DR. SHEELA NAMBIAR, M.D.

Working out through menopause has several benefits. Here's why you should continue to exercise through that difficult phase.

Menopause can be defined as the cessation of ovulation and, therefore, menstruation for a minimum period of a year. It results from the drop in the hormone oestrogen. It can be a demanding time for some women.

Besides the physical symptoms like hot flashes and fatigue, weight gain and wrinkles, they are often plagued by mood swings, depression, anxiety, memory problems and irritability. It is, however, a natural aging process. A stage in life that has to be endured, if not effectively managed.

Perimenopause is that transitional period of a couple of years before actually attaining menopause. It has been found that exercising regularly through your perimenopausal years makes the transition easier and symptoms less traumatic.

There are several benefits of working out through menopause. The typical ‘menopausal weight gain', which most women use as an excuse to take cover under, need not be the bane of your life. Yes, of course, the body slows down and losing weight or, for that matter, even maintaining weight at this point seems like a herculean task. It doesn't help to be fatalistic.

Working out through menopause helps you stay positive even when everything appears bleak and dismal. This perhaps is one of the biggest benefits. The emotional roller coaster one suffers seems somehow more manageable.

Exercise routines

What is the kind of exercise routine one needs to follow?

If you have been working out regularly and are in a fairly fit condition, there is no need to settle for a rocking chair once you attain menopause. When you find your energy levels don't permit a high-intensity workout, however, you may need to ease off and listen to your body. It is important to also improve strength and flexibility, which are invariably compromised with age.

In addition, your cardiovascular training should be sustained to maintain or lose weight while improving the condition of your heart and lungs and preventing diseases like coronary heart disease, diabetes, hypertension etc.

Cardiovascular training: 4-5 days a week: Cardio keeps your spirits elevated and adds that much needed zest to your day. Incline walking, cycling, cross training can all be used interchangeably as forms of cardio. They are safe and highly effective when done at the required intensity.

Some women continue to enjoy aerobic classes and even venture into newer forms of exercise styles like salsa, dancercise etc. If you enjoy the variety, more importantly if you have the aptitude for it, there's no reason why you shouldn't experiment. In a class situation, the exercise should be low impact and age appropriate.

The key however is to understand that “intensity” is important. This is where your METs (Metabolic Equivalent) become relevant (www.hindu.com/mag/2009/08/02/stories/2009080250230600.htm).

Your Metabolic Equivalent is the ‘ intensity' or ‘training heart rate level' you need to try to sustain while working out and a new study has stipulated standards specific to women. This intensity can be reached only if one is able to perform the chosen exercise correctly.

Struggling with the complicated choreography of an aerobic class may not elevate your intensity enough for you to get a good workout. In this case you may be required to use plain old walking as your main mode of exercise and leave the classes as an outlet just for fun and diversity.

Weight/Strength training: 20-30 minutes, 3 times a week: Weight Training through menopause is probably one of the most crucial and over looked aspects of fitness. Indians already endure Sarcopenia or an overall lower muscle mass, which drops further with age. This makes it imperative that women train with weights through their menopausal years.

Don't be afraid of using weights. Increasing the size and strength of the muscles has various benefits; primarily, an increase in muscle mass helps increase fat loss. If that isn't motivation enough, an older woman has poorer reflexes, balance and strength. All of these encourage falls and recurrent injury.

A rational way of reducing these accidents is to get stronger and better coordinated. The abdominal fat that typically accumulates with age, thickening the waist to non-existence, cannot be addressed with cardio alone.

Osteoporosis, which is a debilitating disease, can be prevented with weight training. Last but definitely not least, the improvement in muscle tone makes for a younger and much shapelier silhouette.

While many women want to concentrate on the lower body, it's equally important to train the upper body, especially for menopausal women who are losing bone mass and could be experiencing spinal changes (developing “dowager's hump,” for example).

Keeping the muscles of the upper back and chest strong can help prevent this. The arms and shoulders are rarely exerted against resistance (when was the last time you moved a cupboard or ploughed a field?), and therefore need to be addressed using moderately heavy weights.

An older woman who is more mature (hopefully), is often attracted to the slower pace of an exercise modality like weight training which requires enormous focus and is very different from the frenzied cardio sessions that one used to enjoy and attribute to a younger age. Take advantage of this paradigm shift and re-organise your workout to include more weight training and mind-body workouts, relaxation and breathing.

Flexibility Training: 10 Minutes, preferably, every day: Simple total body stretches are a remarkable way to stay limber. Combine east and west to add variety to your stretching. For example, t'ai chi is wonderful for shoulder flexibility, and the imagery that goes with it is very soothing. Keep in mind modifications for safety. Yoga is a tremendous complement to your fitness routine and adds a touch of Indian ethnicity that a lot of women enjoy besides improving flexibility of the entire body. There are several forms of yoga that also increase strength by using the upper body.

Stay motivated

Finally, Training the Mind. The menopausal years often coincide with retirement, children leaving home and other events that can create the illusion of not being needed or even a sense of lack of meaning to one's life. From a different perspective, this can be a great time to focus on oneself and grow to great personal strengths.

Staying motivated and passionate about work, hobbies, friends, or causes help keep the mind youthful. Losing interest in life in general is perhaps more detrimental than the hot flashes, moodiness or memory loss. These symptoms are but a passing phase. A phase that can be facilitated to a great extent by working out!

It has been found that working out regularly improves self-esteem, cognition, memory and coordination. So be advised, even if your last meal or where you parked your car or left your house keys is sometimes a hazy memory, make a note of your fitness routine and stick with it.

Dr. Sheela Nambiar M.D, is a Obstetrician/Gynaecologist, Fitness and Lifestyle Consultant NAFC (USA) and Director, TFL Fitness Studio, Chennai. E-mail drsheela@tfl-inc.com