Generally speaking, the basic Primal Blueprint for fitness and physical activity applies equally to men and women of all ages. Lifting heavy things works in everyone. Sprinting is a fantastic way—for anyone who’s able—to compress workouts and improve training efficiency. Improving one’s aerobic capacity through easy cardio doesn’t discriminate between the sexes. And everyone should walk, hike, garden, and perform as much low level physical activity as possible. These basic foundations—the 30,000 foot view of fitness—don’t really change across age or sex.
But the details do, especially for women.
You see, women are in a unique position. As men age, the hormonal environment degenerates. They still make the same basic hormones in the same proportions, only the absolute numbers decline. As women age, the hormonal environment shifts dramatically. The menopausal ovaries no longer produce enough follicle-stimulating hormone (FSH) and luteinizing hormone (LH) to regulate estrogen, testosterone, and progesterone, causing the latter hormones to fluctuate in novel ways.
What kind of hormonal changes and physiological developments occur in the aging woman that might affect how best to train?
- Atrophied muscle and reduced strength. As estrogen drops, so does muscle function.
- More of a “male” body fat distribution. Postmenopausal women tend to gain more belly fat.
- Reduced bone mass. The menopausal hormonal environment leads to a reduction in vitamin D synthesis and absorption, lower calcium levels, and reduced bone mass.
- Vascular changes. After menopause, arteries become stiffer. Hypertension becomes more likely.
- Exercise intolerance. This one’s a real bummer. You know you need to exercise more than ever to stave off some of the side effects of aging, but your aging hormonal environment is making exercise harder to tolerate.
What takeaways are there? How can you counter or mitigate some of these effects?
Exercise Can Improve Body Comp
Exercise becomes more effective at improving body composition after menopause than before. This may be a “benefit” of the more male body fat distribution patterns. After all, men’s body comp tends to respond more quickly to training than women’s.
Get Started Right Away
If you don’t have much experience with exercise, do it immediately. Don’t wait for the negative effects to accrue. Even if you’ve lived a charmed life where not exercising didn’t really impact your ability to function, that could very well change. The earlier into menopause you start training, the better. The negative changes to exercise tolerance, bone density, and muscle function take awhile to develop, and during the early post-menopause period, your ability to train and reap the benefits of that training is pretty similar to your pre-menopause ability.
Just Do Something
The perimenopausal and early menopausal years can be rough going for many women. You just feel off. You’re not sleeping well. Things are, well, different, and you don’t necessarily have a lot of support to make sense of it or adjust to it. Even though research shows that a minimal amount of exercise can have a big effect on weight gain and disease risk after menopause, sleeplessness or fatigue might be telling you not to do it. Well, that’s not going to cut it. Overcome that. There’s no easy way to say this. No tricks. Just make the decision to exercise, do so regularly for at least a couple weeks, and your exercise tolerance will go up, physical activity will be intrinsically rewarding, and everything will start to improve.
Make Sure You Eat Enough Meat, Dairy, and Other Animal Foods
Protein utilization efficiency drops the older you get, so the older you are the more protein you need to get the job done. Even studies that purport to show negative effects from meat consumption find that older adults benefit from increasing meat. Total protein and dairy protein intake also predict muscle mass and bone mass in postmenopausal women. And meat isn’t just about the protein. It’s also about the micronutrients, like iron, copper (found in organ meats), zinc (high in red meat), carnitine (high in red meat), and phosphatidylserine (high in egg yolks, present in Primal Calm)—all of which have been found to improve women’s physical performance when packaged in a convenient supplement.
Go Into Middle Age As Fit As Possible
Good fitness—aerobic capacity, muscle mass, physical strength, mobility—is a reserve against aging-related degeneration. The fitter you are when menopause hits, the more manageable the transition and the slower that degeneration will be over the subsequent decades.
Intensity Is Important
If anything, it’s more critical for the older woman to push the intensity than anyone else. She often has the most to lose in muscle mass and bone strength. Again and again, across study after study in menopausal women, “low-intensity” doesn’t work as well as higher-intensity training. It still works, mind you. But the greater intensity stuff gives extra benefits.
For instance, in a study comparing a low-intensity aerobic/resistance program to a higher-intensity aerobic/resistance program, both improved muscle strength and walking ability, but only the higher-intensity program improved dynamic balance—a major risk factor for falls.
Intensity Is Relative
By “high-intensity,” I’m not suggesting that a 62 year-old woman do high-rep bodyweight front squats or try to do a double bodyweight deadlift (unless she knows what she’s doing), just that she push the envelope ever so slightly. If your inclination is to do rows with 20 pound dumbbells, consider 25 pounders. If air squats are easy, try them with a weight vest. Sprinting doesn’t have to take place on a track; it can happen in a pool, on a tough hike, or on the bike. Things should be tough but doable.
Volume Should Be Moderate
Exercise has a way of brute forcing glucose tolerance by increasing insulin sensitivity and glucose uptake by muscles, so you’ll be better off than the women who don’t exercise at all, but there’s still a limit because menopause tends to inhibit carbohydrate metabolism and glucose tolerance. High volumes of training, especially if you’re heeding the previous advice to increase the intensity, demand a level of carbohydrate intake that your body probably isn’t prepared to handle.
Lift Heavy Things Twice a Week
You could do more, but I don’t think it’s necessary. Lifting (relatively) heavy weights provides the necessary stimulus to maintain bone density and muscle strength. Movements that engage the whole body, like deadlifts and farmer carries, will be most effective and efficient. These exercises replicate real world movements, like picking up grandkids or carrying grocery bags, that you need to perform. If you’re uncomfortable with these movements, find a good trainer.
Walk a Ton
Walking is magic for everyone, but especially post-menopausal women, for whom a three-day-a-week walking habit improves resistance to heart failure. Join a walking group. Better yet, start one in your circle of friends. Be the example, the leader. No one else will. And set a brisk pace when you do walk. The brisker, the better.
Always Choose the Stairs
Stair climbing itself is a great form of exercise for post-menopausal women, improving leg strength and endothelial function. As a mindset, “taking the stairs” is even more valuable. It’s doing the hard thing. It’s parking in the far lot and walking a quarter mile. It’s carrying your own bags. It’s a mindset to embody: “I’m strong enough, capable enough, and tough enough to take the stairs while people half my age use the elevator to go one floor.”
Compare Yourself To Who You Were Two Weeks Ago, Not the 20-Year-Olds At the Gym
The trend is everything. If you’re getting better, that’s what matters. You are not other people. We all have different situations, capacities, genetic histories, and hormonal profiles. Focus on beating your former self, even if only by a couple pounds lifted or seconds shaved from a sprint time—and nothing else.
Look Into Hormone Replacement Therapy
Since estrogen plays such a key role in women’s physiological function, many studies find exercise to be more beneficial in postmenopausal women who take HRT than in postmenopausal women who do not. It’s a highly personal choice, but I’ll have more on this topic in the future.
Aging women aren’t a different species. Menopause doesn’t really change how you should train in a fundamental way. There aren’t any magical menopause-specific exercises. It just makes certain types of training—and exercise in general—that much more important for health and overall function. You could “get away” with not training much before (not really, but you can fool yourself). Now you can’t. Now you have to exercise and move on a regular basis if you want to maintain functional capacity, take care of yourself, and stick around to enjoy your loved ones.
Thanks for reading, everyone. Take care, and I’d love to hear from any people out there with direct or indirect experience with menopause. How did your training change? How did you change?
As always, direct any questions down below.
About the Author
Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.
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