Making sense of Menopause

Hot flushes. Night sweats. Interrupted sleep. Mood changes. Weight gain. Irregular periods. Exhaustion. What more could you ask for!

For many women, Menopause is often something that arrives unexpectedly. Some women will need treatment. Some will not.

Called ‘the change of life’ and for good reason, because for each woman, it’s entirely different. When they come to you in studio it’s often new sensations over consecutive months that may draw the puzzle together for them or for you. Or maybe they’ve been to see their GP after seeking answers to the changes in their body.

While Menopause is often a topic shirked away from, we are getting better about being open and real about this life stage that will be part of every woman’s life. 

We are tackling it here, because it’s our role as Pilates practitioners to help guide and provide safe and effective movement during this challenging period of our clients’ lives.

So let’s start with the different stages of menopause.

The Transition into Menopause

Peri-menopause refers to the time the female body makes the natural transition to menopause, marking the end of the reproductive years of a woman’s life. This can be a time of grief for many women as they adjust from a time of being young and fertile to ageing and being infertile. Women start peri-menopause at different ages.

With peri-menopause Oestrogen drops, Cortisol rises and this causes mood swings. Women tend to put on belly fat due to the changes in hormones, and this can impact self-esteem. Some women may be tempted to exercise more and eat less, but this can create an exhausted body that is already processing a number of changes. It’s important to maintain a healthy weight. Some may think that HRT (Hormone Replacement Therapy) is a magic pill, but this is not the case as HRT can create a risk for breast cancer.  

Stepping into Menopause

Most women become menopausal between 45 and 60 years of age. Symptoms during menopause include changes to the menstrual cycle, hot flushes, night sweats, muscle and joint aches, mood swings, tender breasts, emotional changes, vaginal dryness, trouble sleeping, fatigue, joint stiffness, and negative changes in cholesterol and vascular function. 

Some cancer treatments such as removal of ovaries (e.g. for certain types of breast cancer), and chemotherapy can also bring about menopause abruptly. 

During Menopause a client may experience:

·       a dramatic loss of bone density

·       decreased muscle mass

·       laxity in the joints

·       exhaustion and or

·       feeling stiff to name a few.

As we support our clients through Menopause our program goals should include helping to improve a client’s confidence and mood, to focus on supporting bone density, building muscle mass, improving sleep, stabilising joints and creating better balance.

Below are 8 key areas of focus for working with Menopausal clients:

1.     Warm them up and cool them down slower

Remember to do a longer warm-up - 10 to 15 minutes and a longer cool-down to aid the body more for movement.

2.     Keep pelvic floor muscles functioning well

The lack of Oestrogen decreases muscle mass and the pelvic floor is made up of muscles, so it is important to keep these muscles functioning well too.

·       Practicing lifting and also relaxing the pelvic floor to maintain tone. If there is prolapse then the Pilates exercise program should limit exercises with excessive intra-abdominal pressure. So many of the core exercises we know and love should be limited and in some cases omitted completely. Focus on functional exercises such as:

·       Sprinter on the Reformer,

·       Wunda Chair or mat work.

3.     Build strength through bone building and muscle mass

In order to build muscle mass,

·      use hand weights with exercises such as scooter, standing side splits skater series on the reformer, and standing leg press on the Wunda Chair

·      donkey kicks sprung from below on the Cadillac,

·      Bridging on the Chair from the floor with pulses,

·      Knee stretches on the Reformer and

·      side lunges on the Wunda Chair.

4.     Maintain muscle mass

The lack of Oestrogen decreases muscle mass so it is essential to maintain this. (Also, muscles burn more energy than fat, so the more muscle mass the better the metabolism, which is another benefit to the menopausal woman).

Exercises such as:

·       scooter on the Reformer,

·       Lunges on the Wunda Chair,

·       Standing leg springs on the Cadillac.

·       Standing arm springs with the Cadillac that work to build muscle mass with resistance are of great benefit. 

5.     Keep joints supple

Focus on exercises like:

·      legs in straps on the Reformer,

·      kneeling thigh stretch on the Reformer.

·      Mermaid on the Chair.

·      The ballet stretches on the Ladder Barrel or Cadillac.

·      Thoracic extension stretch over a chi ball.

6.     Balance work

Balance is so important for post-menopausal women. Falling and breaking bones is not fun, but the fear of falling can be debilitating.

Practice the:

·      standing leg press on the Chair with all its lovely variations of weight transfers,

·      slow blinking, head turns,

·      wobble board,

·      dura disc and rotator disc to keep it challenging. 

It’s also important to note that Pilates exercises such as jumping on the Reformer can assist in reducing or maintaining weight and improving mood.

7.     Stabilise the joints

Pilates exercises will help to stabilise joints, reduce pain and inflammation.

·       Stabilise the pelvis with sidelying clams, oysters, knee kisses, and clams in the air. 

8.     Focused breathing work

·       Focused Breathing with Footwork on the Reformer 

·       Stretching and mobility such as the supine scapular series on the Cadillac,

·       Mermaid on the Wunda Chair,

·       Kneeling thigh stretch on the Reformer,

·       Standing cat with the rotator disc and push-through bar on the Cadillac, and

·       all of the ballet stretches on the Ladder Barrel or Cadillac. 

As you look to incorporate the above into your classes don’t forget that we want to target different aspects of the workout to keep our clients engaged. From building muscle mass and bone density to keeping the body supple. 

We also need to encourage them to rest and recuperate. If a client does too much then the body may think there is a serious energy crisis going on, and it will slow the metabolism down. If they keep pushing themselves, their body may become exhausted and they may leave themselves open to injury. Encourage them to rest, encourage them to read their body’s signals and provide acceptance at all stages of their journey.

And finally, we all know that every client's experience will be unique. So it’s important that we show them compassion and support during this potentially unsettling time and help them appreciate what their bodies can do and embrace this change with positivity.

You can subscribe to Taube Pilates and get a free cheat sheet here. Louise offers a Pelvic Floor Course and an Active Ageing Course among others. Find out more about Taube Pilates.