My name is Lisa Austin, I am a personal trainer and soft tissue therapist. I am also studying cognitive behavioural therapy which is proven to be a hugely beneficial therapy for women in menopause suffering with hot flushes, anxiety and low mood.
I am a 49-year-old mum of 3 boys, 22, 15 & 14. Menopause and puberty in the same household is not be laughed at!
I had a total hysterectomy & oophorectomy in December 2019, so I am now in surgical menopause as I have no ovaries. I embarked on a journey to learn everything possible about menopause when I was told of my upcoming surgery in May 2019.
Even though I was 47-years old I did not think I was in peri- menopause! I didn’t have hot flushes, anxiety, or brain fog (the most well-known symptoms) so I didn’t connect the strange onset of constipation over the previous 18 months to being peri- menopausal. The worrying thing is, neither did the colorectal consultants, GP or gynaecologist who performed a number of invasive tests to only note everything was initially normal. It’s only when I started to dig deeper that I realised my digestive/bowel issues were caused by the falling oestrogen levels. This constipation over time led to a severe uterine prolapse and there I was, booked in for major surgery and facing a future with surgical menopause.
One thing I noticed while researching surgical menopause was how little information was available regarding exercise for peri & post-menopausal women. Yes, there are mentions of the benefits and you can find general information, but I was looking for the deeper science, the specifics and evidence in medical journals of research papers documenting proven results and most importantly the programming. As a personal trainer I wanted to find the best proven type of training to give me the finest possible quality of life going forwards.
Menopause is a completely natural and normal event that every woman will experience. Our reproductive years end and our periods stop. Meno – Pause, translates to the pausing or stopping of menstruation. We are deemed to be peri- menopausal in the time of transition prior to this and post menopause after 1 year of our last period. In the UK the average age for a women to reach menopause is 51.
If the menopause occurs before the age of 45, it is medically classed as early menopause and this actually affects around 10% of women. We also have women that are put into early menopause, surgically. My mum died of breast cancer at the age of 41 and was put into surgical menopause at the young age of 37. I was only 17 at the time, but I recall the hot flushes, night sweats and her mentioning heart palpitations.
Let’s look first at what happens to a woman’s body when we start to enter peri- menopause. Women have two ovaries, grape sized glands located at either side of your womb (uterus). The ovaries produce the eggs for fertilization and they produce hormones – oestrogen, progesterone and testosterone. These hormones regulate mood, affect processes such as growth and development, sexual function and reproduction. Each hormone is important and as our ovaries come to the end of their natural life, the amount of each hormone reduces.
Oestrogen – Protects our arteries and heart, lubricates the vagina, regulates mood, body temperature and memory (cognition). It also helps stimulate bone growth, maintains strength and lubricates the joints. We also produce small amounts of oestrogen in our adrenal glands and fat tissue but the main source is from our ovaries. So with depleting oestrogen comes a reduction in muscle mass (sarcopenia) and this loss can be reduced by resistance training
Most adults will lose approximately 6 pounds of muscle per decade, which is a huge amount of wonderful muscle mass to drop! Muscle keeps our joints supported, moves our limbs, improves our metabolic rate and gives us shape/structure. Having strong muscles will reduce our risk of injury, improve stability and improve our performance in daily life. There are other factors that reduce muscle mass as well as physical inactivity and oestrogen loss, such as inadequate dietary protein, injury, illness and some neuromuscular conditions.
Sarcopenia in women starts to occur most rapidly after the age of 50. Here are some facts:
Several studies have shown that resistance training is effective in reducing age-related loss of muscle mass in post-menopausal women (e.g. 3 times a week for a year)
Menopause is also associated with a reduction in bone mineral density, and use of HRT and resistance training can both reduce the extent of these losses
Bone is a living tissue that regenerates throughout our lives. Up to the age of about 30 we will build more bone than we lose but after that, our bone tissue naturally starts to decrease, hence we see skeletal degeneration. Lack of oestrogen impacts on loss of bone density hence why it reduces so much after menopause
It’s not looking great for menopausal women is it? Muscle loss and reduced bone density! I was not ready to become weaker and risk broken bones. But with evidence showing that weight bearing/strength/resistance training is hugely beneficial I started looking for more evidence and research for a specific tested program to refer to that related directly to women and menopausal symptoms – such as hot flushes! Can we continue to build muscle mass as we age and go into our menopause?
Reduced hot flushes
In 58 post-menopausal women, a 15-week high-load resistance training programme has been shown to reduce the frequency of hot flushes in women (average age 55 years)
Here are the details of the specific program
Participants in the control group were instructed not to change their physical activity habits during 15 weeks and to avoid any other treatment for hot flushes.
