Exercise during the perimenopausal life stage is non-negotiable and its benefits are well researched. It has a positive influence on so many different body systems, including the cardiovascular, mental, digestive and musculoskeletal.

Did you know that one in three women over the age of 50 will experience a fracture due to osteoporosis? Exercise is crucial to maintaining good bone health in your perimenopausal years and builds a solid foundation for the future. From your 40s, you begin to lose more bone than you make and this process continues at pace until the menopause. The good news is, it’s never too late to take action, as your bones are constantly changing and will respond to stress and load. This is why high-impact activities such as jogging, tennis, dancing or simply stomping up the stairs builds healthy bones. Strength training, body weight exercises such as planks, squats, lunges and resistance band exercise should also be a priority as they help to maintain muscle mass and body strength, both of which decline with a reduction in oestrogen. Movement is also essential to supporting regular bowel function and in turn a healthy pelvic floor system. 

Don’t let pelvic floor symptoms become a roadblock to exercise or life quality. A significant number of women—upwards of 54 percent—suffer symptoms such as painful sex, urinary or anal incontinence, and urinary frequency—and accept them as a normal part of ageing without seeking medical help. The decline in oestrogen in perimenopause can lead to changes in the genito-urinary system, but there are plenty of things you can do. A good starting point is a women’s health physiotherapist for specific assessment and treatment of any pelvic floor issues. Research supports pelvic floor muscle strength re-training programmes, which can help to treat stress incontinence. Individualised help can also address many less-talked-about issues such as painful sex, vaginal dryness and flatus. Some quick fixes may be as easy as using a vaginal lubricant, pelvis and/or hip stretches or changing sexual positions. 

Feeling moody, anxious or irritable are some of the more commonly reported emotional experiences associated with perimenopause. Accepting that these feelings may occasionally surface and be part of your perimenopause journey is the first step. It may also be worth considering whether some of these things need a closer look. Are you always getting irritated by the same thing? Perhaps it’s the situation you’re in that needs changing. Have you always felt a bit anxious, but now it’s worse? Try learning some anxiety management strategies. Keep track of your moodiness and other emotions in the same way you would your cycle. This can help you to recognise, accept and ride the wave. If you need time for yourself, take it. Stop putting everyone else first. 

It’s worth remembering that perimenopause and menopause are natural processes that our bodies are designed to go through. Consider the other things our bodies are designed to do: to move—all the time. Where are our stress levels designed to be? Low—only triggered by an actual threat to our physical safety. What diet is our body designed to need? Fresh produce, whole foods, nothing artificial. How are we designed to breathe? Slowly, deeply, fully. We’re meant to connect with nature—trees and soil release microorganisms that are beneficial to human health. The more you can get back into balance with the things that your body is designed to do, the more you can ride the wave of perimenopause with less anxiety and resistance.

Kathryn Gale is a registered psychologist and mindfulness meditation coach at Joint Dynamics Evolve.

Kym Toller is a women’s health physiotherapist at Joint Dynamics Evolve.

Front & Female’s Women’s Health With Evolve series is a collaboration with Joint Dynamics Evolve, Hong Kong’s first multidisciplinary women’s health clinic with services spanning physiotherapy, osteopathy, rehabilitation, personal training, nutrition and psychology. The series addresses all aspects of female health to support women at various life stages and open up the conversation around women's health topics, from the awkward to the unknown.

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