“What do you need to consider when training perimenopausal, menopausal or postmenopausal women?”

Perimenopause presents an array of challenges for women, including mood swings, depression, irritability and sleep disturbances. Pilates is an excellent way to improve a woman’s mood and ability to sleep, as well as increase her energy. The breathing techniques used in Pilates calm and relax the mind. The weight gain around a woman’s midsection, which often accompanies menopause, can be reduced with Pilates.

Postmenopausal women are at risk for decreased bone density. They may also face osteopenia or osteoporosis. Weight-bearing exercise is excellent for these women, and more resistance can be added to aid in improving bone density. However, if the client has received a diagnosis of osteoporosis, flexion exercises should be avoided, and extension exercises added. Balance is a factor as women age, so many of the Pilates exercises are useful in improving balance and maintaining ankle strength and flexibility.

I have found Pilates one of the best types of exercise for both perimenopausal and postmenopausal women. It increases strength, flexibility, endurance and energy levels, improves posture and gives participants an overall sense of well-being.

Patricia Welter
Suncoast Pilates
Palm Harbor, Florida

When I began perimenopause and menopause, about 20 years ago, I real- ized that I had entered an interesting new chapter in my life. I was fit and ate a nutritious diet, yet much to my surprise there were still subtle changes to my body that were accompanied by a sudden shift in self-confidence. To help me get back on track, I began reading the latest research on the subject, and my research eventually helped me “tweak” my life-style so that I could cope with most of the unwanted side effects of menopause.
I have managed (with some effort) to stay confident and in reasonable shape.

As a personal trainer, I originally thought that helping this population would be simple. As trainers, we know how to prescribe a good lifestyle plan. I quickly discovered that in the case of women with shifting hormones, devising a plan is not necessarily a simple task; the hormonal imbalance makes the response to everything different for each woman.

One of the biggest challenges is the occurrence of insulin resistance and that darned belly fat. Orthopedic problems are common in this population. Mood swings and a lack of confidence make adherence to exercise programs difficult for some clients. Tiredness creates odd cravings, in particular for carbohydrates, starting a vicious circle of lack of sleep and poor eating habits. Body shape begins to change, with the accompanying reduction in confidence. Other health problems may also occur.

If you are an IDEA member, you probably already know that there is a mass of information on this subject on the IDEA website.

Good trainers can design programs for their clients that will ensure the clients’ success. However, in the case of menopausal women, trainers may have to be just a little more particular.

For example, one of my clients worked part-time as a lawyer and was also a wife, a mother of two children and a grandmother of two. Menopausal symptoms had crept up on her “out of the blue,” she said. She did not regularly work out, so to help her develop the exercise habit I used the 10,000-steps-per-day program, as well as strength and flexibility training. I also asked her to keep a food diary.

She attended every training session and kept a comprehensive food diary, but she seemed reluctant to begin the walking program. Eventually, I asked if there was a problem with walking as exercise. After some initial embarrassment, she admitted that she had pelvic-floor and stress-incontinence issues. To address these problems, we mapped out a walking route that passed a supermarket, where she could use the facilities if necessary. I also suggested she attend my Pilates class to work on pelvic-floor exercises.

My client ate a relatively low-fat diet, but to save time she regularly used pre-cooked, packaged food. I taught her to read food labels and showed her that it was just as easy to make simple meals from scratch that were quick to prepare, free of added sugar, nutritious and relatively low in fat.

She occasionally complained of backaches, and her posture needed work. I introduced standing Pilates techniques into our sessions to help with these issues.

I also suggested that since she had been a swimmer when she was younger, she might start swimming to add variety to her exercise program. I was not prepared for her reaction to this. She told me she had not been in a swimsuit for 25 years and wasn’t about to do it now. She did not turn up for her next session with me. A few days later she called and apologized, saying she had been feeling a little unhappy that day and was just generally feeling old. I said I understood and appreciated how she was feeling. I explained that it was probably her hormones speaking and not her. I suggested that I would go with her to the pool, and that we would go to a ladies-only session to see how it worked. She was delighted.

Today she has lost the extra pounds around her waist and belly that she had gained at the beginning of her menopause. I attribute this to the fact that when she began to feel better, and the hot flashes diminished temporarily, she became more interested in exercise. She tells me that avoiding added sugar seems to make her less tired during the day; she feels more alert in the evenings; and most of the time she sleeps better at night. I taught her to recognize those days when her hormones make her feel unhappy and when an extra walk or swim might help. She still sees me for a training session from time to time, and I suggest solutions to any difficulties she may have with her exercise program due to her menopause.

Pamela Anne Smith
Group Exercise Instructor, Personal Trainer and Certified Pilates Teacher
Aberdeen, Scotland

Over the years I have worked with women in their 40s and 50s, and now I’m one of them! The most important advice is to be sensitive to their needs and present yourself as a good role model.

Remain professional at all times and listen to what these clients are telling you. Also, look for any negative attitudes on their part. Over the years, I’ve learned that this might be their way of communicating something verbally that they may be experiencing internally.

Ana Yount
Elite Fitness Training for Women
Ojai, California