10 ways to exercise smart during perimenopause

It can be overwhelming to say the least. How do you know which ones work? Which advice is based on outdated science? And, more importantly, are you at risk of making your symptoms worse?

If you’re currently in the thick of perimenopause and you feel like your body isn’t adapting to exercise in the way that it used to, we’ve consulted with renowned perimenopause experts Dr Emma Ross and Baz Moffat of The Well HQ to create your no-nonsense training guide. Here’s everything you need to know.

“Rather than oestrogen leaving the scene swiftly, it can take years to level out, with both progesterone and oestrogen fluctuating dramatically on their way down,” says Dr Ross, consultant physiologist.

This unpredictable pattern gives rise to the classic perimenopause symptoms, such as anxiety, night sweats and brain fog. However, one massively overlooked aspect is the effect it can have on your fitness, as well as how your body responds to exercise.

As your hormone levels peak and crash, it’s common to notice shifts in your energy levels, endurance, muscle recovery time and performance metrics. With all this going on, it’s no surprise that your motivation can take a dive too.

According to Baz, a women's health and fitness coach, training smarter and not harder is the way forward. “Rather than burning yourself out with back-to-back cardio sessions and restrictive dieting, women often see better results if they dial things down with quality strength training sessions and a bigger focus on recovery.

“There’s two big benefits to this,” she continues, “it avoids loading extra cortisol into the system that can hinder fitness results, and it also changes your body composition, maintaining a leaner balance between muscle and fat mass.”

Here, she shares her top perimenopause fitness tips:

As we age, muscle mass decreases by 3-8% per decade over the age of 30,1 and this accelerates as oestrogen drops. "Every woman should strength train during perimenopause," says Moffat. "Studies show that shifting your focus from cardio to weights can slow muscle and bone loss." Not only does this boost strength and reduce injury risk, but it also helps build a lean physique that many women mistakenly turn to crash dieting to achieve.

Having more muscle can work wonders for firing up your metabolism too. The thinking is that the more muscle you have, the higher your resting metabolic rate (RMR),2 which is the number of calories your body burns at rest.

To make strength training effective, focus on progressive overload - gradually increasing the weight in your workouts. And remember, if you’re a gym newbie then remember to start slow and grow your strength with the support of the gym staff or a beginner’s class.

“Prioritise big, compound movements like squats, deadlifts, and leg presses that work multiple muscle groups at once,” Moffat recommends.

Brisk walking, cycling, jogging and stair climbing are all great choices for boosting your heart rate to 50 to 70% of its maximum capacity - the sweet spot for working your cardiovascular strength without pushing it too hard.

“Training too late in the evening can spike cortisol and adrenaline, which might add to your struggles with falling asleep later on,” warns Moffat. “Likewise, if you’ve had a rough night with very little kip, it could be better to skip the 6am run and rest up instead.”

The key takeaway here? Stay flexible. Timing for your workout schedule can help regulate your circadian rhythm, and a midday training session might become your new favourite way to reap the benefits of exercise without sabotaging your sleep.

“In your 20s and 30s, you might have managed back-to-back runs with ease, but as you age, sustaining that intensity becomes tougher,” notes Moffat. “Hormonal changes, particularly reduced oestrogen, can impact muscle recovery, so you’ll need more frequent rest days to let your muscles repair.”

Active recovery, a type of movement-focused rest, can help to reduce the post-exercise aches and pains that can ramp up during perimenopause. Try incorporating activities like yoga, walking or gentle Pilates into your routine, and leave at least 48 hours of downtime between big energy sessions.

Not sure how much you should be eating? A 2024 review⁵ estimated we should consume roughly 0.8-1.2g per kilogram of body weight daily, with at least half coming from plant-based sources like beans, lentils, tofu, nuts, seeds and whole grains. So, if you weigh 70kg, that’s around 56-84g of protein each day.

Since perimenopause puts you in a heightened inflammatory state, even one glass of wine could exacerbate symptoms and disrupt sleep. And that restless night can ripple out, affecting your exercise routine, dietary choices and even how much caffeine you need the next day.

“Not because you’ve already run into an issue, but as an insurance policy against urinary incontinence and other issues down there.” The Squeezy app has guided exercises if you’re not sure where to start.

“When you link brain training skills with physical exercise, the benefits are twofold, working your cognitive and physical fitness at the same time,” says Moffat. “Sports that require you to think on your feet, like boxing, netball and indoor climbing challenge your hand-eye coordination, helping you to stay sharp as a tack.”

With the potential to make symptoms like headaches, tiredness, dizziness and irritability worse, hydration is a key part of the training puzzle.

The great news is that when you understand what’s happening to your body during perimenopause, you can tailor your movement to work with these changes, rather than against them.

By making just a few smart adjustments to your training, you can transform how exercise feels and achieve powerful, effective results at the same time.