Creating a training protocol for menopausal and postmenopausal women
Calling all women 40 and over.
I don’t need to tell you that belly fat is a problem that literally grows from this time onwards, I’m sure your clothes remind you everyday.
I’m a big advocate of loving your body and accepting it as it is (and how hard is that to do!), but I’m also a big advocate of improving your health and wellbeing, and that means taking an honest but not too harsh look at your body status quo.
This time of menopause, whenever it occurs, brings a flood of wonderful experiences. Hot flushes, depression, anxiety, intolerance, tiredness, night sweats loss of sex drive, mental confusion, mood swings… the list goes on …
….and on
…….and on.
You know already your hormones are taking a beating, they are up, mainly down, and suddenly you realise how much impact hormone levels have on your quality of life.
One of the things we notice is that belly fat comes on quickly and appears to really stick there and previous ways of getting rid of it don’t seem to work.
It’s not your imagination.
Ageing is unfortunately associated with increased belly fat (interestingly it corresponds with a decrease in the legs) in women (Ambikairajah et. al. 2019), a decrease in lean muscle, less fat oxidation during exercise and increase in intramuscular fat deposits (Abildgaard et. al. 2013, Isacco & Miles-Chan 2018, Kapoor et. al. 2017, Anahita 2018).
And all this is not necessarily triggered at menopause but menopause absolutely hastens this and thus the risk for chronic and metabolic diseases after menopause is greatly elevated.
It’s not nice, but if a doctor said they had a pill that would increase your energy, firm your body, lose you fat, make you feel more normal and will greatly reduce your risk of cardiovascular disease, cancer, dementia and metabolic diseases such as insulin resistance, diabetes, you would probably leap over their desk in your haste for a lifetime prescription.
Well, there kind of is.
…….. It’s exercise.
Study upon study upon study is now available that shows, beyond doubt, that exercise achieves all those things.
I know you know this already
You do don’t you?
Menopause is a great time to reevaluate life. You probably have a little more freedom with family now and it’s a perfect time to build your life and body up for this new era that could last another third to half of your life.
It’s all up to you.
What you do with yourself now will have direct repercussions on your lifestyle now and later.
The average woman 45 years onwards has a diet low in vegetables, low in protein, high in high glycemic foods and becomes less and less physical activie
Is that you?
Imagine that woman I described.
What will she look like in 20 years? 30 years? 40 years?
Imagine another woman, who regardless of what she has been doing, starts today living a life where her diet is 80% on point (so has plenty of room for fun foods) and is filled with daily movement and lifting heavy things.
What will she look like in 20 years? 30 years? 40 years? Hey, even 50 years? What could her life look like compared to the other woman?
Minimal medical care ….. more money and time for fun things
Not restricted by an immobile, tired body
Think of any woman you know over 80. Is she mobile? Why yes, why no?
Which one do you want to be?
……… Settled.
There are many factors to creating this wonderful postmenopausal life, and if you are postmenopausal, you are included in this too. We need to address diet, physical activity, mind/ stress.
Today we deal with physical activity.
Adding a regular exercise regime into your daily life will have a very positive effect on your body composition and thereby lowering your risk factors, PLUS adding immensely to your quality of life (Anahita 2018, Dugan et. al. 2010, Kapoor et. al. 2017).
Today we are going to go through a potentially ‘ultimate’ training protocol. Rashti et. al. (2019) went searching for the ultimate plan for postmenopausal women. They found that both moderate aerobic training combined with resistance training, and high intensity interval training with resistance training, compared with a control group, improved all body measurements. Out of both methods, the exercise regime that lost the most visceral fat and body fat was the interval combination group.
They are not alone finding this occurrence.
So let’s look at our plan.
We need 3 x a week of full body resistance training. The protocol used by Rashti et al. (2019) used 2-3 sets of 8-10 repetitions of each.
Try:
GYM:
Leg Press
Chest Press
Deadlift
Latpulldown
Bicep curls DB
Tricep extensions
HOME:
Squat
Pushup
Banded Row
Banded Deadlift
Bicep curls (Band or DB)
Tricep dips
Note muscle growth happens with training more to fatigue, so don’t be afraid with going heavier than normal at the gym or in the case of bodyweight training at home, doing your reps to fatigue will mean you will probably do more repetitions.
3 x week High intensity interval training.
Warmup gently for 5-10 minutes and then go all out. Breathing heavily. Feel you are giving it around a 9/10. This lasts 4 minutes. Take 4 minutes break. Easing down and feeling you are working around 5-6/10.
