everyday movement. Steps, stairs, breaking up long sitting periods.
4. Spread your protein. 25 to 30 grams per main meal; especially important after strength training (Eating after training).
5. Fix your minerals into a routine. A steady evening ritual beats a daily scramble - the body takes minerals in best when it is calm.
6. Take flushes seriously. If they rule your days, seek medical advice. That is not weakness, it is planning.

The takeaway

The menopause transition changes your starting point: muscle and bone lose substance faster, abdominal fat gets an easier game, energy expenditure quietly drops. But the control is not taken from you - the counter-play works: strength training two to three times a week, dosed endurance, more protein, calcium and vitamin D. For hot flushes, sport is no medicine; for everything else it is the strongest card you hold yourself.

My fixed evening building block stays FitLine Restorate Citrus - calcium, magnesium and vitamin D in one glass while the body processes the building materials for the night. With that, plus two proper strength sessions per week, this phase can be trained through rather than merely endured.

Photo: Shixart1985, CC BY 2.0.