The best exercises for menopause, according to a trainer and a doctor

When you enter perimenopause, it’s easy to feel like you missed the boat on being “fit.” This is likely when you first learn, in the throes of hot flashes and sleep disruption, that muscle and bone loss actually started in your mid-to-late 30s.

But the thing about exercise is that it starts working immediately. “We know that people, even if they started [exercising] in their fifties and sixties, they're likely to continue to be healthy later on,” says Dr. Sara Shihab. M.D., a board-certified internist at the Mayo Clinic specializing in sexual health and menopause.

That said, says Shihab, get the green light from your doctor before you start any new type of exercise, especially if you have a medical condition — including but not limited to kidney disease, cardiovascular disease, or type 2 diabetes. And get help right away if something doesn’t feel right.

Exercise during menopause is not just about managing weight — though it helps with that, too. Research links physical activity to reduced risk of chronic conditions such as heart disease, type 2 diabetes, osteoporosis, and certain cancers. It also improves sleep, mood, immunity, metabolic health and sexual function.

Movement can also ease menopause symptoms. A 2019 Polish study found that women who were physically active reported fewer and less severe symptoms, including helping with vaginal dryness and urinary problems. Research also suggests exercise may reduce hot flashes.

Strength training is especially critical. Hormonal shifts, including a drop in estrogen, can impair muscle regeneration and lead to fat replacing lost muscle. “If you want to fight that fat redistribution, boost your metabolism, [and] increase your muscle mass, you can achieve that essentially by exercise,” Shihab says.

It can also guard against bone loss. Frailty — the gradual weakening of the body’s ability to bounce back — raises the risk of fractures and hospitalizations.

“Any movement regularly is better than not moving,” says Tina Tang, certified personal trainer and founder of Iron Strong Fitness in New York City. Even a 10-minute daily walk is a good start, agrees Shihab.

But several types of exercise offer distinct benefits during this stage of life, including:

“Strength training is arguably most important,” Tang says. Research shows it builds muscle and protects bones. If you’re new to exercise, start moving first with regular walks, then add resistance with dumbbells, resistance bands, or machines in the gym.

Eventually, aim for “progressive overload” by increasing difficulty over time — whether that’s heavier weights, more reps, or an additional workout day. Tang also recommends one-sided movements, like single-leg deadlifts, to improve balance and help prevent falls.

Learn more about the benefits of strength training

The American Heart Association recommends at least 150 minutes of moderate-intensity aerobic activity weekly. That’s about 30 minutes, five days a week — walking, cycling, swimming — enough to elevate your heart rate but still allow conversation.

“Especially for women around menopause and perimenopause, it's really important to do this,” Shihab says, noting the increased cardiovascular risk during this time.

HIIT, which stands for High Intensity Interval Training, alternates short bursts of intense movement with recovery. It can support both heart health and fat loss: a 2020 meta-analysis found it reduced abdominal fat in women.

But moderation is key. “If you can do HIIT for 30+ minutes, you’re probably not working hard enough,” Tang says. Once or twice a week for 20 minutes each is plenty.

As for the idea that HIIT might spike stress hormones in menopause, Shihab is skeptical. “Exercise in general is a positive form of stress," and you only have to really worry about negative results "if done excessively or with the wrong form.”

Higher-impact movements — like jumps — can help preserve bone density, provided there are no joint issues. Start small: bouncing on your heels or gentle hops. For those with joint concerns, upper-body power moves like medicine ball slams are a smart alternative.

Stretching is also vital. Just 10 minutes post-workout can improve joint health and mobility. Incorporating yoga or Pilates offers added benefits: better sleep, less anxiety, and improved mood, according to a review in Menopause.

Physical activity doesn’t just happen in a gym. Taking the stairs, walking the dog, even cleaning — all fall under non-exercise activity thermogenesis, or NEAT.

“We know that non-exercise physical activity has health benefits,” Shihab says. “It should just be part of your lifestyle to be physically active.”

All those little movements add up. Though there isn’t menopause-specific research on NEAT, data shows it increases your daily calorie burn — a win for anyone trying to lose or maintain weight during menopause.