Growing muscle

Why exercises that preserve and grow muscle should be your new habit.

Lifting bars

Goals

At first, I thought the point of exercising and building muscle was simple: to preserve my independence. To make sure I could still get out of a chair at 90, under my own steam.

But the more you learn about movement, the more you realise it goes far beyond mobility or muscle mass.

Regular, intentional exercise affects how your brain works, how your hormones behave, and how your cells age - long after you’ve kicked off your trainers.

This blog explores how exercise can significantly benefit individuals during perimenopause and menopause, and how I’ve tailored my approach based on the latest scientific research. It’s a lot, so feel free to skip to the end if you just want the cheat sheet.

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Exercise for the win

First of all, let’s acknowledge that exercising has multiple benefits for everyone, but there are specific reasons to re-focus on it during perimenopause and menopause.

1. Cognitive function

Oestrogen loss reduces synaptic plasticity and neuroprotection, particularly noticeable in the hippocampus and frontal cortex, impairing both memory and higher cognitive function.

→ Aerobic exercise (30 mins/day): improves neuroplasticity, memory, and reduces dementia risk (1)

→ Resistance training: boosts growth factors (e.g., BDNF, IGF-1) that support the survival and plasticity of neurons (2)

→ Advanced option: heavy lifting (up to 80% of your 1-rep max) is especially effective for neuroplasticity and executive function (3)

→ Dance & balance-focused workouts will improve coordination and stimulate spatial awareness

2. Mood:

Declining oestrogen disrupts serotonin synthesis and receptor sensitivity; its decline increases vulnerability to low mood and anxiety (4).

→ Moderate-to-vigorous aerobic exercise increases serotonin, dopamine, and endorphins that act like natural antidepressants

→ Group training (e.g. Parkrun) adds community and accountability

→ Yoga or mindfulness-based movement lowers cortisol, supports the parasympathetic system.

Exercise modulates the hypothalamix-pituitary-adrenal axis (cortisol) and promotes resilience to stress

3. Cardiovascular health:

Loss of oestrogen accelerates arterial stiffening and lipid imbalance, increasing cardiovascular risk; exercise reduces both blood pressure and risk of heart disease by up to 40% (5).

→ Moderate aerobic exercise improves endothelial function, lowers LDL, raises HDL

→ Short bursts of high-effort (interval training) increase VO₂ max and cardiac resilience (6)

Mix it up! Even interval walking (brisk and stroll) has benefits over a moderate activity (7)

4. Metabolic effects:

Reduced oestrogen impairs insulin sensitivity, allowing blood glucose levels (HbA1c) to rise and increases the risk of developing type 2 diabetes.

→ You can calculate your risk of getting metabolic syndrome here…metabolic risk score

→ Skeletal muscle absorbs glucose both during exercise and for up to 48 hours after via GLUT4 activation (8)

→ Aerobic exercise reduces visceral fat and triglycerides, improves HbA1c and HDL (9)

Combining the two yields the greatest reduction in risk (10) (see below on how)

5. Immunity boost:

Oestrogen modulates the immune response. Its absence raises baseline inflammation through increased cytokine activity (e.g., IL-6, TNF-alpha).

→ Moderate regular exercise reduces chronic inflammation, increases immune surveillance (11)

→ The key word here is moderate - under-fuelling or over-exercising without rest can suppress immunity and raise cortisol (12)

Moderate really covers the range; think brisk walk, gentle circuits, low-impact cardio

6. Longevity:

Loss of oestrogen impairs mitochondrial function and cellular repair, increasing oxidative stress and speeding biological ageing.

→ Mixed training; aerobic and resistance slows biological ageing and improves mitochondrial resilience.

→ Exercise reduces rates of cancer (especially breast and colon) and rates of cancer recurrence (13) and all-cause mortality by 30% (14)

One NEJM study showed that colon cancer survivors who walked briskly for 2.5 hours/week had a 28% survival benefit at 3 years (13)

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Exercise and the sex hormones

Exercise doesn’t just respond to hormones - it also regulates them.

And has been repeatedly shown to reduce the risk of breast cancer (13,14), and two key research findings might explain this:

1. The Hypothalamic–Pituitary–Ovarian (HPO) Axis

→ Moderate aerobic exercise helps stabilise GnRH pulsatility from the hypothalamus, supporting balanced LH/FSH release and more regular hormone production

→ This stabilises mood and symptoms, avoiding the dramatic highs and lows of hormone swings in perimenopause

→ BUT, intense exercise without proper fuelling (especially without protein) can suppress the HPO axis, leading to functional hypothalamic amenorrhoea and increased cortisol

2. Oestrogen Metabolism

Exercise also influences how oestrogen is metabolised (13):

→ Promotes protective breakdown products (2-hydroxyestrone)

→ Reduces potentially proliferative metabolites (16α-hydroxyestrone)

This may partly explain the link between exercise and reduced breast cancer risk (14,15)

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Just tell me what to do

Yes, it’s a lot. But here’s what I try to do - based on the evidence and my reality:

THE BONUS - start gently, you don’t need to go hard

Almost all the studies above found statistical differences with moderate regular exercise that begins with a 30-minute brisk walk, albeit about 5x a week.

You don’t need to go the gym, you can start with using resistance bands at home. like these: TRX resistance bands.

COMPOUND - mix modalities for maximum benefit

→ Warm up with a brisk walk

→ If you can, finish with a 30-second sprint to raise your heart rate & push your VO2 max

→ Check your weight lifting form with someone you trust, like a recommended PT (or join a lift class); you’ll make sure you are using the right muscles and avoid damaging yourself

→ Test your ability to lift/push weights closer to your maximum single rep and aim to achieve 4 repetitions at a time; there are better gains in muscle at this level, and it takes less time

→ Switch it up to keep it interesting; try all the machines in the gym and throw in a yoga or pilates class to meditate, stretch and test your balance

DON’T do too much; the biggest gains come from the lowest rungs of effort. Going harder adds marginal returns, but rushing can raise cortisol and undo your good work.

SUSTENANCE; it’s really important to feed the body with the fuels it is using during the exercise to avoid stimulating a stress response.

→ Sustained exercise (over an hour) will need carbohydrates afterwards, or you risk the body breaking down precious lean muscle

→ Building muscle will need protein, and adding it in soon after you exercise will help avoid the above; aim for at least 1mg/kg of protein a day

→ Time your fasting to work around your exercise; you can build your resilience to exercising and fasting together, but doing it without that could trigger a stress response

→ Listen to your body and your menstrual cycle, and tailor the exercise you do to what feels good that day.

Some days you’ll want to sprint. Some days, stretch. That’s normal.

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The Lowdown

Exercise isn’t just about strength or stamina. It’s one of the most powerful tools we have to regulate hormones, protect long-term health, and improve quality of life, especially through midlife and beyond.

You don’t need to do it perfectly. Just start. Consistency beats intensity, every time.