Physical activity engagement during the menopause transition
- Dr Kelly McNulty
- Apr 24
- 6 min read
What is the menopause transition?
The menopause transition – or perimenopause - is the time between having regular periods and reaching menopause (1). Menopause happens when a woman has gone 12 months in a row without a period, due to the ovaries stopping normal function, and not any other medical reason.
Menopause symptoms
Although every woman experiences the menopause transition differently, research shows that most women will experience some symptoms during this time (2).
These can include physical symptoms like:
Hot flushes/night sweats
Muscle and joint pain
Body shape/weight changes
Vaginal dryness
As well as psychological symptoms like:
Mood swings
Depression
Anxiety
Memory problems or ‘brain fog’
These symptoms and any related physical or mental health challenges can continue after the menopause transition into post-menopause, affecting a woman's health and well-being.
Benefits of physical activity during the menopause transition
Research suggests that healthy habits, like staying physically active, can help women maintain good health and well-being during and after the menopause transition (3, 4). In fact, many studies show that regular physical activity has several benefits, including better heart and muscle health, healthy weight management and improved mental well-being.
Declines in physical activity during the menopause transient
Despite the known benefits of physical activity, research shows that many women become less active during the menopause transition. For example, data show that one in three women in the UK, aged 41 to 60 years, are not getting the recommended 150 minutes of physical activity per week, including muscle-strengthening exercises twice a week (5). In Ireland, 61% of women in midlife are not meeting physical activity guidelines (6). To help address the drop off in physical activity during the menopause transition, it is important to understand what motivates, supports, or stops women from staying active.
Understanding the motivators, facilitators and barriers for physical activity during the menopause transition
In our 2024 paper, we explored how Irish women experience the menopause transition and how it impacts physical activity engagement. To do this we interviewed 12 women asking them about their experiences, focusing on motivators (e.g., what encourages or drives you to be physically active during the menopause transition?), facilitators (e.g., what factors make it easier for you to stay physically active during the menopause transition?), and barriers (e.g., what challenges or obstacles prevent you from engaging in physical activity during the menopause transition?) to staying physically active. The interviews were audio-recorded, transcribed and analysed thematically*.
*Thematic analysis helps researchers make sense of large amounts of text by organising it into key themes or topics that explain what is going on in the data.
Key findings
All participants self-reported experiencing physical and psychological symptoms related to the menopause transition, with the top three being:
1. Weight gain/body shape changes
2. Lack of energy, tiredness, and fatigue
3. Anxiety, depression, and mood changes
Twelve themes were identified which fell under three main categories:
Categories | Themes |
Motivators to engage in physical activity |
|
Factors that facilitate engagement in physical activity |
|
Barriers to physical activity engagement |
|
Motivators to engage in physical activity
Managing menopause symptoms:
Women spoke about how symptoms affected their health, which motivated them to participate in physical activity. In particular, women reported that physical activity helped reduce symptoms like mood swings and anxiety, improving their mental health. Despite challenges like fatigue, physical activity provided relief, motivating continued participation.
Future health: While not facing major health issues, many women became more health-conscious in midlife. They were motivated to engage in physical activity to prevent future health problems and ensure independence, often inspired by older relatives’ struggles with ageing. Additionally, for most women their motivation shifted from engaging in physical activity for body image reasons to optimising healthy ageing.
"This is an asset to me for the rest of my life. The physical activity for me isn’t just to get me through menopause, but beyond. It’s important for health reasons, both physiological and psychological. I’ve always felt it was important, but now, for me, it’s even more important to keep being active for health reasons as I get older." Roisin.
Social engagement and reward: Socialising with friends and family was a key motivator for women, making physical activity more enjoyable. Family support helped overcome midlife barriers, while achievements like reaching fitness goals or proving others wrong by challenging negative perceptions of physical activity during midlife, provided additional motivation.
Role models: Relatable role models, particularly other women in midlife, inspired women to stay active. Many also viewed themselves as role models, motivating them to engage in physical activity, especially for their children.
Factors that facilitate engagement in physical activity
Fraternity: A sense of community with other women experiencing the menopause transition encouraged physical activity participation, offering a space to share experiences. Many preferred women-only spaces for their empathy and understanding.
"You know, you meet your little tribe of people. In the running club, we’re all in our 40s and 50s. We’ve all either been through menopause or are going through it, and since we have different symptoms, we’re able to talk about things." Alison.
Adaptation and modification: Women adapted physical activity to their life stage, joining menopause-specific classes or modifying exercise intensity. Pre-planned group activities also helped with accountability, boosting participation on low-motivation days.
Medical supports: Medical treatments like hormone-replacement therapy (HRT) helped some women improve quality of life, making it easier to engage in physical activity despite menopausal symptoms.
Barriers to PA engagement
Perceived reduced capability: Many women felt less capable of high-intensity activities due to aging or injuries, such as wrist or back pain, and illnesses like long COVID. Past physical activity experience also led to self-doubt, while negative past experiences discouraged others from trying again.
"I wouldn’t be trying anything like a dance class or aerobics now. At this stage, I feel like I wouldn’t be as capable as I would have been before. I did think about running, but I think I’m past the age for it. I might injure myself if I start running now." Sue.
Symptoms associated with the menopause transition: While some women were motivated by menopausal symptoms to stay active, others struggled with physical symptoms like heavy bleeding or weight gain, and psychological challenges such as low energy and motivation. Lack of education about menopause and the potential benefits of engaging in physical activity reinforced these barriers.
Busyness of life and competing demands: Balancing work, caregiving, and menopause made it hard for many women to prioritise physical activity. Competing responsibilities often led them to neglect their own needs.
Lack of supportive environments: Many women felt out of place in intimidating, male-oriented gyms and lacked access to menopause-specific programs. They also felt fitness professionals often lacked knowledge of menopause, adding another barrier. Other challenges, like travel and cost, further discouraged physical activity participation.
Conclusion
Overall, our findings indicate that the menopause transition strongly influenced physical activity in Irish women. The main motivators included managing symptoms, improving future health, social connections, rewards and relatable role models. Supportive communities, adapting activities and medical help also made it easier to stay active. However, women faced many barriers, such as feeling less capable, menopause symptoms, busy lives and a lack of supportive environments. It is important to raise awareness and address each of these unique motivators, facilitators and barriers to ensure that women’s needs are met throughout the menopause transition, which will allow them to either continue or (re)introduce physical activity during this time.
Calls to action
Below are six key steps to help keep women engage in physical activity during the menopause transition:
Keep it fun and social: Physical activity during the menopause transition should be social, fun, and engaging. While health benefits like symptom relief are important, the focus should be on enjoying the activity itself.
Build communities: Community should be central to physical activity during the menopause transition, fostering connection and shared experience. This can be done by offering activities alongside support groups.
Targeted opportunities: Women in the menopause transition often feel overlooked in physical activity settings, highlighting the need for targeted and tailored opportunities as well as encouragement to try new activities.
Flexible options: Initiatives could offer flexibility, like pay-as-you-go sessions, in-person/online activities, as well as shorter/modified sessions, to remove physical activity barriers during the menopause transition.
Welcoming spaces: It is important that the environment for physical activity is welcoming and non-judgmental, with women-only spaces preferred during the menopause transition.
Relatable role models: Imagery used to promote physical activity should feature women in the menopause transition, offering relatable role models. Featuring real women in this life stage can break down barriers and inspire others.
To read our paper in full please see here: https://doi.org/10.1186/s12905-024-03524-y
Research Report- Link to the Research Report
Infographic - Link to the Infographic
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