Physical activity doesn’t strengthen all bones, just those that are stressed, so you need a variety of exercises or activities to keep all your bones healthy. Such “weight-bearing” exercises include walking, dancing, jogging, weightlifting, stair-climbing, tennis & badminton, aerobics. Swimming is a useful form of exercise for the heart and cardiovascular system but because water supports the bones, rather than putting stress on them, it’s not considered a good “weight-bearing” exercise for bone strength so is not my go to for menopausal women.
I have always been an advocate for strength and resistance training for women. Many ladies worry that they will become bulky and look masculine when they start a strength/hypertrophy program but I assure them that muscle is very difficult to build. It is much easier to lose fat than build muscle and women lack human growth hormones, we cannot bulk up the same way men can without stimulants.
When I take on a new female client and I ask them what is your goal? The most common reply is ‘to lose fat and get toned!’. This ‘tone’ is muscle so please do not be fearful of lifting heavy weights, it is of huge benefit to us.
Jo Latham, a Nutritional Therapist from Well & Nurtured, works with me to provide all nutrition plans and recipe books to ensure women are given the most up to date and correct advice on nutrition. We offer bespoke, personalised plans and also a full testing platform if women want investigate gut health and intolerances.
What we eat can make a real difference to the way we look and feel and this is particularly true in the lead up to and during the menopause. A few small changes in your diet can have a big impact, providing your body with the essential vitamins
Remove/Reduce the following…
Eat plenty of fruit & vegetables…
Go for complex carbs…
Ditch white carbohydrates and opt for brown rice, whole wheat pasta, beans, chick peas, oats and wholegrain breads. You will feel fuller for longer and your energy levels will stay constant.
Love good fats…
We need the right kind of fats to balance hormones, keep skin supple and prevent heart disease, cancer and even depression.
Know your phytoestrogens…
Look for good sources of Fibre…
Aim for a minimum of 30g per day to support regular bowel movements, calcium and magnesium absorption and blood-sugar balance.
Grains such as oats, barley, quinoa, buckwheat, wholegrain wheat and rye
Fruit especially raspberries, oranges, strawberries, kiwi, apples, blueberries, figs, grapefruit, plums.
Beans and Pulses such as chickpeas, lentils, black beans, pinto beans, kidney beans.
Vegetables such as carrots, parsnips, beetroot, squash, green peas, spinach, Brussels sprouts, cabbage, Swiss chard, cauliflower, kale, sweet potato, white potatoes, mushrooms (shiitake), onions, leeks.
Calcium is a vital mineral for bone health. It is also very important for other physical functions, such as muscle control and blood circulation. Calcium is not made in the body — it must be absorbed from the foods we eat. Jo recommends that we only consume organic dairy products due to the added antibiotics and growth hormones in non-organic products.
Enjoy the sunshine…
Vitamin D is vital for hormone and general health.
The best source is the sun! Around 5 –30 minutes daily exposure on face, neck and arms minimum is beneficial, especially if you work indoors.
Helpful Tip: depending on your skin type you may need more or less sun exposure; the darker your skin, the longer you need to get adequate levels of Vitamin D from the sun.
Supplementation of 10 micrograms is recommended by Public Health England during October to March.
Ensure you get adequate amounts of restful sleep…
It will reduce stress levels and support adrenal function. Exhaustion can lead to blood-sugar imbalances. At night time our bodies eliminate toxins and produce hormones, so restful sleep is so important.
Tip: Create a daily routine to help support your natural circadian rhythms. Wake up and go to bed at the same time, even on weekends.
It’s not easy to reduce stress levels in this day and age. But it’s vital to support the balance of hormone production as adrenal fatigue, from being stressed over long periods, can dramatically alter this balance. Try adaptogens such as Rhodiola, Ashwaghanda and Korean Ginseng.
The Easiest Breakfast Smoothie –
1 big handful of spinach (35g)
2 handfuls of frozen berries (these keep it cool and are much cheaper than fresh berries, but fresh berries and a little ice work perfectly instead)
1 cup of almond milk (250ml)
3 tablespoons of oats
1 tablespoon of hemp powder
1 tablespoon of chia seeds Optional:
2 medjool dates
Simply peel the banana and pit the dates, then pour everything into your blender and blend until smooth.
Please feel free to contact me if you would like any advice on exercise protocols. I will be offering sessions from mid-June in line with government guidelines following social distancing and cleaning.
Lisa runs a gym based in Great Offley which is near Hitchin, Hertfordshire called Rock Health and Fitness. They offer personal training, group classes, Yoga, a free running club and various other workshops and events throughout the year.