Menopause: The Journal of The North American Menopause Society

Vol. 22, No. 12, pp. 1351-1358

DOI: 10.1097/GME.0000000000000536
ß 2015 by The North American Menopause Society

INVITED REVIEW
Menopause and exercise
Natalia M. Grindler, MD, and Nanette F. Santoro, MD

Abstract
Objective: Accumulating data suggest that regular physical exercise reduces mortality and extends the functional
life span of men and women. This review seeks to describe the current state of the medical literature on this topic.
Methods: A narrative review of the current medical literature including randomized clinical trials and clinical
guidelines that address the benefits of physical fitness and regular exercise on the health of midlife and
postmenopausal women.
Results: Reduction and avoidance of obesity and its related comorbidities (hypertension, glucose intolerance,
dyslipidemia, and heart disease) are one major benefit of exercise. However, long-term physical exercise is also
associated with reduced rates of cancer, dementia and cognitive decline, adverse mood and anxiety symptoms, and
reduction of osteoporosis, osteopenia, falls, and fractures. Beneficial physical activity includes exercise that will
promote cardiovascular fitness (aerobic), muscle strength (resistance), flexibility (stretching), and balance (many of
the preceding, and additional activities such as yoga).
Conclusions: Given that it is unambiguously beneficial, inexpensive, and minimal risk, maintaining a healthy
exercise regimen should be a goal for every participant to enhance lifelong wellness. Clinicians should use a number
of behavioral strategies to support the physical fitness goals of their participants.
Key Words: Exercise – Menopause – Physical fitness.

I
ndividuals aged 65 years or older are now the fastest-
growing section of the population.1 As the world popu-
lation increases, along with an increase in life expect-
ancy, many millions of women will be spending a third or
more of their lives after menopause. Menopause heralds an
opportunity for prevention strategies to improve the quality of
life and enhance longevity.
Obesity has emerged as a global health issue, and the
prevalence of obesity, defined as body mass index (BMI)
greater than 30 kg/m2, is higher in women than in men.2
Obesity is associated with increases in multiple medical
comorbidities, including diabetes mellitus, cardiovascular
disease, dementia, some cancers (ie, endometrial, breast,
colon), depression, and osteoarthritis.3-5 Primary prevention
of obesity resides in an appropriate balance between energy
intake and expenditure. Emerging evidence suggests that
regular physical activity is among the most important lifestyle
Received May 21, 2015; revised and accepted July 8, 2015.
From the Division of Reproductive Endocrinology and Infertility,
Department of Obstetrics and Gynecology, University of Colorado
School of Medicine, Aurora, CO.
Funding/support: None.
Financial disclosure/conflicts of interest: Both authors are lifelong,
enthusiastic exercisers.
Address correspondence to: Nanette F. Santoro, MD, Division of
Reproductive Endocrinology and Infertility, Department of Obstetrics
and Gynecology, University of Colorado School of Medicine, 12631
E 17th Avenue, Aurora, CO 80045. E-mail: Nanette.santoro@
ucdenver.edu
factors for maintaining normal body weight, and thereby good
health into older age.6
Women experience a concurrent reduction in basal meta-
bolic rate and loss of lean muscle as they transition to
menopause.7 Although midlife weight gain is often attributed
to menopause, it is primarily impacted by age, and not
necessarily menopause itself.8,9 Midlife women gain an aver-
age of 4.5 to 4.9 pounds over a 3-year period.8 In the Study of
Women’s Health Across the Nation cohort of midlife women,
waist circumference increased by 2.2 cm over 3 years, particu-
larly in postmenopausal women.8,10 This weight gain and
reduction of metabolic rate is accompanied by reduced
activity, as women significantly reduce regular exercise
during middle age by up to 40%.11,12 Menopause is also
associated with an increase in total and central fat13 and
decrease in muscular strength.14 The decrease in estrogen
at menopause is associated with increased abdominal and
visceral fat if no concomitant change in physical activity or
total body weight occurs.15 This results in a transition to an
android pattern of fat distribution and an increase in total body
fat in women.16 The accumulation of abdominal fat in post-
menopausal women is important for the development of
insulin resistance, which is a major risk factor associated
with the development of type 2 diabetes. Postmenopausal
abdominal weight gain is also associated with the develop-
ment of an adverse lipid profile, with an increase in low-
density lipoprotein cholesterol and a decrease in the total
cholesterol to high-density lipoprotein cholesterol.15 Each of

