I have broken down the talk into sections so you can pause for a break as you go along, At the top right corner of the the video you will see 1/5 and a little arrow, here you can click and go to the next part ie 2/5, 3/5. The videos will automatically follow on from each section if you choose to watch all the way through. I would really appreciate and trust you not to use the “Share” button – Thank You.

Pilates for Menopause

Well, well.  The Menopause HAS changed !

I’m really excited to be bringing you some groundbreaking information, in this brand new Menopause Workshop.

All women need to understand this period of their life, knowledge is a powerful tool, because you will be able to better understand the hormonally-influenced changes around this time. 

I hope this knowledge will be reassuring, practical and useful.

Research has now shown menopause has changed greatly over the last few decades.

Menopausal symptoms can be mild, but for some women this is not the case.  

The workshop will give you some perspective, some learning and some reasons and answers.  

The understanding will definitely help if you want to minimise some of the negative impact the symptoms of menopause may have on you.

Menopause used to last a couple of years, it can now last for 10. It used to start in your late 40s, now it can be 10 years earlier.  The age range can be from 35-55 years old.  Women would  report hot flashes of around 3 per day, now there can be 15. Weight gain through the perimenopause, menopause and post menopause period has now increased massively.

We cannot stop what is a natural, hormonal transitional period but we can minimise unpleasant symptoms, reduce the weight gain and live in the healthiest way we can.  

It is fascinating that some cultures have little or no symptoms.  Therefore, lifestyle is a factor, so some changes together with information on how to approach our menopause, is vital.  As time passes, we need to treat our bodies a bit differently than we did in our 20s and 30s.

In a way, menopause is a fairly recent phenomenon, after all talk about it today in the way we recognise it as it is today.  In the 1800s, the average age for menopause was 57 — and the average age for death was 59 !!  — women in those days did not experience it in the same way we do –  thankfully, we are living for 30 years longer than our predecessors, but we are living in a totally different way and we are dealing with the effects of that. 

We can be described today as the ‘sandwich’ generation, we have work, kids, grandkids, elderly parents who are living longer, some with dementia. In previous generations more women were housewives, the kids had left home and the elders did not live as long.  Today, we may put our menopausal symptoms down to the stress of everyday life and not recognise that hormonal changes may also be to blame.  However, it is not unreasonable to believe that menopause may be harder than it once was. 

There are 3 stages of menopause.

The average age you will get Perimenopause symptoms is around your mid 40s ie perimenopause is when you first start to feel symptoms.

Menopause is the end of our periods.  Post menopause is after.  

Symptoms start as our hormone levels decline and we gradually stop producing eggs. 

In the UK the average age of menopause is between 49 to 53. Menopause under the age of 40 is described as premature menopause.  

When menopause happens depends on a few things; hereditary factors such as when your mother had her menopause. It can be determined by;

   how many follicles we have (ie eggs that are produced in the ovaries) 

   the number of pregnancies we have, and breastfeeding. 

Thereby, if we look back to the 19th century we can see why menopause was much later.  

A premature menopause can be brought on by other factors; chemotherapy (which, due to its toxic nature can affect the ovaries) by ovarian surgery, and by endometriosis.  Smoking (even secondhand) is also a factor in early menopause due to the toxins produced.

Lets take a look at Oestrogen 

Oestrogen is produced in our ovaries and is an amazing hormone, like an internal messenger in our body.  It is present in all areas of our body – the oestrogen receptors are present in your hair, your skin, your brain, in the uterus, bones, breast tissue – just about every organ in the body has oestrogen receptors that help the body to function.  Oestrogen levels in women start to drop at age 30 and then again at age 35. (We become less fertile as we grow older and we are less fertile than in our teens and twenties) As menopause nears, physical changes happen as your body adapts to the different levels of hormones. The ovaries make less oestrogen and your menstrual cycle starts to change, becoming irregular and then stopping.

When oestrogen levels drop,  this starts to become a big deal and causes issues – because there are over 30 different menopause symptoms !   

Lets touch on some of the more common ones. I’m not going to lie, the list of symptoms is not cheery.  Remember though, there is help with ALL of your symptoms.  Some menopausal symptoms may be similar to those of other conditions too,  and any of the following symptoms could have an underlying cause that needs treatment, please get unusual symptoms or those that affect your quality of life checked out.  