Repeat the 4 minute work load 3 more times with the rest in between. So 4 workloads in total.
Cooldown for 5-10 minutes.
This can be quite confronting if you are not used to it. Use heart rate as a guide if you can. Heart rate used in the study was 85-95% of max. This can be very uncomfortable so don’t worry if you can’t get there or maintain it long. The subjects were able to sustain their heart rate at that level during the 4 minute intense session for about 2 minutes. Do what you can and trust the body will adapt.
Heart rate max for a 50 year old is 173 bpm (age x 0.7; subtract answer from 208). 85% is about 147 bpm. Make your rest intervals around 65%, which is 112 bpm; for a 60 year old 166 bpm is max, 85% = 141 bpm and 65% = 108 bpm.
Resistance and interval training can be done on the same day or different days. Put them in when it works for you. Doing something nearly everyday is probably the optimal way to go if possible.
So that’s it.
Does that intrigue you? Inspire you? I hope so. Imagine if you changed nothing else about your diet and lifestyle but added the above in. What would you look like? What would you feel like?
It will change your outer appearance definitely, but your inner appearance that your soul cares about will be stronger and far more disease resistant. This is the kind of body that moves as we want it to through the day and doesn’t complain (sore muscles aside!).
I must add that regardless of what I have talked about today, the key will always be movement and consistency. There will be days you don’t want high intensity. In fact you may even feel right now that that is way too hard, but 30 minute walks is something you could do instead. Do that.
The universal rule that outweighs everything is:
Any exercise you like to do and you actually do, is the best one.
Pick exercise styles you like and do them.
Do them regularly, and voila, magic, you will achieve that healthy, strong body that will lessen greatly the inevitable breakdowns of ageing.
Much love, Vashti :-)
References:
Abildgaard, J, Pedersen, AT, Green, CJ, Harder-Lauridsen, NM, Solomon, TP, Thomsen, C, Juul, A, Pedersen, M, Pedersen, JT, Mortensen, OH, Pilegaard, H, Pedersen, BK & Lindegaard, B 2013, ‘Menopause is associated with decreased whole body fat oxidation during exercise’, American Journal Physiology Endocrinology Metabolism, 301, pp. E1227-E1236, viewed 12 July 2020.
Ambikairajah, A, Walsh, E, Tabatabaei-Jafari, H & Cherbuin, N 2019, ‘Fat mass changes during menopause: a metaanalysis’, American Journal of Obstetrics & Gynecology, Centre for research on Ageing, Health and Wellbeing, Australian National University, Canberra, vol. 221, iss. 5, pp. 393-402, viewed 11 July 2020.
Anahita, S, Ramin, S, Setila, D & Rad Afagh, H 2018, ‘The effect of concurrent endurance and resistance training on cardio-respiratory capacity and cardiovascular risk markers among sedentary overweight or obese post-menopausal women’, vol. 6, iss. 4, pp. 123-129, viewed 14 July 2020.
Dugan SA, Everson-Rose SA, Karavolos K, Avery EF, Wesley DE & Powell LH 2010, ‘Physical activity and reduced intra-abdominal fat in midlife African-American and white women’, Obesity (Silver Spring). vol.18(6):1260-5, viewed 30 August 2020, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3139333/#!po=86.1111>.
Isacco, L & Miles-Chan, JL 2018, “Gender-specific considerations in physical activity, thermogenesis and fat oxidation: implications for obesity management’, Obesity reviews, World Obesity Federation, Suppl. 1, pp. 76-80, viewed 12 July 2020.
Kapoor, E, Collazo-Clavell, M & Faubion, S 2017, ‘Weight Gain in Women at Midlife: A Conise Review of the Pathophysiology and Strategies for Management’, Mayo Foundation for Medical Education and Research, 92(10, pp. 1552-1558, viewed 12 July 2020
Rashti BA, Mehrabani J, Damirchi A & Babaei P 2019, ‘The influence of concurrent training intensity on serum irisin and abdominal fat in postmenopausal women’, Menopause Review, vol.18(3), pp. 166-173, viewed 30 August 2020, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6970417/#!po=30.5556>.
Menopause and Weight Gain; Inevitable?
““It is fairly brutal and you go through all the accompanying side effects: hot flushes, weight gain, a sense of mourning for lost youth, sexiness and somehow the point in anything. I became depressed, which I ended up getting help with.” ”
Have you hit that time in your life where your cycles are fluctuating, your brain is foggy, energy at an all time low, maybe night sweats, flushes and just generally feeling miserable? Me too!
