10 ways to exercise smart during perimenopause

If you’re currently experiencing perimenopause and feel like your body isn’t adapting to exercise in the way that it used to, we’ve got your back – and so has our H&B nutritionist, Millicent Chapman. Together we’ve got all you need to know about exercise and perimenopause.

“Hormonal fluctuations are unpredictable, so it can be helpful to adjust training intensity and recovery based on how you feel rather than following a rigid plan. Maintaining regular physical activity, including both resistance and aerobic exercise, can help preserve muscle mass, bone health, cardiovascular fitness and overall wellbeing throughout the menopausal transition.”^2,3

“Across perimenopause and menopause some people experience symptoms such as poor sleep and hot flushes which can lead to increased fatigue, reduced energy and slower recovery after exercise."^1,4 Without smart strategies to keep it in check, this stress may be linked to reducing muscle strength and muscle mass and higher levels of fatigue.⁶  “As a result, some days you may feel able to train harder than others. Listening to your body, adjusting your training when needed and staying physically active can help support your health, recovery and long-term fitness.”^1,4

If you take away one thing today, let it be this: resistance training is incredibly beneficial during perimenopause. As we age, studies have shown that muscle mass can decrease and this accelerates as oestrogen drops.⁷ Not only does it support strength and reduce injury risk, but it can help improve your physique too.

Building and maintaining muscle can support your metabolism too. That’s because the more muscle you have, the higher your resting metabolic rate (RMR), which is the number of calories your body burns at rest.⁸ To make strength training effective, focus on progressive overload – gradually increasing the weight in your workouts. And remember, if you’re a gym newbie, start slow and grow your strength with the support of the gym staff or a beginner’s class.

While strength training is important during perimenopause, remember to not ditch the cardio and aerobic exercises. As women age, the risk of cardiovascular disease increases. Studies also suggest the risk of heart attack is higher after menopause than before.⁹ Brisk walking, cycling, jogging and stair climbing are all great choices for boosting your heart rate – the sweet spot for working your cardiovascular strength without pushing it too hard.

When you're testing your fitness limits – whether that’s through intense HIIT sessions, a long walk or sprinting at the local ParkRun – it's important to give your body the time it needs to unwind and recover. If you’ve just finished a workout at home, instead of jumping straight back on your laptop to get back to work, try adding a few minutes of gentle stretching or breathwork to help your body shift into recovery mode.

Protein-rich foods become more of a biggie during perimenopause when we’re aiming to maintain our muscle mass. Not sure how much protein you should be eating? A 2024 review estimated we should consume roughly 0.8-1.2g per kilogram of body weight daily, with at least half coming from plant-based sources like beans, lentils, tofu, nuts, seeds and whole grains.¹³

Athletes involved in strength and endurance sports typically require more protein (around 1.4-2.0 g/kg/day) than those who aren't physically active (approximately 0.75 g/kg/day).^14,15 “In most cases, however, a healthy, balanced diet that meets overall energy needs will provide sufficient protein to support these increased demands,” says Millicent. “Protein intake should be spread evenly across the day to maximise muscle protein synthesis.” For those aiming to increase muscle mass, combining resistance training with a diet that provides adequate energy, carbohydrate and protein (around 1.6-1.7 g/kg/day) is recommended.¹⁶

Elsewhere, healthy fats and complex carbohydrates are great for overall wellbeing while omega-3 fatty acids, found in fish and flaxseeds, are another good addition to your diet. “Carbohydrates are the body’s main source of energy for exercising muscles. Requirements differ depending on activity levels, but most people can meet their carbohydrate intake by eating a healthy balanced diet.¹⁷ This means having a balanced meal plate across each of the three meals, aiming to include a portion of complex carbohydrates, a portion of protein, a source of healthy fats and a portion of fruit or vegetables.”

Complex carbohydrates are high in fibre and digested more slowly. They include wholegrain foods like brown rice, quinoa, brown bread and spelt pasta – all of which can provide longer more sustained energy levels throughout the day.¹⁷

Many of us juggling stressful jobs and busy schedules often reach for a glass of wine in the evening. There’s no need to quit entirely, but it’s helpful to monitor your symptoms in relation to your nightly glass or two.¹⁸ Even one glass of wine could exacerbate symptoms and disrupt sleep, so it’s helpful to keep track of this and limit alcohol where possible. Drinking alcohol could potentially affect your exercise routine, dietary choices and even how much caffeine you reach for the next day.^19,20

The vagina is packed with oestrogen receptors and as levels drop, many women start to notice unwelcome changes like vaginal dryness and atrophy. These issues can then impact other parts of life, including comfort and confidence with exercise. For countering atrophy, make regular pelvic floor exercises part of your routine – include a couple of minutes dedicated to strengthening the muscles that support the bladder, uterus and bowels.²¹ Not because you’ve already run into an issue, but to prevent urinary incontinence and other issues down there in the future.

Misplacing your gym kit, losing your locker key and difficulty focusing is common during perimenopause, when brain fog is on the rise.²² When you link brain training skills with physical exercise, the benefits are twofold – working your cognitive and physical fitness at the same time. Sports that require you to think on your feet, like boxing, netball and indoor climbing challenge your hand-eye coordination, helping you to stay sharp.

How many glasses of water have you drunk today? If the answer is 'not enough', you're not alone. Hot flushes and night sweats can cause you to lose more fluid than usual during perimenopause, increasing your risk of dehydration. Staying hydrated can also help reduce the likelihood of symptoms such as headaches, tiredness, dizziness and irritability, making it an important part of your exercise routine.²³

“Adequate hydration is also essential for optimal exercise, recovery and normal functioning. The NHS recommends six to eight glasses of fluid daily for typical hydration guidelines,” says Millicent.²⁴ “However, exercising can increase this requirement due to sweat released during exercise.”

After some supplement inspo? Take a look at our top picks of perimenopause supplements or discover how to find the right formula for you with our nutrition for women round-up.