Training menopausal clients

By understanding the changes that happen to women during menopause, you will be better able to help clients experiencing this stage of their life to stay fit, focused and in control, says Lyn Miller.

Fitness professionals need to be sympathetic to clients' unique circumstances in order to maximise the benefits delivered and results achieved. Picture these scenarios;

You're in the middle of a workout, feeling the endorphins kick in, when suddenly the heat surging through your body becomes as intense as a big-block V8 idling in a New York City gridlock on a hot summer day. Or…

You have your regular training session today – the one you always look forward to – but for no particular reason you feel absolutely drained, like you're being dragged down by heavy chains, and you just don't think you can do it. Or…

You haven't changed your diet or exercise regime in years, and you've always maintained the same weight. Now, in the blink of an eye, you're feeling bigger than Ben Hur and not fitting into any of your clothes. Or…

Just as your group ex class kicks into high gear, you burst into uncontrollable tears.

Would you know how to respond if a client recounted one of these experiences to you? If your client was aged in her forties, would it cross your mind that she could be suffering from a symptom of menopause? Would you be able to explain what was happening to her, and why? And would you be able to develop a diet and exercise plan to help her get fit and feel fantastic while her body went through its natural changes?

Menopause; the 'big M'; the 'change of life'; whatever you choose to call it, it's a physical reality and a growing concern for women aged over 40. It's also an issue many fitness professionals have traditionally not understood, or simply ignored.

You are in a unique position to help women manage menopause, improve their quality of life by diminishing menopausal symptoms, prolong their lives by countering menopause-related conditions and diseases, and boost their self-esteem.

You are also in a position to benefit professionally: by taking a little time to understand menopause and the challenges it presents, you'll be able to help this demographic achieve optimal results and to retain them as clients.

The following 'beginner's guide to menopause' will enable you to reap the rewards of helping clients experience optimal health, energy, vitality, attention span, mental focus and fitness during menopause.

What is menopause?

Menopause is the permanent ending of menstruation. Natural menopause is caused by hormonal changes, and it occurs when a woman has not had her period for 12 consecutive months. It signals the end of fertility and the beginning of a new – and potentially rewarding – stage of a woman's life.

Premenopause and perimenopause refer to the transition years, usually between two to seven years, before menopause, when a woman's hormones begin to fluctuate and start to cause menopausal symptoms.

What causes menopause?

Natural menopause is caused by shifts in a woman's hormone balance, particularly in ovarian hormones like oestrogen, progesterone and testosterone.

Oestrogen helps regulate the menstrual cycle and prepare the uterus for pregnancy. Oestrogen levels fall by between 40 and 60 per cent during menopause as the ovaries cease to produce it. Other organs, and fat cells, continue to produce low level amounts, which is why overweight women often suffer fewer menopausal symptoms than lean women.

Progesterone's role is to change the character of the uterine lining to prepare for pregnancy. It has many other functions as well, including protecting a woman's body from many types of cancers, normalising blood sugar levels, helping metabolise body fat, relieving anxiety and acting as a natural antidepressant. In menopause, progesterone levels can fall to as low as zero.

Testosterone is commonly referred to as the 'male' hormone. It helps build muscle and bone, and it affects a woman's libido, mood and energy. By the time a woman reaches the age of 40, her testosterone level will drop to half that of when she was in her twenties and it will continue to drop as she ages.

The graph in Figure 1 shows cyclic changes of oestrogen and progesterone in a normal cycle. At 14 days ovulation occurs which stimulates the production of progesterone. If fertilisation does not occur, the result is menstruation around 28 days.

As a fitness professional, it is important that you recognise and understand your clients' symptoms, particularly as many women don't want to face the signs of menopause, which they sadly see as ageing, and will not inform you of them directly. Naturally, certain symptoms will be beyond your powers of detection, but many are physically recognisable or may arise in conversation.

Nutrition and menopause

Common symptoms of menopause
  • Weight gain
  • Mood swings
  • Cravings
  • Fatigue
  • Irritability
  • Hot flushes
  • Insomnia
  • Headaches
  • Decreased libido
  • Vaginal dryness
  • Incontinence
  • Increased risk of conditions and diseases like heart disease and osteoporosis.

One hundred per cent of women, regardless of their weight, will gain weight during menopause if they do not change their lifestyle habits. It is proven that symptoms of menopause, including weight gain, can be reduced or exacerbated depending on what a woman eats during these years. Numerous studies based on the nutrient content of food provide us with the following guidelines:

Rules of thumb
Generally, the following dietary habits are advisable for menopausal women.

  • Eat three to five small meals per day
  • Focus on portion size, not calories
  • Eat protein at every meal
  • Eat a wide variety of organic fruits and vegetables daily
  • Eat healthy fats every day.

 

 

Exercise and menopause

Increase Decrease
  • soy
  • herbal supplements: dong quai, chaste berry, black cohash, licorice root
  • water
  • flaxseed lingan, fibre, and Omega 3 fats
  • bioflavanoids (cherries, grape skins, blueberries, cranberries, whole grains, red clover)
  • green tea
  • vitamins and minerals including calcium.
  • M.S.G. (monosodium glutamate)
  • caffeine
  • aspartame (diet sodas)
  • refined, processed and high glycemic foods (white bread, white rice, sweets, candy)
  • chocolate
  • alcohol
  • peanuts.

Exercise is a menopausal woman's best friend. It allows a woman to control her body and emotions using her own internal resources. Regular exercise can help reduce many menopausal symptoms: it can help regulate weight; stimulate the production of oestrogen; strengthen muscle and bone; help reduce the risk of high blood pressure and diabetes; increase mental agility; sweep excess cortisol (see article on page 32 for more on this stress hormone) from the bloodstream; reduce menstrual cramps and PMS; reduce depression; and contribute to an overall sense of wellbeing.

As a trainer of a menopausal woman with fluctuating hormone levels, it's important to take into consideration how your client feels, and her energy level, on a day-by-day basis. Training should include a balance of cardiovascular exercise, strength exercises, stretching and relaxation. Walking, tai chi, resistance training and dancing are excellent options. Avoid jumping, skipping and sudden movements that can exacerbate incontinence, and remember that menopausal women generally need a longer recovery time.

 

 

 

Perimenopausal fitness goals Postmenopausal fitness goals
  • protect bone mass and reverse bone loss
  • enhance cardiovascular function
  • strive for healthy body composition
  • reduce menopausal symptoms
  • delay age-related losses in function.
  • protect bone mass and reverse bone loss
  • enhance cardiovascular function
  • fall prevention and balance training
  • enhance and maintain daily living and quality of life.

The joy of menopause

'The joy of menopause is the world's best-kept secret. Like venturing through the gateway to enter an ancient temple, in order to claim that joy a woman must be willing to pass beyond the monsters who guard its gate. As you stand at the brink of it, it can appear that only darkness, danger and decay lie beyond. [But] … as thousands of women from all cultures throughout history have whispered to each other, it is the most exciting passage a woman ever makes.'

Leslie Kenton, Passage to Power; London: Ebury Press; 1995

As a fitness professional you have the unique opportunity to help women experience 'the joy of menopause'! Armed with understanding and awareness, you can apply your knowledge to help women embrace the vigour, energy, creativity, attention span and mental focus they need to continue to enjoy what matters most to them – family, friends, career, fitness and fun!

Lyn Miller
With over 10 years experience in the fitness industry, Lyn is the director of Menofitness Australia, which has developed the first online Fitness Australia and Kinect Australia accredited course for fitness professionals on the topic of menopause. For a free demonstration of the course visit www.menofitness.net or www.gotrain.com.au/meno_fitness.php