Women’s Health and Exercise
Share tips from women's health research with clients to help them address anxiety disorders and menopause symptoms through movement.
Keeping up with women’s health issues gives fitness pros a unique opportunity to guide their female clients toward a healthier, movement-oriented lifestyle.
This women’s health research update discusses scientific findings you can use to educate your clients and plan smart programs. Following are two of five topics originally covered in the July-August 2018 issue of IDEA Fitness Journal. After going in-depth with these two topics, revisit the other 3 women’s health issues originally covered (type 2 diabetes, cardiovascular disease, and osteoporosis). Learn about each health condition, associated risk factors and pertinent research developments; then apply the practical training guidelines.
Anxiety Disorders and Exercise for Women’s Health
Intermittent worry is a normal part of life for many women. Meeting deadlines at work or school, paying all the bills on time, and making life-changing decisions are events that can add stress and apprehension until the situations are resolved.
In contrast, for a person with an anxiety disorder, the anxiety does not readily go away and may get worse over time. There are several different anxiety disorders: generalized anxiety disorder, social anxiety disorder, panic disorder, obsessive-compulsive disorder and posttraumatic stress disorder. It is estimated that 28.8% of individuals experience an anxiety disorder over their lifetime (Kessler et al. 2005).
Women with a generalized anxiety disorder have excessive worry that may last for months. Symptoms include irritability, muscle tension, difficulty controlling worry, sleep problems and fatigability (HHS 2016a).
A social anxiety disorder is also referred to as a “social phobia.” Women with a social anxiety disorder have a fear of situations where they expect to feel rejected, judged or embarrassed or are fearful of offending others. Symptoms include (1) worrying for days or weeks before an event that other people will be attending; (2) staying away from places where there are other people; (3) having a hard time making friends and keeping friends; and (4) feeling very self-conscious in front of other people (HHS 2016a).
Women with panic disorder have recurring, intermittent panic attacks, which are unforeseen periods of harsh fear that may include accelerated heart rate, heart palpitations, trembling, sweating and shaking (HHS 2016a). Some women may also have sensations of smothering or choking. During a panic attack, the person has feelings of being out of control. Women who experience panic disorders often worry about when the next attack will happen and try to avoid places where a panic attack has previously occurred.
Obsessive-compulsive disorder (OCD) is a persistent disorder in which uncontrollable obsessions (i.e., repeated thoughts, urges or mental images) and compulsions (i.e., repetitive behaviors that a person with OCD feels the urge to do) can interfere with aspects of a woman’s life (HHS 2016b). Common symptoms include aggressive thoughts toward others or oneself; needing things to be in perfect order; fear of germs; and unwanted “forbidden” thoughts involving religion, harm or sex. A woman with OCD may be excessive about cleaning, hand-washing or arranging things in a particular way. Some individuals with OCD also have a tic disorder. This involves repetitive movements, such as blinking, shrugging, grimacing, sniffing, clearing the throat, or jerking the head or shoulders.
Posttraumatic stress disorder (PTSD) is a disorder that some women develop as a result of fear experienced during and after a dangerous or shocking event (HHS 2016c). This fear triggers changes in the body, which reacts with the fight-or-flight response. Women with PTSD may feel stressed or frightened even when they are no longer in danger. It should be noted that any person can get PTSD at any age (HHS 2016c). This includes war veterans but also survivors of physical and sexual assault, abuse, car accidents, disasters, and terror attacks. Symptoms include bad dreams, frightening thoughts and flashbacks—reliving the trauma over and over.
Assessment of any anxiety disorder should start with a visit to a qualified care provider who has experience in helping people with the particular disorder. Anxiety disorders are typically treated with medication, psychotherapy or both.
Existing research on the effects of exercise for the treatment of anxiety disorders is relatively new and somewhat limited. It’s hoped that more research will eventually lead to guidelines for mode, intensity, duration and frequency.
Research Findings on Anxiety Disorders and Exercise
A study by LeBouthillier & Asmundson (2017) investigated the effectiveness of aerobic and resistance exercise in treating anxiety-related symptoms. In this randomized controlled trial, 48 participants (females and males aged 18–65), all of whom were diagnosed with an anxiety-related disorder, were divided among an aerobic exercise group, a resistance training group and a waitlist group. Participants were initially doing less than 150 minutes of exercise a week, but screening (using the Canadian PAR-Q+) showed that they could safely engage in the study.
Exercise sessions were held 3 times per week for 1 month, supervised by a personal trainer. The aerobic exercise group cycled for 40 minutes at 60%–80% of maximal HRR. The resistance training group performed seven exercises (machine leg press, machine chest press, machine hamstring curl, dumbbell single-arm row, machine shoulder press, machine triceps extension and machine biceps curl), completing 2–3 sets of 10–12 repetitions.
Both aerobic exercise and resistance training were successful in favorably influencing anxiety-related disorder symptoms and related factors.
