Postmenopause is marked by accelerated muscle and strength loss, and, consequently, an increased risk of osteoporosis and falls. Fortunately, exercise can help us slow down this muscle and strength loss, so we can continue living full independent lives without fear.

To ensure we keep our bodies strong, balanced, and mobile, engaging in a wide range of exercise types is key. Different modalities target muscle mass and strength as well as proprioception (body awareness) and balance. What’s more, mixing things up keeps things from getting monotonous—so you can reframe exercise as a choice, not a chore.

Strength Training

Resistance training (also called strength training) is vital for maintaining and increasing muscle mass, as well as supporting bone health. Body composition changes in postmenopausal women may require larger training volumes than you’re used to, with at least two resistance training days (> 6–8 sets/muscle) per week.

The building blocks of an effective strength training routine include:

• Duration: It takes about 6 to 9 months, but preferably 12 to 24 months, to see bone health benefits from strength training.
• Frequency: Try to commit to engaging in strength training at least two to three times per week, targeting all major muscle groups, especially hip and spine (areas where low bone density is common).
• Intensity: Aim for ****moderate to high-intensity loads (meaning heavy for you) during your exercise. In other words: 2–3 sets of 8–12 repetitions at 70–85% of your maximal muscle strength.

Creatine can also enhance the benefit of strength training. A recent literature review highlights the many benefits of creatine supplementation for women across their lifespans. It can improve strength, power, and athletic performance by increasing lean muscle mass and delaying neuromuscular fatigue. Creatine may also provide cognitive benefits such as reducing mental fatigue, supporting normal memory functions, and improving mood—specifically in menopause! Creatine has been widely used and studied across different populations and is generally safe (look for creatine monohydrate).

How to take creatine:

• Option 1: Use a loading dose phase to reach saturation quicker. Take 20 mg (spread over 4x5 mg doses) of creatine for five days.
  • Maintenance dose: continue with 3-5 mg/day
  • (The calculation for how much to take is 0.3 grams of creatine per kg of body weight every 4 hours for 5 days and then 0.03 g/kg/daily which is 5 grams per day for a 150 lb woman. This 20 mg loading dose is calculated for a 150lb woman)
• Option 2: Use a consistent routine dosing, 5 grams per day. It will take 3-4 weeks to reach saturation with this dosing; however, some women prefer this as there can be water retention with using the loading dose regimen. If water retention with this dosing is still too much, decrease to 2.5 grams per day.

Take creatine with a usual meal or add it to a protein shake. Note that creatine is not appropriate for women with kidney disease. As always, when in doubt, you should discuss any supplementation with your provider.

Plyometric Training

Plyometric training, which includes jumping and other explosive movements, can have similar effects on muscle growth as resistance training. Research indicates that plyometric exercises, in combination with resistance training, can enhance bone density, reduce fracture risk, and significantly benefit bone health in postmenopausal women. Pretty cool, right?

Proceed with caution. If you’re diagnosed with osteoporosis, you should skip high-impact exercises. Always consult with your doctor before starting any new routine.

Flexibility and Balance Exercises

Interestingly, for many women, the fear of falling itself can actually become a self-fulfilling prophecy. When we reduce our activity (out of fear of falling) this can cause a slow decline in mobility and functionality that actually increases the likelihood of falls.

Practices like Tai Chi and Pilates can improve balance, strength, flexibility and prevent falls. For fall prevention, aim for 3 hours of balance exercises per week.

Aquatic exercises ****have been shown to significantly improve strength, agility, flexibility, and overall quality of life in postmenopausal women as well. Many women find water exercise enjoyable—who doesn’t love a refreshing dip?—and it may also be easier for those of us managing joint pain or injuries.

• Take One Step: if you’re just starting out, pick one type of exercise you can incorporate easily. For example, Tai Chi or bodyweight strength training are great starters, because they don’t require equipment and can be practiced anywhere. Whatever modality you start with, try focusing on getting consistent and ensuring you enjoy the activity before you take the next step and invest in equipment or join a group.
• Keep progressing: To continue reaping the rewards, gradually increase the intensity, volume, and/or challenge of exercises.
• Mix it up: You can't get all the benefits from just one type of exercise, so add variety to your movement practice to spice things up. This not only helps you reap the most benefits, but also keeps you from getting bored—meaning you’ll probably be more likely to keep it up!
• Listen to your body: Pay attention to how your body responds to exercise. If you experience pain or discomfort, scale back or modify the activity to avoid injury.
• Consider hiring a fitness pro: If you’re starting out, hiring a fitness pro can help set you up for success. Studies show that people who participate in supervised training have higher adherence, motivation, and safety.

Incorporating a mix of exercise modalities, starting slowly, setting realistic goals, and choosing enjoyable activities are they key ingredients for jump-starting and maintaining an active lifestyle during your postmenopausal years. But let’s not just leave it there. Remember, the positive impact of exercise extends far beyond physical health, offering significant benefits for your mental and emotional wellbeing as well. So, get curious and get moving, so many good things are ahead!