Best Exercises for Perimenopause: Strength Training & Hormonal Health

If you grew up in the 1980s, exercise was all about cardio—burning calories to stay thin. But now, as hormones shift during perimenopause, you may notice that your usual workouts aren’t delivering the same results. If you’re gaining weight despite maintaining your routine, it’s time to rethink your approach to exercise.

Perimenopause, the transition leading to menopause, isn’t just about hormonal changes—it’s a key time that shapes your health for decades to come. You could spend 40% of your life post-menopause, so how you move your body now can help you build muscle, support metabolism, and reduce your risk of chronic diseases.

This article dives into:

• How perimenopause and aging impact your health

• The best exercises to support hormonal changes

• Why strength training matters more than ever

• Practical exercise recommendations that are simple to follow

• Tips for getting the most out of your new routine

How Perimenopause Affects Your Body

Perimenopause is marked by a significant drop in estrogen (especially estradiol) and progesterone. Estrogen plays a key role in metabolism, and its decline can lead to insulin resistance, increased belly fat, and loss of muscle mass. Starting in our 30s, we naturally lose about 1% of muscle per year, which means lower energy expenditure. Even if your weight stays the same, body composition changes, with muscle decreasing and fat increasing—especially around the midsection.

This metabolic shift also increases inflammation and raises the risk of heart disease, osteoporosis, and diabetes. To make matters worse, many women in perimenopause exercise less, with some research showing a 40% decline in physical activity. But staying active is one of the best ways to counteract these changes.

The Benefits of Exercise in Perimenopause

Exercise helps combat metabolic dysfunction by improving insulin sensitivity, preserving muscle mass, and reducing inflammation. Women who stay active through perimenopause tend to have:

• Lower body fat and healthier body composition

• Greater muscle mass and bone density

• Lower risk of heart disease and diabetes

• Better mood, sleep, and overall well-being

One study found that just 12 weeks of moderate exercise improved sleep, reduced insomnia, and helped with depression in sedentary women. Another showed that regular exercise can help reduce hot flashes. The key is choosing the right type of exercise for this stage of life.

Why Strength Training Is Essential

If you’ve been a cardio lover for decades, it might feel unnatural to prioritize strength training—but it’s one of the best things you can do in perimenopause. Lifting weights won’t make you bulky; instead, it helps build lean muscle, improve body composition, and boost metabolism.

Strength training offers powerful benefits, including:

• Improved insulin sensitivity

• Stronger bones and reduced risk of osteoporosis

• Lower risk of heart disease and hypertension

• Decreased anxiety and depression

• Reduced risk of cancer and overall mortality

Shifting your focus from cardio to strength training might feel uncomfortable at first, but it’s worth it. Aim for at least two strength sessions per week to maintain and build muscle.

Exercise Recommendations for Perimenopausal Women

The North American Menopause Society and CDC recommend:

• 150 minutes of moderate exercise per week (walking, dancing, yoga, Pilates, or anything you enjoy)

• Strength training 2-3 times weekly, working all major muscle groups

• Short bursts of movement throughout the day to break up sedentary time (think of movement as “snacks” for your body)

If you’re new to strength training, start with bodyweight exercises and focus on good form. As you get stronger, gradually increase resistance with bands or weights.

Tips for Sticking to Your New Routine

• Prioritize protein: Aim for 1.2 to 1.6 grams of protein per kilogram of body weight daily to support muscle growth. For a 150-pound woman, this means 82 to 110 grams per day.

• Eat whole, nutrient-dense foods: Balance your meals with protein, healthy fats, fiber, and complex carbs to fuel your workouts and support metabolic health.

• Focus on sleep: Recovery happens when you sleep. If you’re not getting quality rest, your body won’t repair and build muscle as effectively.

• Shift your mindset: Instead of exercising to “be thin,” focus on getting stronger and healthier. Exercise should feel empowering, not like a punishment.

• Support estrogen receptors: Foods like flaxseeds and soy, as well as herbal supplements like black cohosh, can help support estrogen receptors and ease perimenopausal symptoms.

The Bottom Line

Exercise during perimenopause isn’t just about maintaining weight—it’s about setting yourself up for long-term health and feeling your best. Strength training IS especially effective at preserving muscle, boosting metabolism, and reducing health risks. The key is consistency—start small, stay consistent, and make exercise a regular part of your life. It’s never too late to start!