This workshop is not a substitute for medical advice. Always seek a GPs advice for these symptoms to rule out any other cause. 

SYMPTOMS

Hot flushes are very common, and can be quite debilitating. This is because the drop in oestrogen levels messes with our hot and cold regulatory system.  This kicks in when we get too hot or too cold . We have a temperature scale that goes up and down,  if we go up the scale and we get too hot, we sweat, if we go down the scale and we get too cold we shiver.  The temperature dysfunction during menopause can mean that just a hot drink can trigger a hot flush, or lead to night sweats that disturb sleep. 

Period changes. Periods become irregular, or much heavier, some just fade away gradually.

Mood swings are common.  If you already suffer from PMS,  it can go through the roof at this time. 

Vaginal dryness is common and can be a problem in a physical relationship. 

Lack of libido/sex drive

Headaches 

Breast soreness 

Burning mouth

Joint pain. Think of oestrogen as a WD40 for your body! It is anti inflammatory, keeps things elastic and flexible.  Oestrogen also responds to collagen in your body – the good springy stuff thats in all our tissues. If we are less flexible and springy,  we get more joint pain.

Digestive system problems. You may start to have IBS type symptoms, bloating, constipation, diarrhea, cramps.  

Electric shocks, a bit of a weird one but oestrogen is a brain regulator so tingling electric sensations may be felt.

Muscle Tension.  Stress and anxiety can add to this but we can get tighter muscles due to less oestrogen not having the same kind of ‘moisturising’ effect. 

Itchy skin, Tingling skin

Sleep disruption/Fatigue (this como with night sweats!)

Hair loss

Memory lapses

Poor concentration

Irritability

Weight gain – we are  going to look at this in a bit more detail later

Parathesia – tingling, numbness, skin crawling, or itching

Gum problems 

Anxiety & Panic disorder, Irregular heartbeat, you may feel these things together. The anxiety/ hotflushes combo,  could set  you up for panic disorder, or a first time panic attack.  Hot flushes can be accompanied with a faster heartbeat

Bloating

Brittle nails

Allergies

Body Odour

Dizzy spells

Incontinence – we will look into this in a bit more detail later

Depression – is 4 times more likely (sandwich generation stresses) 

HRT could be more useful than antidepressants, as hormonal influences can be a factor

Osteoporosis – we will look into this in a bit more detail later

All in all not a pretty picture, but there are things we can do to help with all these symptoms.

HRT has had a mixed press, you may remember that past studies scared quite a few people off taking it, those studies have now been shown to be inaccurate, and now show that the benefits of taking HRT far, far outweigh the small risks that are associated with it.  

Benefits that include, reducing the risk of Alzheimers, dementia, heart disease and protecting against osteoporosis.  Speak to your GP about the risks and benefits of HRT. In the next part of the video, I am going to shine a bit of light onto the three main topics that Pilates can help with.

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The three main topics that Pilates can help with, are;

Pelvic Floor

Bone Density

The Female Fat Cell 

Pelvic Floor (tends not to be missed until it’s gone!)As mentioned, oestrogen receptors are everywhere and they are in our bladder, our urinary system and our pelvic floor.

70% of women will experience some incontinence – this is huge. At least 1 in 5 women over the age of 40 buy Tena lady,  and do not seek help or talk about it.   Tena lady is a money making industry where they mention sensitive bladder, which is totally different from stressor urge incontinence

What does the PF do? 

The PF supports our bladder, our bowel and our womb, it is springy and supportive and moves with our breath, we want it to be strong and thick and act like a hammock, holding those internal parts in place. 

The PF may weaken with;

    Pregnancy – during pregnancy there is a lot of downwards pressure on the PF

    Childbirth especially with traumatic delivery, episiotomy, big babies, twins  

    Chronic constipation

    Chronic coughing

Heavy lifting – some exercise programmes involve heavy lifting and if you experience wetting yourself, you must stop !

High Impact exercise – eg running, if you are running and wearing a pad – you must stop until  you have strengthened your PF !

Being overweight and obese, puts more pressure on the PF

As oestrogen falls the PF becomes less elastic.

Pelvic floor exercises are imperative, we do a few in class but there are loads on the internet.

If you ignore PF symptoms you could end up with pelvic organ prolapse (where your womb, bladder or vagina bulge down and surgery may be needed) Tena lady may be ok short term but do not ignore the problem, pelvic floor exercises will help and a specialist physiotherapist can help even further with any issues.

