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Welcome to my Women's Integrative Medicine Blog- First Post: Musings about the opening symposium of the Menopause Society Annual Meeting.

ampolonsky
8 minutes ago
3 min read

I have just started watching the Menopause Society Meeting lectures- I am attending virtually- and am so excited to see that the opening symposium is called “Cutting Through the Noise, the evidence for incorporating the 6 pillars of lifestyle medicine in menopause care.  I am just loving that Women’s Integrative Medicine is finally becoming “mainstream”!

For those that don’t know, the 6 pillars of lifestyle medicine are:

  1. Optimal nutrition

  2. Restorative Sleep

  3. Physical Activity

  4. Stress Management

  5. Connectedness 

  6. Avoidance of risky substances.


The first lecture in the session was about the importance of exercise, particularly resistance training in midlife women.  Why is this important?  Because there is a 1-1.5% annual decline in muscle mass after menopause and the risk of sarcopenia (frailty) goes from 3% in early perimenopause to 32% post menopause.  Additionally, there is a 2.5% annual Bone Mineral Density loss in perimenopause, with total 10% bone loss over the menopause transition.  Menopause is a critical window to protect strength, skeletal health and independent function.


One of my favorite slides in this lecture is titled: “The Clinical Endpoint is Independence”- something I try to hammer home during my office visits. As you age, you want to make sure you preserve these things:

  1. Functional Strength- Will you be able to carry groceries, rise from a chair, climb stairs

  2. Resilience to Injury- preserve functional mobility, reduce risk of falls and fractures

  3. Improve Metabolic Health- insulin sensitivity, support a healthy body composition, enhance metabolic flexibility


The good news is that it is never too late- resistance training is associated with improvements in strength and body composition throughout the lifespan.  Both resistance training and aerobic exercise improve cardiometabolic health AND Cognitive/ Executive Function.


Next came the “Exercise Prescription”

  1. Aerobic:  150-300 min/ week moderate or 75-150 vigorous- walking, jogging, cycling, swimming, dancing.  If starting from zero, build up to this.

  2. Resistance:  At least 2 days per week, all major muscle groups.  Progress the load as technique, capacity and recovery allow

  3. Bone Specific: Progressive Overload, Add Impact (jumping) when appropriate

  4. Balance/ Falls- multicomponent balance and functional strength activities, 3 times per week

  5. Avoid sedentary behavior.  Move throughout the day.  Even if you get your exercise minutes in, there are adverse effects to sitting for extended periods during the day


Perfection can be the enemy of progress.  You need to work up to these goals.  If you can’t yet do a “full workout” or if you are short on time, do what you can! Consider exercise “snacks” and space that movement throughout the day when you have 5-10 minutes- a few sessions can add up to that "full workout". 

For resistance training you can start with body weight exercises, then add resistance bands, machines if you have access to a gym, and then free weights or barbells. 

Focus on compound exercises that involve multiple muscle groups-


Squats Deadlifts Chest Press Overhead Press

Row Lat Pulldown Plank Lunges. 


She even mentioned SMART goals as a great method to help you get started, anticipate obstacles and make lifelong new healthy habits. If you are an IWH member and haven’t already, please check the video of the recorded session and fill out your own SMART goals worksheet and bring it to your next appointment).


Towards the end of the lecture, she shared advice from one of her patients- a breast cancer survivor who found her sense of self again through exercise.  Her advice included:  

  1. Find your support system (family, friends)

  2. Set small attainable goals (think functional- walking up a flight of stairs, giving your grandchild a piggyback ride, etc)

  3. Enlist a professional.  If you are new to lifting, consider some sessions with a personal trainer or physical therapist

  4. Have fun- the best program is the one you can stick with long term.


Consider- train for something- a 5K, Hydrox.  Look for resources online:  Carolyn Girvan Iron Program on You Tube, Peloton Strength Programs, HaileyHappensFitness.com


And remember, it is never too late to start, or to RESTART.


 
 
 

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