Menopause, Vol. 22, No. 12, 2015 1351

Copyright @ 2015 The North American Menopause Society. Unauthorized reproduction of this article is prohibited.
 GRINDLER AND SANTORO
these elements contributes to the atherosclerotic process and
is a component of potentially life-threatening metabolic syn-
drome. Exercise reverses or attenuates each of the above-
described effects of aging and menopause.
Menopause and specific exercise recommendations
The American Heart Association (AHA) and the American
College of Sports Medicine provide recommendations for
adults over the age of 65.17 Notably, these generalized
recommendations are based on laboratory training data and
are not based on data collected from a free-living condition.
These recommendations for exercise are categorized into four
broad areas of physical fitness: aerobic exercise, muscle
strengthening, flexibility, and balance. Aerobic exercise
involves the use of large muscle groups and must be sustained
for a minimum of 10 minutes. Examples of aerobic activities
include brisk walking, swimming, tennis, water aerobics,
dancing, and bicycle riding. The Borg Rating of Perceived
Exertion (RPE) Scale measures perceived exertion and is
particularly useful in exercise testing. It ranges from 6 to
20 where 6 means ‘‘no exertion at all’’ and 20 means
‘‘maximal exertion.’’18,19 The RPE can be used to estimate
the general heart rate of a healthy adult by multiplying by 10.
For instance, a perceived exertion of 12 would be expected to
coincide with a heart rate of roughly 120 beats/min. The
American Heart Association and the American College of
Sports Medicine suggest a minimum of 30 minutes of mod-
erate-intensity aerobic activity (RPE 12-13) on 5 days each
week or a minimum of 20 minutes of vigorous-intensity
activity (RPE 14-15) on 3 days each week, or some combi-
nation of the two.17 Muscle strength is developed with weight
training, resistance training, or weight-bearing calisthenics.
Muscle-strengthening activities should be done a minimum of
2 nonconsecutive days of the week and should target 8 to 10
major muscle groups (abdomen, bilateral arms, legs, should-
ers, hips). Individuals should strive to perform 10 to 15
repetitions of each exercise at the intensity of 60% to 75%
of one-repetition maximal and increase resistance over time.
Flexibility in activities such as stretching and yoga is necess-
ary to perform daily life activities such as reaching overhead
and putting on shoes. Balance exercise improves stability and
may prevent falls or reduce injuries related to falls.20-22
Physical activity/inactivity and health
The advantages of regular physical activity include
reduction in risk of cardiovascular events, reduction in
obesity, diminished risk of hypertension and diabetes melli-
tus, improvement in blood lipid profile, reduction in risk of
cancer, and many others.23 Physical activity improves the
quality of life for people of all ages and may increase life-
span.24-27 In fact, data from the Dose-Response to Exercise in
Postmenopausal Women study, which examined the health
benefits of the 50%, 100%, and 150% of the NIH Consensus
Panel physical activity recommendation in postmenopausal
women, illustrated that exercise-induced improvements in
quality of life were dose-dependent and independent of
1352 Menopause, Vol. 22, No. 12, 2015
Copyright @ 2015 The North American Menopause Society. Unauthorized reproduction of this article is prohibited.
weight change.28 Individuals who are regularly physically
active report better overall health, lower mobility limitations,
and lower healthcare expenditures than their sedentary
counterparts.29-31 Consistent activity helps to maintain aero-
bic capacity, strength, and muscle mass over the aging
process.
Aerobic capacity declines at about 1%/y from midlife
forward and at one-half that rate among habitually active
persons.32 Loss of muscle mass and strength also accelerate
after midlife.33 When combined with physical inactivity, the
presence of elevated central adiposity, oxidative stress,
inflammatory markers, and cognitive impairment has been
associated with sarcopenia.34,35 Sarcopenia, in turn, interferes
with the activities of daily living and limits the independence
of the elderly, particularly women.
Common barriers for middle-aged women considering
initiation of exercise are lack of time, safety concerns about
exercising outdoors, weather, and not having a family mem-
ber or friend to exercise with.36 Lack of time may be an
especially significant barrier for midlife women, given their
multiple responsibilities and roles within their households,
extended families, and work.37 The aim of this review is to
evaluate the evidence supporting exercise in menopausal
women.
SHORT TERM BENEFITS OF EXERCISE
Symptom relief
Physical activity may be an effective way of preventing or
attenuating some of the common menopause-related symp-
toms.38 The North American Menopause Society and the
UK’s Royal College of Obstetricians and Gynecologists
recommend aerobic exercise and regular exercise as an
intervention for treating mild to moderate menopausal symp-
toms in perimenopausal women.39 The top three menopause-
related symptoms in Chinese women include fatigue, irrita-
bility, and arthralgia.39 In a 12-week randomized, controlled
trial of brisk walking for 30 minutes at least three times a
week, women who exercised reported decreased paresthesia,
insomnia, irritability, arthralgia, and fatigue. In addition,
weight, BMI, waist circumference, triglycerides, and total