As we age our bladder becomes smaller and less elastic and we can develop 

Urge incontinence (more frequent weeing) or 

Stress incontinence where PF is unable to hold under times of pressure. Stress incontinence comes from High impact, sneezing, coughing, laughing etc

You may even have or a mix of the two 

We also get a thinning of the urethra, this predisposes us towards more urinary tract (water) infections.  Always wipe from front to back –  also when we wee, to decrease this risk.

Stop smoking if you do ! Smoking is an irritant to the bladder, makes you cough more and triples the risk of bladder cancer

Urge incontinence is different than Stress incontinence

This is a leakage without pressure, ie more frequent weeing -more than 8 times a day, 

Nocturia- weeing more than once during the night 

Urge to go, you cant wait and you might leak before you get to the loo.

Your overactive bladder is contracting whether it is full or not

What you can do;

Make it easy to get to the loo

Seems counterintuitive but you absolutely must keep up your fluid intake and stay hydrated, if you are dehydrated that irritates your bladder

Losing weight helps as there is less pressure on the PF

Caffeine- is a big irritant.  Coffee before a workout is not a weight loss tool !

Stretch out the time in between visits to the loo, can you wait just a bit longer before you go, train your bladder to go for longer, say,  5 mins, but don’t do this away from home it will just stress you out ! And don’t visit the loo ‘just in case’.

Take medication and seek a health care professional who can help with bladder training

DO NOT PUT UP WITH THIS – GET HELP!

Osteoporosis – Build you bones 

The WHO coined this term in 1994, before that time, it was thought there was a natural decline in bone mass due to age. However, osteoporosis is a micro architectural deterioration of bone which makes it more susceptible to fracture and affects both men and women of all ages.  Its commonly known as brittle bones disease.

We build bone mass density from birth until we are around 30 years old. By a process of osteogenesis, bones are constantly renewing and rebuilding during this time to become stronger and stronger until we build our peak bone mass during our late 20s.  Oestrogen stimulates osteoblasts and osteoclasts, the cells that produce and regenerate bone growth.

Osteoporosis occurs when we either lose bone too quickly or we never formed it fully.

Those most at risk are caucasean and Asian women.  Those with a slight frame, with  less weight of gravity putting pressure through the bones to strengthen them, or with a family history or an early menopause.

50 % of women over 50 will have an osteoporosis related break.  That is massive ! You may have osteoporosis and not know it. Hip fractures are a serious issue – pain, disability, deformity, loss of independence and increased morbidity

The fastest loss of bone for women is usually the first 5 -8 years of menopause – typically around a 20 per cent loss, but some women can lose up to 50 per cent. Men are also at risk of osteoporosis.

Exercise is absolutely vital !  

We must avoid certain exercises if we have osteoporosis, eg, strong rotational forces through the hip, forward and lateral spine flexion, poor posture.  We want some movement but never excessive forward bending or twisting. Speak to a health professional if you have concerns.

Pilates Fountain of Youth movements !

Bone is reshaped in response to the forces/loads acting on it 

Thoracic extension – Strengthening upper back

Hip extension – strengthening glutes

Bone loading, Weight bearing prevents a creating a Piezoelectric effect (production of voltage under tension, creating an electrical effect that strengthens bones through osteogenesis)

Extension with small range rotation

Plyometrics (for core pelvic floor) Skipping or jumping

Balance for fall prevention, avoiding breaks

Lengthening

THE FEMALE FAT CELL !

This is what we have all been waiting for ! 

The average weight gain in women during menopause is 10-15 pounds.

We have 3 billion fat cells, an unbelievable number! And yes, male and female fat cells are different. Womens are larger, more active and more resistant to dieting as they are programmed for the  key times of our life such as puberty, pregnancy and menopause. There is a surge of oestrogen and the laying down of fat stores in puberty, in readiness for menstruation and in pregnancy in order to breastfeed and to look after mother and baby during famine.

So why do we put on weight in menopause when our oestrogen levels are dropping ? 

Because, as oestrogen declines, our fat cells start to produce oestrogen to make up from the drop from our ovaries !  

Fat storing enzymes are activated to help with this building up of the fat cells, they decrease fat releasing enzymes and they expand by 20 %. The bigger they become, the more oestrogen they produce, so often larger ladies have an easier time of menopause than slimmer ones. In our mid 40s the fat cells change and start to divide to produce the extra oestrogen.

