Menopause workout plan: strength, balance and bone

A good menopause workout plan is three strength sessions a week that slowly get heavier, five minutes of standing balance practice in each one, and walking on most other days. Strength training gives your bones a reason to hold on, and balance training has the strongest evidence of any type of exercise for preventing falls. Exercise may not do much for hot flashes, so plan your training around them rather than counting on it to stop them.

What changes after menopause

Once your periods have stopped for good, three changes matter most for how you train:

• Bone. Bone loss speeds up in the years around your final period. Our guide to strength training in perimenopause walks through the numbers from a long-running US study that tracked it.
• Balance. Thinner bones make a fall more costly, and the best-supported way to prevent falls is regular balance practice.
• Heat and sleep. Hot flashes and night sweats can make a warm gym or an evening session harder, and a short night makes every weight feel heavier.

What the research shows

Bone: small gains that still count

A 2020 review in Frontiers in Physiology pooled 75 exercise studies with about 5,300 women past menopause. Exercise improved bone density at the lower spine and the hip, but the average effect was small, and results varied a lot from one study to the next. The authors put much of that down to the exercise programs themselves, many of which they felt weren't designed well enough to work.

A few details are worth knowing:

• No clear winner. The review didn't find that one type of training beat the others.
• It isn't too late. The effect looked similar in women early and late after menopause.
• Pair impact with lifting. Jumping combined with strength training had some of the larger results, though the differences between types weren't clear-cut. Jumping alone, in the few studies that tested it, didn't look helpful.
• The true effect may be smaller. There were signs that studies with positive results were more likely to be published.

The honest takeaway: lifting helps your bones a little, and a little matters when the alternative is steady loss. For bone health, the NHS lists weight-bearing and resistance exercise, calcium-rich foods and vitamin D, and notes that HRT can also lower the risk of osteoporosis. Whether HRT suits you is a conversation for your doctor.

Balance: practice standing up

A 2019 Cochrane review looked at exercise for preventing falls in people over 60. It pooled 108 trials with 23,407 people, about three quarters of them women, with an average age of 76. Exercise cut the rate of falls by 23%.

The strongest evidence, rated high certainty, was for programs built mainly around balance and functional exercise, which trains the movements of daily life. Cochrane's summary notes that most of these exercises were done standing, because that trains balance better. Programs that mixed balance work with strength training looked helpful too, though with less certainty. For strength training alone, walking or dance, the evidence was uncertain.

The World Health Organization's 2020 guidelines build on this. From age 65, they recommend varied activity that focuses on balance and strength, at moderate or greater effort, on 3 or more days a week, to keep you capable and help prevent falls.

Here's the limit: most people in these trials were well past menopause. We didn't find trials showing that balance practice in your 50s prevents falls years later. But it takes five minutes, costs nothing, and builds a habit that will already be in place when you need it most.

Hot flashes: don't count on exercise alone

A 2014 Cochrane review found five trials and rated the evidence low quality. Compared with no treatment, exercise made no clear difference to how often women had hot flashes or how strong they were, and one very small study found hormone therapy worked better than exercise. As the reviewers put it, "Evidence was insufficient to show whether exercise is an effective treatment for vasomotor menopausal symptoms."

One later trial in Maturitas is more encouraging. Postmenopausal women who had at least four moderate or severe hot flashes or night sweats a day either did 15 weeks of strength training, three times a week, or kept their usual routine. Of the 65 women who enrolled, 58 finished. Hot flashes fell by about 44% in the training group and about 2% in the comparison group.

It's one small trial, but it's a good reason to keep lifting through rough weeks. If hot flashes or night sweats are disrupting your sleep or your days, talk to your doctor. The NHS notes that cognitive behavioral therapy (CBT) can help with hot flashes, and a doctor can talk you through the medical options too.

The 3-day menopause workout plan

Each strength session takes 40 to 50 minutes and needs dumbbells, a bench or sturdy chair, and a resistance band.

Next week, run B, A, B, and keep alternating. The walks get you most of the way to the 150 to 300 minutes of moderate activity a week the WHO recommends for adults.

The exercises

How heavy, and how many

For carries, walk for about 30 seconds, 2 or 3 times. For gym machine versions of these moves, see our strength training plan for women over 35.

The balance block

Stand next to a kitchen counter or a sturdy rail so you can steady yourself, and spend about five minutes here. Start at the first level you can't hold for 30 seconds, and move up when it feels easy on both sides.

Optional impact work

If you haven't been told you have osteoporosis or broken a bone in a minor fall, add a little impact after Wednesday's session: 10 small hops or heel drops per leg, adding about 10 a week. Keep it as an add-on to lifting, not a replacement. Our perimenopause strength guide covers how UK bone experts suggest building impact up over time.

On hot flash days

• Train earlier or somewhere cooler, with a fan if you have one.
• Wear light layers you can take off. The NHS suggests light clothing and a cool bedroom at night for hot flashes in general.
• Watch your pre-workout coffee. The NHS lists caffeine, alcohol and spicy food as triggers worth cutting down on. If coffee before a session seems to set off a flash, have it afterward.
• Trim, don't skip. After a night of sweats, one fewer set per exercise and longer rests is still a good session.
• Swap hot, hard cardio for a walk outside or a swim.

What to do this week

• Pick three days with a day off between each, such as Monday, Wednesday and Friday.
• Do Session A on day one with light weights: 2 sets of 10 to 12.
• Try each balance level at your kitchen counter to find your starting point.
• Walk on two of the other days.
• Write down your weights, reps, balance times and how you slept.

If you'd rather have the sessions planned for you, HerShape asks about your life stage during setup, including menopause, and builds your training plan around it. Either way, your log is what shows you whether it's working.

What to change as you go

• Add weight in small steps. When every set reaches the top of the rep range with good form, use the next dumbbell up.
• Move up a balance level when you can hold the current one for 30 seconds on each side without reaching for the counter.
• Change the exercise, not the plan, if a joint complains. Use a higher box for squats, or floor press instead of bench press.

If you're still having periods, even irregular ones, our perimenopause workout plan shows how to adjust a week like this around your cycle.

What to watch for

Talk to your doctor before you start, or before adding heavier weights or impact work, if:

• You've been told you have osteoporosis or low bone density, or you've broken a bone in a minor fall.
• You have a heart condition, or you get chest pain, palpitations, dizziness or unusual breathlessness when you exercise.
• You've fallen recently or often feel unsteady. In the Cochrane review, programs that worked were often set by a physical therapist or trained exercise leader, so ask about one.
• You leak urine when you lift, jump or cough. A pelvic health physical therapist can help.
• You have joint or back pain that lasts more than a day or two after a session.
• Hot flashes, sleep problems or low mood are getting in the way of daily life.

The bottom line

Three strength sessions a week, five minutes of balance in each, and plenty of walking cover the basics after menopause. The bone benefits are modest, the balance evidence comes mostly from older people, and exercise may not ease hot flashes much. None of that is a reason to skip it. Start light, write it down, and let small, steady increases do the work.

Sources

• Frontiers in Physiology (2020): Effect of Exercise Training on Bone Mineral Density in Post-menopausal Women: A Systematic Review and Meta-Analysis of Intervention Studies
• Cochrane (2019): New Cochrane review assesses the benefits and harms of exercise for preventing falls in older people living in the community
• British Journal of Sports Medicine (2020): World Health Organization 2020 guidelines on physical activity and sedentary behaviour
• Cochrane (2014): Exercise for vasomotor menopausal symptoms
• Maturitas (2019): Resistance training for hot flushes in postmenopausal women: A randomised controlled trial
• NHS: Things you can do to help menopause and perimenopause symptoms