The Best Exercise Routine for Perimenopausal Women To Ease Hot Flashes and Burn Fat

We often talk about the challenges of menopause. But perimenopause – the transition phase between menstruation and menopause – can come with its own unique symptoms, such as stress and anxiety, trouble sleeping, muscle aches and more. One of the best ways to manage these symptoms is with regular exercise, so we reached out to the experts to find out the best exercise routine for perimenopausal women. 

What is perimenopause? 

“Perimenopause means ‘around menopause,’” explains Tina Hendrick, MD, board-certified ob-gyn and medical director at Pediatrix Medical Group. “It’s the time period when your estrogen and progesterone levels start to decline.”

Perimenopause can be a time of sporadic periods and emotional whiplash, or it can feel totally normal – everyone is different, says Dr. Hendrick. 

“There are so many possible symptoms of perimenopause. You name it, it can be a symptom!” Dr. Hendrick says. “Some of the more common symptoms are changes in menses, hot flashes, night sweats, irritability/anxiety, vaginal dryness, decline in libido, sleep dysfunction and weight gain.”

Benefits of an exercise routine for perimenopausal women

One of the best things you can do to manage these kinds of symptoms during perimenopause and menopause is developing a regular fitness routine. 

“Exercise has been shown to alleviate many symptoms in perimenopause and have a positive impact on mental health and sleep,” explains Heather Jeffcoat, DPT, owner of Feminina Physical Therapy in Los Angeles. 

“For sleep, it helps you fall asleep and stay asleep,” she says. “For mental health it’s been shown to positively impact both anxiety and depression by preventing or reducing existing symptoms in perimenopausal women.”

Both cardio and strength training can be beneficial, and may help alleviate different symptoms. 

“Mood changes, sleep disturbance and energy levels can greatly be improved by increasing cardio exercise, specifically exercise that increases endorphins and heart rate,” says Lexi Burtman, pelvic floor physical therapist at Solstice Physiotherapy. 

“Weight training can improve the decreased metabolism caused by perimenopause, and also improve the maintenance of bone density, which is known to decrease with dropping estrogen levels,” she adds.

Exercise routine for perimenopausal women

When it comes to finding the best exercise routine for perimenopausal women, Jeffcoat has a tip: Pay attention to your heart rate. 

“Physical fitness should be at a moderate level, which is approximately 50-70 percent of your maximum heart rate,” says Jeffcoat. 

“The easiest way to figure out your maximum heart rate is to use the following formula: 220 - your age. So, if you are 42 years old, your estimated maximum heart rate is 178 beats per minute. Working within your 50-70 percent range would put you at 89-125 beats per minute.” 

To nail this range and ease perimenopause symptoms, Jeffcoat recommends a combination of exercises. “You can get in this range using various cardio equipment, or swimming or hiking,” Jeffcoat says. Cardio equipment, such as a Stairmaster, can be a great way to get exercise even on a rainy day. 

Check out the video below for tips on proper stairmaster form: 

Jeffcoat also recommends starting slow and building consistency in your workout routine. And that's true whether you’re doing cardio, resistance training or weight-bearing exercises. 

“It can be challenging to fit these practices into a new routine, so I have my patients start with one or two days per week and build up from there,” she adds. 

Exercise routine for perimenopausal women: Beginner

Getting into a regular fitness routine not only eases perimenopausal symptoms. It can also increase muscle mass, which helps you burn fat. And it doesn’t require grueling high intensity workouts, either. Here’s what Jeffcoat recommends for beginners:

• 30 minutes of moderate intensity aerobic exercise (such as running or swimming) four times per week. 

• An additional 15 minutes of mindfulness practice (such as tai chi, yoga, pilates, stretching, qigong, baduanjin or meditation) four times per week. 

Get started with this pilates for perimenopause video:

Exercise routine for perimenopausal women: Intermediate

If you’re able to exercise for a little longer (you can work your way up to this!), consider this workout Jeffcoat recommends:

• 60 minutes of moderate intensity aerobic exercise twice a week

• 15 minutes of mindfulness practice four times a week

Get started with this yoga workout for perimenopause video:

More on supporting perimenopause:

Struggling to Stay Awake? Perimenopause Exhaustion May Be the Reason Why

The Perimenopause Diet: Foods to Eat and Avoid

Perimenopause Cramps: Doctor Explains Causes and Best Practices for Relief

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.