We accumulate more fat around our mid section as the liver and adrenals produce the necessary enzyme to convert testosterone to oestrogen and then more fat cells accumulate there. 

Coupled with that, muscle mass declines if you do not exercise – at a  rate of 3 to 8 % per decade after the age of 30. This rate increases further after the age of 60

Heres the math ! Half a pound of muscle means 40 fewer calories a day so if you have lost five pounds of muscle since you were 30 that is 400 calories a day that you are no longer burning. (The more muscles you have the more calories you burn) 

So, when women say ‘Im eating exactly the same, but Im putting on weight’ that is completely right,  but you no longer need four hundred of those calories . 500 extra unnecessary calories a day x 7 days  is 3500 calories which equals a pound of fat. Multiply that week on week and there is your weight gain even though you may not be eating more than you did. All down to female fat cells being laid down to protect you. 

A long history of yo-yo dieting can make this worse.  A very low calorie diet raises ghrelin, a appetite hormone,  for up to two years after the diet.  Very restrictive diets cause you to lose muscle, and when you return to eating normally a vicious circle is produced. 

So we must ;

Build more muscle

Eat to actual hunger (to tummy grumbling – not to emotional eating craves like chocolate)

Control portion sizes (calorie counting is hard as you need to measure everything)

Focus on quality of food

This is why exercise and maintenance becomes essential as we are so different than we were in our 20s and 30s. You absolutely have to exercise ! 

Here’s what exercise does;

Fights fatigue

Boosts metabolism by 8% – remember those 400 calories?  they are cancelled out with the boost in metabolism from exercise

Mental alertness improves

Gives us Better sleep

Stabilises mood

Lessens food cravings, less fat and sugar cravings

Reduces hot flushes to half the amount

Stengthens bones, you can maintain your bone density with exercise – fit women maintain, sedentary women lose at least 1% per year as well at the big loss at the start of menopause

Reduces risk of breast cancer and dementia by 30 %.  This is huge. There is no drug on this planet that can do this, if there was everyone would be on it !

Reduces the risk of heart disease, some studies have shown this could be by 300% 

Help to stabilise blood sugar levels thus reducing the risk of Type 2 diabetes

You will live a longer life, even just one hour of exercise a week (which I will always say is not enough) can reduce the risk of early death by 25%

Reduce BMI – fit women average BM1 of 25%, sedentary women average 39%

This is why exercise is absolutely key and why there can be a difference of 2 to 15 in weight gain.  So, on the back of this learning, I bet you have now decided to become a triathlete !? Haha.  Whatever you do, do not do that !  You will do more harm than good.  

You have to now exercise SMARTER not harder, because our final thing to consider is to avoid CORTISOL.  Cortisol is a natural stress hormone in our bodies, but increased levels are not good for us and oestrogen plays a big role in reducing cortisol, so if we exercise too hard, say,  for instance to High Intensity levels, this can increase the cortisol levels.  This increase in cortisol could lead to hypothyroidism, cravings, autoimmune diseases, worse sleep. We must balance our cortisol levels for these reasons as well as to prevent further weight gain. Over Exercising can be dangerous and cause an increase in cortisol and a 3% reduction in bone density!  Remember the moisturising effect oestrogen has on our body with lower levels of oestrogen we increase the risk of injury.. 

So, train smarter, using moderate exercise. 30 to 60 mins of exercise per day is more than enough, focusing on strength training, with some cardio but not to olympic levels (walking briskly is enough).

In summary

Some weight gain is to be expected but its a choice between 2 to 15 pounds

Consider lower impact and PF exercises

Eat good quality food and limit portions, nourish your body, dont starve it !

Build a regular and sustainable exercise programme steadily to avoid injury

Get professional help where necessary, consider HRT 

And if its a Smart workout you are booking for then I have just the thing ! 

Your workout

The workout is in two parts, you’ll need a chair or fireplace for support and a mat.

There is an upright standing part (with the support) for bone density building, for work of the deep pelvic floor and there is no forward flexion so it is completely safe for osteoporosis sufferers.  The mat work is with a focus on strength.

Make sure you have a safe environment, keep the workout to your own level, resting as needed, and drink plenty of water, before, during and after your workout.

Ange x