In response to a recent request from several of my friends to address the topic of menopause—something for which I have no direct personal experience. I can never have a true understanding of what it is like for women experiencing this. We men can talk about “menopause”, but the symptoms (e.g., reduced libido, muscle loss, and fat gain) are far less challenging to men emotionally and psychologically. Thus, men never refer to a “change of life”. So, in response to my friends, I will keep it to what I know and with the understanding that symptoms—and magnitude there of—vary. When it comes to fitness, though, the rules remain much the same.
As we age, we begin to lose muscle mass at the age of 25. According to the exercise physiology text I teach from, we lose approximately 10% of our muscle mass between the ages of 25 and 50 years. We lose an additional, 40% from 50 to 80 years. Seems hopeless, does it not? It is not. These numbers are largely affected by the life changes that lead to inactivity. There is some influence of endocrine changes with age, but most of the blame lies in our being less active. And, yes, it does become harder to see the same physiological responses to exercise.
The several friends who requested I write about menopause commented about increasing difficulty with weight gain. Remember that weight changes come from a caloric imbalance. Thus, weight gain is the result of being hypercaloric—having a caloric intake that exceeds caloric expenditure. It is not as simple though as just eating less. Often that can result in a further reduction in metabolism and, subsequently, more weight (i.e., fat) gain. One friend commented that her husband said she “eats like a bird”. I jokingly reminded her that birds eat nearly twice their body weight, but I understand what the phrase is intended to imply—that she eats very little. So, for my friends struggling with menopause, eating less is not the solution to the problem. In fact, eating more—particularly premium fats (hormones like estrogen are build off of cholesterol and free fatty acids)—might be warranted. The question for some may not be how much one eats, rather what one eats. More importantly, the question also includes what activities is the woman doing.
In consider what I might write about exercise and menopause, I did what most today do. I Googled the topic. It was no surprise that the Mayo Clinic* offered no surprises. The benefits to exercise during menopause include: reducing weight gain, reducing the risk of cancer, strengthening your bones (something that should be done long before menopause), reducing the risk of other diseases (e.g., type 2 diabetes), and boosting your mood. These benefits are not unique to menopause—or to women. Likewise, the Mayo Clinic recommends the following options for exercise: aerobic activity, strength training, stretching, and stability/balance exercise. Again, no revelations here. These are the same recommendations I would offer anyone. Knowing my friends, they are following these guidelines. So, what is the problem?
Historically, the approach of most women to exercise has been misguided. We often here from women: “I don’t want to lift weights because I don’t want big bulky muscles.” and “I just want to tone.” First, I despise the term “tone”. Second, women with big “bulky” (a rather subjective phrase) got those muscles through a lot of hard work and careful dieting. So, out of fear of building muscle, women tend to favor cardio over weights. My best suggestion for peri- and post-menopausal women is go less on the cardio and more on the weights.
When menopausal women do cardio it should be more of the high-intensity interval training (HIIT) type (under the guidance of a physician) and be sweat producing. Casual brisk walks with friends is not going to produce the needed response. HIIT more greatly affects one aerobic fitness and magnifies the caloric expenditure. It is more time effective (i.e., more calories are burned per minute of exercise) which extends greater opportunity to do other exercise.
Weight training is a must. It need not be extensive, but it must be intense. In other words, light dumbbells for high repetitions (with little progression) is not going to cut it. Borrowing from Sally Roberts (founder of “Wrestle Like A Girl”), women need to change the perception of what it means to “lift like a woman”. Men and women need not train differently. Menopausal women should be hitting the weights at least 2-3 times a week, performing at least 3 working sets per body part at an intensity of 8-12 repetitions per set (I would offer the suggestion that the goal should work toward a higher intensity of 5-10 repetitions). The training need not be complex. Personally, I stick to the “basic five” (squat, deadlift, bench, row, and press).
Lifting weights will offset the inevitable decline in muscle mass and offer a boost to the metabolism. Don’t worry about excessive hypertrophy. It is much harder for any of us over 50 years—female or male. It is important, however, to pursue progression. You will be surprised how much stronger you can become, if you try.
If one can only do one form of exercise to counter the effects of menopause, I would recommend high-intensity interval resistance training (HIIRT) or high-intensity resistance training (HIRT). (Refer back to my earlier posting on these.) While these will have less effects on cardiorespiratory fitness and muscle strength/hypertrophy, they are possibly the best approach to burning fat and maintaining muscle—particularly for those of us over 50. While the calorie expenditure may not be as high as an equivalent duration of cardio exercise (the right program can come close, though) the extended energy expenditure can last several days, adding a boost to weight management. A critical consideration is technique. Never sacrifice form for repetitions or time!
Diet is critical for maintaining body composition as we age. Healthy eating does not change with age. The very same principles apply post-menopause as they do pre-menopause. Caloric balance is top priority followed by macro (carbohydrate, protein, and fat) balance. Focus on what you put on your plate. Choose quality proteins and vegetables first. Include some fruits. Avoid other carbohydrates except to fuel exercise performance. “Other” carbohydrates should be of the “premium” type (rice, beans, whole grains, etc.). Avoid processed foods, particularly baked goods. Choose high fiber foods. Choose fats wisely.
The one thing that my friends might not want to hear is to limit alcohol. Sure “science” is showing benefits to moderate wine or beer consumption. If you drink in your 50s, your likely didn’t start because of the research. So, if you don’t drink alcohol, don’t start. In our 50s, we can’t handle the alcohol we could in our 20s. For weight management, limiting calories from alcohol is significant. Fewer than 7-8 glasses per week is perhaps a safe recommendation. More will lead to greater weight gain (or slow weight loss). I suspect this is going to be the least well-received of my advice for friends experiencing menopause, but it is important. Playing off my friend’s comments, you can’t eat like a bird and drink like a fish. Choose wisely what goes into your body.
Menopause is a struggle. It is inevitable, though.
Men, we can support our women as they go through it. We have to be understanding and empathetic. Above all, we mustn’t put pressure on women about their changing bodies (period) and neglect our own. Encourage them is their diet and exercise.
Be your best today; be better tomorrow.
Carpe momento!