What is the best workout for menopause?
A mix of strength training and aerobic exercise. In a meta-analysis of 101 trials in postmenopausal women, aerobic training did most for fat loss and strength training did most for muscle, and combining them is the sensible plan. The WHO recommends muscle strengthening on two or more days a week and 150 to 300 minutes of moderate activity. Pair training with enough protein, about 25 to 30 g per meal, so the work turns into muscle.
Key takeaways
- In 101 trials of postmenopausal women, exercise reduced fat mass, waist size and visceral fat, and increased muscle.
- Aerobic training did most for fat. Strength training did most for muscle. Combine them.
- The WHO recommends strength training on 2 or more days a week and 150 to 300 minutes of moderate activity.
- Heavy, supervised lifting improved bone density in women with low bone mass in the LIFTMOR trial.
- Exercise does not reliably reduce hot flashes. Do it for muscle, bone, heart and mood.
- Protein turns training into muscle: aim for 25 to 30 g at each main meal.
- Check with your doctor first if you have osteoporosis, a heart condition or a painful joint.
Most menopause workout advice is either too gentle to change anything or copied from programs for 25-year-olds. The research on postmenopausal women points to something simpler: two kinds of training, done consistently, with enough protein behind them.
What the evidence says
The largest summary is a 2023 meta-analysis of 101 randomized trials with 5,697 postmenopausal women. Exercise training increased muscle and reduced fat mass, body fat percentage, waist size and visceral fat. Aerobic and combined training did most for fat. Strength and combined training did most for muscle.1
The WHO recommends muscle strengthening for all major muscle groups on two or more days a week, plus 150 to 300 minutes of moderate activity, for adults of every age.2 NICE tells clinicians to explain to everyone going through menopause the importance of keeping muscle mass and strength through physical activity.5
A weekly menopause workout
| Session | Time | |
|---|---|---|
| Monday | Full body strength | 30 to 40 minutes |
| Tuesday | Brisk walk or bike ride | 30 to 45 minutes |
| Wednesday | Full body strength | 30 to 40 minutes |
| Thursday | Brisk walk, plus 5 minutes of balance work | 30 to 45 minutes |
| Friday | Full body strength, or rest | 30 to 40 minutes |
| Weekend | A longer walk, hike, swim or dance | 45 to 60 minutes |
The strength session
Pick one exercise from each movement and do 2 or 3 sets of 8 to 12 reps:
- Squat: sit to stand from a chair, then a goblet squat holding a dumbbell.
- Hinge: hip bridge, then a dumbbell Romanian deadlift.
- Push: wall or counter push up, then a dumbbell press.
- Pull: band row, then a one arm dumbbell row.
- Carry: walk with a heavy bag or dumbbell in each hand.
The weight should make the last two reps hard while your form stays clean. When 12 reps feel easy, go up a little. That steady increase is what builds muscle and bone.
Heavier than you might think is fine for most women, built up slowly. In the LIFTMOR trial, women with an average age of 65 and low bone density did supervised heavy lifting twice a week and improved spine and hip bone density, with one minor injury in the whole trial.3 Strength training for women over 50 explains the moves in more detail.
The cardio
Brisk walking, cycling, swimming or dancing, at a pace where you can talk but not sing. Aerobic training did the most for fat loss in the postmenopausal trials.1
What about belly fat?
No exercise burns belly fat on its own. In the trials, exercise reduced waist size and visceral fat as part of overall fat loss, and the combination of aerobic and strength training covered both fat and muscle.1 Menopause belly fat covers the food side.
What about hot flashes?
The Menopause Society's 2023 review did not recommend exercise as a treatment for hot flashes.4 That is not a reason to skip it. It just means you exercise for muscle, bone, heart and body composition, and treat hot flashes separately if they bother you. Hot flashes has the options.
Protein makes the training count
Training is the signal to build muscle. Protein is the material. In a meta-analysis of 49 trials of people doing resistance training, extra protein added to gains in strength and muscle, up to about 1.6 g per kilogram of body weight a day.6 PROT-AGE suggests 25 to 30 g of protein at each main meal for older adults.7
Protein Buddy works out a daily target from a short quiz on your weight, age, activity and goal, and Home shows how many grams are left today as you log. Typing meals in by hand is free with no limit. If you are already training and eating enough protein, creatine for women explains the one supplement with evidence for a small extra gain.
Before you start
Most women can start a program like this safely. Check with your doctor first if you have osteoporosis or have had a fracture, a heart condition, blood pressure that is not controlled, or a painful or recently injured joint. A physical therapist or a coach used to working with women in midlife can adapt every movement.
More questions about Women over 40
What are the 3 best exercises to lose belly fat after 50?
There is no exercise that burns belly fat specifically. The combination that worked best in trials of postmenopausal women was aerobic exercise, such as brisk walking or cycling, plus strength training. If you want three moves, a squat, a row and brisk walking cover legs, back and cardio.
How often should I work out during menopause?
The WHO recommends muscle strengthening on 2 or more days a week and 150 to 300 minutes of moderate activity for adults. A practical week is two or three strength sessions plus a brisk walk or ride on most other days.
Does exercise help hot flashes?
Not reliably. The Menopause Society's 2023 review did not recommend exercise as a treatment for hot flashes. Exercise is still one of the most valuable habits in menopause for muscle, bone, heart and body composition.
Is it safe to lift heavy weights in menopause?
For most women, yes, built up gradually. In the LIFTMOR trial, women around 65 with low bone density lifted over 85 percent of their maximum under supervision and improved bone density with one minor injury. If you have osteoporosis, get advice on which movements suit your spine first.
What should I eat when working out in menopause?
Enough protein, spread across the day: about 25 to 30 g at each main meal. In trials of people doing resistance training, extra protein added to gains in strength and muscle up to about 1.6 g per kilogram a day.
References
- The effects of exercise training on body composition in postmenopausal women: a systematic review and meta-analysis
- World Health Organization 2020 guidelines on physical activity and sedentary behaviour
- High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial
- The 2023 nonhormone therapy position statement of The North American Menopause Society
- Menopause: identification and management (NG23)
- A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults
- Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group
