Although menopause – the time when periods sign off for good – kicks in at around 50, symptoms like hot flushes, fractured sleep and a spreading waistline can start in the 40s. It's called the perimenopause: the years when ovaries start winding down, creating hormonal changes that can influence bone health, heart health – and where you stack on weight.
But an exercise habit can do a lot to help, says Professor Lily Stojanovska, a researcher in women's health at Victoria University's College of Health and BioMedicine (in Australia).
"There's good evidence that exercise improves sleep and mood, and leads to better blood glucose control, as well as healthier blood fats and blood pressure. Exercise also improves the immune system and with that comes better health," she says.
Where women store weight can shift in midlife. Although women tend to store any extra fat around the hips and thighs during their reproductive years, come menopause any surplus fat tends to gather around the middle instead. That's more than a cosmetic issue – too much abdominal fat ups the risk of type 2 diabetes and heart disease.
That's why it makes sense to get an exercise habit that includes strength training before you reach 40 if you can, Stojanovska points out.
"The more strength training we do, the stronger bones become, the more muscle we build and the less fat we accumulate," she says. "Muscle burns more kilojoules than fat even when we're resting, and the more muscle we build, the easier it is to keep surplus fat at bay."
Can exercise also cool hot flushes? The evidence is mixed – some studies find it helps, but others have found no effect. However some research, including a 2008 Australian study by Professor Wendy Brown of the University of Queensland's school of human movement and nutrition science has linked weight loss to fewer hot flushes – and weight gain to more hot flushes.
The message that regular physical activity and sticking to a healthy weight helps prime women for a leaner, healthier menopause needs to be much louder. Figures from a 20-year study by Women's Health Australia show that women born between 1973 and 1978 who are approaching perimenopause are likely to be eight kilograms heavier at age 47 than women born between 1946 and 1951 were at the same age.
But if you've already reached perimenopause without an exercise habit, now's the time to start.
"You're around half way through your lifespan and at a point where you can influence your health in the second half of your life," says Jennie Burrell, a UK- based fitness trainer who's developed a 30-minute program for women at menopause that's a modified version of CrossFit, mixing cardio with strength training.
"Everyone has to age but you have some choice over whether you'll age with or without preventable health problems like metabolic syndrome, heart disease or diabetes. If we take action, we can probably end up healthier at 60 than we were at 30. Many women at midlife are now caring for elderly parents and often witnessing how the choices their parents made in their mid-lives are contributing to ill health and lack of independence in later life."
Yet the fitness industry doesn't always cater well for women who want to get serious about exercise in mid-life, says Burrell, who's speaking about fitness for women at midlife at the fitness industry conference, FILEX, in Sydney this coming weekend.
"This area of fitness is wildly under-served. In general, the fitness industry goes from full-on, high-impact programs to gentle exercise and aqua-aerobics and often bypasses mid-lifers who are active and strong.
"If a 55-year-old woman is climbing stairs and getting around then she's not ready for the 'soft shoe shuffling' movement regimes often offered to the over 50s. She's probably going to live to at least 85 so for me it's about keeping her strong, active and independent for the next 30 years – not pressing the 'power-down button'."
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