A positive aspect of this age of oversharing, is that we can talk more freely about previously taboo subjects, and menopause is one of them. It was not so long ago women were regularly put into mental institutions because men didn’t understand what was happening…and neither did they!
However it's still, like most female issues, not widely talked about apart from many comedienne’s routines and with coffee (or wine) at your friends.
Its great to laugh at our cycles whether pmt or menopause but when you are actually living and breathing it day in day out, then it becomes a little less funny and more frustrating.
Although there are many facets to menopause and what happens to us, I want to tackle just one thing predominantly today. This is something I hear about a lot (and concerns me too!).
Weight gain
A woman will gain weight during and after menopause and there's nothing we can do about it.
Does that worry you? Are you resigned to the inevitability of it?
““You thicken up around the waist… you just change shape… you gain a little more weight but it’s just placed differently. It’s like you almost lose your waistline.
“Your chest, your décolletage, sort of wrinkles, and you think ‘What’s that?
“I think you start to dress differently because you think, ‘Right, that doesn’t make me look at my best… Stick to skinny legs and baggy tops.’” ”
This thought is quite frightening in all honesty. Loving your body ala naturalle is all very well, but I don’t know anyone who actually likes being overweight…honestly…
.. and the reason for not liking excess weight is not just aesthetics, (although thats a lot of it, lets be honest), but either consciously or subconsciously we know the real reason for keeping our weight down is health and longevity related….. your body knows this even if you are not yet aware…. If you want the best chance for a healthy, full, long life then keeping your fat levels on the lower side is a very important factor.
During perimenopause the female body starts slowing the reproduction cycle down. Progesterone production slows years before oestrogen declines, leading to
Breast swelling and tenderness
Mood swings
“Fuzzy thinking”
Irritability
Trouble sleeping
Water retention
PMS
Weight gain
Testosterone also decreases and it shows often with these symptoms:
Loss of sex drive
Decreased sexual response
Decreased sensitivity in your erogenous zones
Decreased sense of well-being, energy, and ambition
Depression
Loss of or thinning pubic hair
Resting metabolic rate lowers, muscle is broken down at a faster rate, bones become brittle and insulin sensitivity decreases.
Estrogen levels drop towards the end of menopause and this has its own list of symptoms including:
Creator: Diane Diederich
Hot flashes
Night sweats
Vaginal dryness
Decreased energy and ambition
Depression or mood swings
Dizziness
Headaches
Mental confusion
Urinary incontinence
Recurrent urinary tract infections
Increased susceptibility to vaginal infections
When menopause hits, a year after your last period, these issues tend settle as the hormonal holocaust subsides and steadies out.
This hormonal madness you have experienced is basically responsible for that spare tyre and more. Many women gain fat during peri menopause, and it doesn’t often change with time. The older you get, the faster the muscle loss etc. Not only do these factors mean our body doesn’t look and act like it used to but it also impacts our neural networks, weight gain and loss of muscle mean the brain is unable to repair and grow new nerve cells and connections like it used to.
This doesn’t sound good does it?
Is it out of your control?
NO
Thank goodness!
Although women have been taught to dread menopause, this life stage ushers in the springtime of the second half of life and is often accompanied by surges in creativity, vitality, newfound ambition, and the need to be of meaningful service to the community in a larger way. Dr Christiane Northrup
From the Mayo Clinic:
The hormonal changes of menopause might make you more likely to gain weight around your abdomen than around your hips and thighs. But, hormonal changes alone don't necessarily cause menopause weight gain. Instead, the weight gain is usually related to aging, as well as lifestyle and genetic factors.
Lets tackle those factors that will make a difference
Sleep
Sleep is also another staple that is affected during this time. Even if you weren’t going through a hormonal upheaval, lacking restorative sleep alone will prevent that weight from going and encourage more fat storage. When we don’t sleep well our cortisol levels are generally unreasonably high and stay high for much of the day when they should be naturally lowering. Living in this high stress world doesn’t help this either. With high cortisol, and increases in blood glucose and insulin insensitivity, it is no wonder that weight gain tends to be a standard part of menopause.
Fortunately there’s power in knowledge.
We know these things occur so let's look at what will balance them out.
