Excerpt from Mind Over Menopause
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.
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.
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.
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.
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
- 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.