Excerpt from Mind Over Menopause

Excerpt from Mind Over Menopause, by Leslee Kagan, M.S., N.P., Bruce Kessel, M.D., Herbert Benson, M.D.

Chapter 5: Moving Through Menopause

EXERCISE TO IMPROVE MENOPAUSAL SYMPTOMS

In the 5th Century BC, Hippocrates wrote, “Eating alone will not keep a man well; he must also take exercise. For food and exercise, while possessing opposite qualities, yet work together to produce health.” For women, exercise can be a soothing balm in the face of tension, an invigorating release in the presence of hormonal disruptions, and a way to preserve the physical freedoms we all associate with youth. Exercise holds so many benefits for the menopausal woman that we consider it an essential part of our programs.

What’s more, exercise mimics a “fountain of youth” in a number of ways. Studies have shown that much of the physical deterioration that takes place between ages thirty and seventy is related to a sedentary lifestyle, not the aging process. Exercising does its magic by slowing deterioration of various body systems. It can help reverse problems associated with the so-called “normal” aging process, such as loss of muscle strength and bone mass, and impairments in sleep, sex, and cognitive function. Even many of the physical changes generally associated with menopause may actually be a product of inactivity and not solely hormones.

Many women report that exercise improves PMS symptoms and hot flashes while boosting body image and mood. It’s also great for maintaining bone density and helps maintain balance and flexibility, which decreases your risk for falls and fractures as you get older.

Hot Flashes

Many women report that regular workouts help reduce the number of hot flashes and night sweats. And there are data to support their observations. In 1990, a Swedish study followed 142 women going through natural menopause, without hormone therapy. Women known to exercise regularly reported half the number of moderate and severe hot flashes as did women who did not exercise regularly. Eight years later, research from University Hospital, Linköping, added to the data. In this research, only 5 percent of very active women experienced severe hot flushes as compared with 14–16 percent of women who were sedentary. Weight, smoking, or hormone therapy couldn’t explain the difference. Certainly it’s possible that there’s something about women who exercise regularly that makes them less prone to (or less bothered by) hot flashes. However, there is also a potential physical explanation: regular exercise affects the brain chemicals responsible for regulating body temperature.

Exercise offers a natural way to fend off hot flashes, with lots of extra benefits and virtually no downside.

PMS Symptoms

A small study from Duke University examined the effects of aerobic exercise and strength training in healthy premenopausal women. After three months, the women who exercised not only experienced fitness gains, but they also had less severe PMS symptoms. And aerobic exercise appeared more beneficial than strength training, particularly for PMS-related depression. In another study, one group of women participated in a running program — half of them had not exercised regularly before the study; the other half were regular exercisers and ramped up their running to train for a marathon. The second group of women was normally active, but did not undertake an aerobic training program of any kind. After six months, all of the exercisers reported less fluid retention, depression, and anxiety than did the nonexercisers.

These were small studies, but many women report that regular aerobic exercise helps them manage PMS. How might exercise make a difference? First, it boosts endorphins. These neurotransmitters can improve mood and sense of well being. Other possible benefits include stable blood sugar levels, which might help reduce cravings, improve energy, and reduce stress and anxiety.

Mood Swings

For many women, exercise can put the brakes on a bad mood, anger, depression, and anxiety. “I know I feel better when I exercise. If time goes by and I can’t, I can feel the tension in my body. The tension makes the stress worse and stress makes the hormones worse,” said one woman in our program.

This reaction to exercise underscores the important mind/body connection mentioned above. Aerobic exercise prompts the release of mood-lifting hormones and neurotransmitters, which relieve stress and promote a sense of well being. Duke University scientists even found that regular aerobic exercise could be as effective as an antidepressant drug in reducing symptoms of depression in older individuals. A follow-up study found that people who continued to exercise not only continued to benefit, but were also less likely than those on medication to suffer a relapse of depressive symptoms.

Because of our cultural obsession with young and beautiful bodies, some women fear that menopause signals a loss of attractiveness and vitality. For women at mid-life, regular exercise has been shown to improve body satisfaction, self-confidence, and sense of control, and decrease anxiety associated with body image.

Improved sleep

Exercise facilitates sleep by producing a significant rise in body temperature, followed by a compensatory drop a few hours later. The drop in body temperature, which persists for two to four hours after exercise, makes it easier to fall asleep and stay asleep. An extra benefit of quality sleep: improved mood.

Controlling weight changes

As they age, many women also find they put on pounds where they never had before, especially in the stomach and waist. Exactly what causes this is unclear. The end of ovarian function may influence how the body stores fat. Unfortunately, this switch to abdominal fat storage is associated with increased heart disease and may be one reason a postmenopausal woman’s risk of heart disease increases to match that of a man. People who are “apple shaped,” that is they put on extra fat around the middle, are more likely to experience certain health problems compared to people who are “pear shaped” and carry extra weight in their hips and thighs.

Women at any age are generally at a disadvantage compared to men when it comes to keeping the pounds off. The following physiological differences between men and women help explain why women do have to work a little harder:

• Women tend to store fat in their hips, thighs, and buttocks. This is the hardest type of fat to lose, since fat metabolism in this part of the body is less robust than in the upper abdominal region, where men tend to store fat. Women can lose fat, but it generally takes more effort.
• Women tend to have a resting metabolic rate that is 5–10 percent lower than that of men. Because of the lower metabolic rate, women tend to burn calories more slowl y.
• The average American woman has 36 percent body fat, while the typical man has 23 percent. (The amount considered normal is about half that amount: 18–22 percent for women, and 12–15 percent for men.) Because muscle burns more calories than fat, this type of body composition also slows weight loss in women.
• Due to their lower resting metabolism and higher percentage of body fat, when women exercise, they burn up to 40 percent fewer calories than men doing the same activity.

Many women complain they have a harder time controlling weight as they get older. In general, women tend to add more body fat and lose more muscle than men do over the years. Research shows this is because women, in general, become less active as they age. Increasing exercise would help women close this gap.

Regular physical activity, done over a prolonged period, will reshape your body by building muscle, boosting your metabolism and burning fat. The more muscle you have, the more calories you burn all day long, so lowering your percentage of body fat while increasing muscle is an investment that pays off throughout the day.