Try Maca and black cohosh to balance the sex hormones (menopause combination tablets generally have a mix of these in them and I have spoken to some women who swear this reduced their night sweats)
Other herbs for cortisol balancing:
Rhodiola
Ashwagandha
Blood sugar balancing:
Berberine
Bitter Melon
Apple Cider Vinegar
““If you deal with it in a healthy fashion then I think you come out the other side a better person. I’ve got so much more energy now than I ever had in my early 50s before the menopause.” ”
Exercise
Exercise is one of the best things that anyone can do to improve everything. It will help you sleep well, balance hormones, slow bone loss, improve cognitive health and reduce fat and inflammation. Best of all you only need around 20 minutes daily to gain these benefits
We have higher morning cortisol so adding a walk every morning will use this cortisol and leave you with energy for the day. You don’t really want to thrash yourself, using up the energetic cortisol first thing in the morning. Maximise the fatty oxidation by doing the light exercise on an empty stomach. Deep breaths also are shown to be important.
In the afternoon try a little intensity with weights or a tabata workout. You don’t want to over fatigue but you do want to work hard enough to create a temporary lift in cortisol, that can then subside for evening.
To HRT or not?
I wanted to put in a mention regarding hormone replacement therapy.
Is HRT safe?
When I was first aware of HRT many years ago, it was apparently the miracle product and women around the globe raced to their doctors to demand this pill that promised balanced hormones (younger skin!) and more energy. Several years later there was a swing in the opposite direction. Suddenly HRT caused breast cancer and was ‘bad’. Add a few more years, more studies and importantly, longer studies, and there seems to be decent evidence to say that its very helpful and if you maintain your body in a healthy state you should not be of extra risk for the negative effects.
After listening to a wise woman who prescribes them to her very happy patients and self, I decided to take the plunge and ask my doctor whether it was worth going on it. So I am now trying it. For me so far the effects have been minimal. Other women I have spoken to are extremely adamant about how much it has benefited them, their lives and their happier families (anecdotally it seems particularly for those experiencing night sweats)
““So many women I’ve talked to see menopause as an ending. But I’ve discovered this is your moment to reinvent yourself after years of focusing on the needs of everyone else. It’s your opportunity to get clear about what matters to you and then to pursue that with all of your energy, time and talent.” ”
One thing I was very worried about was gaining weight, as if I might blow up over night. Fortunately their are plenty of studies showing no weight gain on the HRT (such as here, here and here). So when I started mine I watched myself carefully. I found when I started mine that my hunger or more precisely, my urge to eat, increased a bit. Not huge, but enough to worry me. I wrestled with this for a few days and then thought logically about it The tablet itself will not magically put weight on me. More food = weight gain. I was able to temper this urge completely by increasing my vegetable and fibre intake. For example I added psyllium husk or glucomanann to my vegetable soups. What a huge difference that made! A daily serve of this keeps my bowels regular and also eliminates my urge to over eat. In full disclosure, I don’t limit the amount of soup at all and some days I need more than on others. I still snack, but I can keep it from becoming a daily habit with this technique.
ROSEMARY CONLEY, 55-year-old diet and fitness guru: from this article
I started taking HRT four years ago and can honestly say it's one the best decisions I've ever made.Before I started going through the menopause I was convinced it wouldn't affect me.
I was fit, ate healthily and had an extremely positive outlook so I presumed I was mentally and physically equipped to deal with it.
I was wrong.
Like most women, my menopausal symptoms really started to affect my life. I became tired, lethargic and miserable.
It was such a horrible feeling knowing I was firing on two cylinders.
I knew I couldn't live that way so I went to my doctor to enquire about HRT.
He was really helpful and suggested that I try an HRT patch which is stuck on the lower abdomen.
He did warn me there was a minute risk of developing breast cancer but I felt that the benefits - a normal happy lifestyle - outweighed the dangers.
HRT has had a really good effect on my life.
Not only is it helping lower my risk of heart disease, it is also maintaining the health of my bones which lowers my chances of developing osteoporosis.
I weigh less than I did before I started wearing the patches even though I haven't changed my diet or exercise regime.
Before my menopause I really felt my age. But now I've recaptured the energy I had in my youth and feel 20 again.
So is weight gain inevitable?
I hope you can see now that it really isn’t.
Is it harder? Well, the body is going through or has gone through huge changes and unfortunately it slows all the pathways that make weight loss easier. However, it does NOT make it impossible or unbelievably hard. Feeding your body the right foods, avoiding sugar and moving everyday is the key to life long health, and doing that fortunately results in a healthy lean body. Consult your doctor, your naturopath, your fitness trainer, be proactive and embrace this inevitable change and make these following years the best of your life.
““All of a sudden I don’t mind saying to people, ‘You know what? Get out of my life. You’re not right for me.’ It’s wonderful and liberating.” ”