Menopause and Exercise for Women’s Health
Fitness pros will most likely have a client who is approaching menopause or is well into her postmenopausal stage of life. Women who are entering menopause (i.e., those who are in perimenopause) still have a menstrual cycle, but their estrogen levels are beginning to decline. The average age for a woman to enter perimenopause is mid-40s, but it can occur earlier or later (HHS-OWH 2018).
Natural menopause (not brought on by medical treatment) is officially diagnosed when a woman has not menstruated for 12 months; this typically occurs between the ages of 45–55 but may happen sooner or later. It is a time when the ovaries no longer release eggs and estrogen is no longer produced. Some women experience unnatural menopause due to surgery (i.e., removal of the ovaries) or ovary damage (e.g., from cancer or chemotherapy) (Cleveland Clinic 2017).
When estrogen is no longer produced, a woman’s risk of developing other health-related diseases—such as osteoporosis, heart attack and stroke—increases (HHS-OWH 2018). Other health issues include physical inactivity leading to weight gain and losses in muscular strength and cardiovascular fitness (Shaw et al. 2016). Symptoms that are bothersome and can cause distress in a woman’s life are hot flashes, sleep complications, mood variations, anxiety and depression.
Shaw et al. note that postmenopausal women have a greater prevalence of abdominal obesity, hypertension and elevated fasting glucose concentrations during the 10–14 years after menopause. The researchers suggest that, because of these changes, menopause is an independent risk factor for developing a multitude of chronic diseases, including type 2 diabetes and high cholesterol. (For information on managing weight gain, see the sidebar below “The Truth About Weight Gain With Menopause.”)
See also: Exercise and Menopause
According to the American College of Obstetricians and Gynecologists (ACOG 2015), regular exercise improves women’s health and slows bone loss.
Cardiovascular exercise. To maintain bone strength, weight-bearing options are encouraged.
Resistance training. Strength training is recommended for muscle strength and bone health.
Balance training is also recommended, as it can help women avoid falls that could lead to broken bones.
Research Findings on Menopause and Exercise
Shaw et al. (2016) sought to determine how resistance training would affect various physiological parameters in 37 postmenopausal women (aged 50–79; body weight = 150 ± 26 pounds; BMI = 25.3 ± 3.5 kg/m2).
For 6 weeks, 19 women completed 40 minutes of RT twice per week. The exercise group performed 3 sets of 10 repetitions (30–90 seconds of rest between sets) at 67%–85% of 1-RM for each of these exercises: dumbbell shoulder press, machine row, machine latissimus dorsi pulldown, machine leg press, barbell squat, machine hip adduction exercise and machine standing calf raise. Participants also did 3 sets of 10 repetitions of dumbbell-loaded pelvic lifts and abdominal curls. The control group (18 women) did not engage in organized exercise but were told to maintain their regular routines.
The resistance group showed significant improvements in upper- and lower-body strength, blood glucose concentrations, systolic and diastolic blood pressure, fat mass, percent body fat, and waist circumference.
See also: Training Loads for Women Over 40
Use the current research on women’s health and exercise to guide female clients to happier, more physically active lifestyles. You have the power to inspire the women you work with to improve their physical health, which in turn will positively influence their quality of life. The road to optimal health and fitness has no finish line.
Updated August 2, 2021
ACOG (American College of Obstetricians and Gynecologists). 2015. The menopause years. Accessed Mar. 27, 2018: acog.org/Patients/FAQs/The-Menopause-Years.
Cleveland Clinic. 2017. Menopause, perimenopause, and postmenopause. Accessed Mar. 27, 2018: my.clevelandclinic.org/health/diseases/15224-menopause-perimenopause-and-postmenopause.
HHS (U.S. Department of Health and Human Services). 2016a. National Institutes of Health, National Institute of Mental Health. Anxiety disorders. Accessed Mar. 28, 2018: nimh.nih.gov/health/topics/anxiety-disorders/index.shtml.
HHS. 2016b. National Institutes of Health, National Institute of Mental Health. 2016. Obsessive-compulsive disorder. Accessed Mar. 28, 2018: nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml.
HHS. 2016c. National Institutes of Health, National Institute of Mental Health. Post-traumatic stress disorder. Accessed Mar. 28, 2018: nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd/index.shtml.
HHS-OWH (U.S. Department of Health and Human Services, Office of Women’s Health). 2017. Osteoporosis. Accessed Mar. 27, 2018: womenshealth.gov/a-z-topics/osteoporosis.
HHS-OWH. 2018. Menopause basics. Accessed Mar. 27, 2018: womenshealth.gov/menopause/menoause-basics#1.
Kessler, R.C., et al. 2005. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychology, 62, 593-602.
LeBouthillier, D.M., & Asmundson, G.J.G. 2017. The efficacy of aerobic exercise and resistance training as transdiagnostic interventions for anxiety-related disorders and constructs: A randomized controlled trial. Journal of Anxiety Disorders, 52, 43-52.
Shaw, B.S., et al. 2016. Anthropometric and cardiovascular response to hypertrophic resistance training in postmenopausal women. Menopause, 23 (11), 1176-81.