Bewegung und SportAllgemeinErnährung:ernaehrungNahrungsergänzung

Evela Health’s 10 Dimensions of Health – No. 1: Exercise

Strength and endurance training are the most effective measures against muscle and bone loss, cardiovascular disease, and dementia.

Evela Health’s ten dimensions of health provide women in perimenopause and postmenopause with a clear, medically sound framework for greater well-being and long-term health. Based on scientific principles, individualized strategies suitable for everyday life are developed—with the goal of better understanding one’s own body and strengthening it in a targeted manner.

Using a structured questionnaire, Evela assigns each woman a level on a five-point scale—from Level 1, indicating a clear need for development, to Level 5, which describes sustainable optimization. This makes it clear where you stand—and what next steps make sense.

What do you want to still be able to do as you age?

Lifting a grandchild at 70, stowing a suitcase, or standing up without assistance—these aren’t matters of chance, but skills that can be trained. In his book Outlive (2023), Peter Attia describes this as the “decathlon of centenarians”: the deliberate training of those movements that ensure independence and quality of life well into old age. Menopause is the ideal time to start, even if “70” still seems far away.

Strength and endurance—two pillars of healthy longevity

For many women, daily life is characterized by sedentary work, digital communication, and little physical activity. Adults spend more than eight hours a day sitting—with measurable consequences. The body loses muscle mass, strength, and endurance. During menopause, hormonal changes further accelerate this process. Physical activity thus becomes a medically important measure for maintaining metabolic stability and physical function.

Strength Training – The Foundation for Muscle Preservation and Metabolic Stability

Starting at age 40, muscle mass decreases by about 1% annually, and muscle strength by 2–3%. This process—sarcopenia—progresses much more rapidly during perimenopause, as declining estrogen levels affect muscle regeneration and energy metabolism.

Several meta-analyses show that targeted strength training significantly improves muscle mass and strength in peri- and postmenopausal women (1–3) and reduces the risk of osteoporosis, insulin resistance, and type 2 diabetes (3).

Functional strength training is particularly effective. These are resistance-based movements that activate multiple joints and muscle groups simultaneously—such as squats, lunges, or horizontal and vertical weight pressing. A randomized study involving women aged 40 to 60 showed that such exercises significantly increase muscle strength and well-being (4).

Two full-body workouts per week, each lasting 25–35 minutes, starting at a moderate intensity and gradually increasing, are ideal—whether at home or at the gym.

Endurance training – a protective factor for the heart, blood vessels, metabolism, and mental health

Regular aerobic exercise—brisk walking, cycling, swimming, or running—strengthens the heart and blood vessels, improves insulin sensitivity, and lowers blood pressure and harmful blood lipids. Several systematic reviews also show positive effects on mood and mental stability (5, 6).

Go dancing! A large meta-analysis from 2024 shows that exercise—especially dancing—is among the most effective natural antidepressants and, in many cases, is more effective than drug therapy (7). Exercise promotes neuroplasticity, modulates inflammatory processes, and strengthens social bonds—all factors that are often under strain during menopause.

The World Health Organization (WHO) recommends 150 minutes of moderate activity per week, supplemented by two strength training sessions. Consistency is key—small, steady steps have a lasting effect.

Everyday Activity as a Core Component of a Fitness Plan

Many women going through menopause juggle work, family, and their own personal goals—often leaving little time for themselves. Structured exercise seems almost impossible under these circumstances. But physical activity can start right in your daily routine: A large study showed that just 4,000 steps a day significantly reduce the risk of death. More exercise brings additional benefits—up to about 7,500 steps daily, after which the effect levels off (8). For women with low activity levels, it can be helpful to set a baseline goal of 5,000 steps and gradually increase it.

Those who want to enhance the training effect can wear a weighted vest. Studies suggest that they slow the loss of muscle and bone mass and help maintain a stable body weight after weight loss (9). A moderate weight of about 1.5–3 kg or a maximum of 5% of body weight is key.

Nutrition and supplements support muscle building

Adequate protein intake is essential for maintaining and building muscle mass. Women who regularly engage in strength training benefit from 1.6–1.8 g of protein per kilogram of body weight per day. You can calculate your daily requirement here, for example: www.evela.health/de/calculators/protein-calculator. A combination of animal and plant-based sources, such as chicken, fish, eggs, cottage cheese, legumes, or tofu, is the most effective way to meet this need.

Protein supplements are helpful when dietary intake is insufficient. However, their benefits are only evident when combined with regular strength training. A large meta-analysis confirmed that protein supplementation combined with resistance training measurably improves muscle mass, strength, and walking speed (10).

Another well-studied supplement is creatine. It acts as a rapid energy store in muscle cells and can enhance the effects of exercise. Studies in postmenopausal women show that a daily dose of 3–5 g of creatine monohydrate improves muscle strength and lean body mass, and may also improve bone density and cognitive function (11).

Higher protein intake and creatine are considered safe at recommended doses, provided there are no pre-existing medical conditions (12, 13). The key remains a combination of a balanced diet, regular exercise, and adequate rest.

Hormonal Effects on Muscle Strength and Endurance

During perimenopause, estrogen levels drop significantly—with noticeable consequences for muscle metabolism, recovery, and energy balance. Estrogens promote the formation of satellite cells, support mitochondrial activity, and protect against exercise-induced muscle damage. As estrogen levels decline, recovery slows down: muscle mass and strength decrease more rapidly, and training progress is slower to materialize.

Menopausal hormone therapy (MHT) can partially mitigate these changes. Large systematic reviews show that, when started early, it has beneficial effects on bone density and metabolic parameters (14). There is also evidence of improved recovery and slightly reduced strength loss in the muscles—though this does not constitute an independent indication for therapy.

Exercise as the Foundation for the Second Half of Life

Menopause is a time of change—biologically, hormonally, and emotionally. Starting targeted strength and endurance training now not only strengthens muscles and bones but also boosts energy, metabolism, and inner stability.

For many women, getting started isn’t easy. Sleep disturbances, exhaustion, or hot flashes often make exercise seem impossible. This is precisely when it makes sense to discuss hormonal support—it helps many women regain their balance and find the strength to exercise.

If you’d like to know which steps make sense for you, we’d be happy to guide you!

Note regarding publication

This article was originally published as part of the Nina Ruge stayYoung newsletter (https://www.stayoung.de/) and is republished here by Evela Health—supplemented with all references and scientific evidence. The goal is to present the content in a transparent and evidence-based manner and to provide women in perimenopause and postmenopause with reliable information.

References

Let's talk

Book an introductory call to find out how Evela Health can help your organization
Contact us