cholesterol were significantly improved in the exercise inter-
vention group.39 The Menopause-Specific Quality of Life
questionnaire divides menopausal symptoms into physical,
vasomotor, psychosocial, and sexual symptoms.40 In a cross-
sectional observational study of perimenopausal Korean
women, Kim et al41 demonstrated that moderate levels of
physical activity were associated with reduced psychosocial
and physical menopausal symptoms, suggesting that physical
activity may improve some of the symptoms of menopause,
thereby increasing the quality of life in menopausal women.
Although several studies have demonstrated that physical
activity reduces menopausal symptoms,42 others have shown
inconsistent results for vasomotor and sexual symptoms.43-46
A randomized controlled trial (RCT) that evaluated the
effectiveness of a 6-month exercise intervention as treatment
for vasomotor menopausal symptoms found it ineffective for
ß 2015 The North American Menopause Society
 MENOPAUSE AND EXERCISE
both hot flushes and night sweats.47 Similarly, another RCT in
late peri- and postmenopausal sedentary women with frequent
vasomotor symptoms found that 12 weeks of moderate-inten-
sity aerobic exercise did not alleviate vasomotor symptoms.48
A recent Cochrane review found that evidence was insuffi-
cient to show whether exercise is an effective treatment for
vasomotor menopausal symptoms.49 The Menopause Strat-
egies: Finding Lasting Answers for Symptoms and Health
research network similarly found that 12 weeks of moderate-
intensity aerobic exercise did not alleviate vasomotor symp-
toms, but resulted in small improvements in sleep quality,
insomnia, and depression in midlife sedentary women.50
Taken together, evidence does not support the routine use
of physical exercise to treat vasomotor symptoms.
Maintenance of weight and healthy body composition
Regular exercise is associated with improved conditioning,
strength, flexibility, and overall physical fitness in older
adults.17,51 If it is sufficiently strenuous, it can prevent weight
gain. For example, Nordic walking, a combination of walking
and cross-country skiing like movement (including pushing
oneself over the ground using poles), reduces weight gain in
postmenopausal women.23,52 Nordic walking results in
weight loss during menopause (6.4%), and decreases in blood
glucose (3.8%) and lipoproteins (10.4%-16.7%), all of which
was substantially better than either Pilates or dietary inter-
vention alone at 10 weeks.23 Long-term (12 moþ) exercise
programs in postmenopausal women have been associated
with positive changes in basal metabolic rate, skeletal muscle
mass, percent fat, and other anthropometric and body com-
position variables.53 These findings are supported by data
from the Study of Women’s Health Across the Nation study
that has associated regular physical activity with beneficial
changes in body composition and fat distribution in peri- and
postmenopausal women,54 specifically lower BMI, less cen-
tral adiposity, and lower prevalence of cardiovascular risk
factors such as diabetes and metabolic syndrome. It is import-
ant to note, however, that although mild-intensity aerobic
exercise training improves some markers of cardiovascular
disease and mortality in postemenopausal women, additional
markers of mortality risk (ie, aerobic fitness, glomerular
filtration rate, BMI, plasma glucose dysfunction, markers
of endothelial dysfunction) only improve in premenopausal
African-American women.55 Additional studies are needed to
evaluate the ethnic and racial differences exercise may have
on menopausal women.
In addition, high intrinsic aerobic fitness is protective
against increases in adiposity and insulin resistance in a rat
model of menopause.56 Similarly, a randomized controlled
study showed that a low–moderate-intensity exercise pro-
gram resulted in decreased inflammatory cytokines (IL-1beta,
IL-6, TNF-alpha),57 all of which are characteristically elev-
ated in obesity. Other studies, however, have shown that
although IL-6 expression may decrease in response to a
16-week brisk walking intervention among sedentary over-
weight and obese women, it did not result in a favorable
Copyright @ 2015 The North American Menopause Society. Unauthorized reproduction of this article is prohibited.
impact on the cardiometabolic risk profile irrespective of
menopause status.58 A 6-month exercise program combined
with 70 mg/d isoflavone supplementation resulted in marked
improvements in body composition parameters known to
influence the development of cardiovascular disease in post-
menopausal women.59 Suppression of obesity, and its related
inflammation, may be a further indirect mechanism by which
exercise exerts beneficial effects on health.
Better mobility and injury prevention
Dynapenia refers to an age-related loss of muscle strength
and may be used as a marker of cardiorespiratory function, as
dynapenic women have significantly poorer cardiorespiratory
function than others.60 Regular exercise has also been linked
to improved mobility and reduced onset of mobility-related
disability,61,62 along with reduced likelihood of falls and fall-
related injuries,63 thereby suggesting that regular physical
activity assists older adults in maintaining independent func-
tion and in decreasing their risk of injury.64 Postmenopausal
women also gain significant psychological benefit from mod-
erate-intensity exercise with continued exercise, resulting in
maintained improvements in psychological well-being and
quality of life.65 It is important to note, however, that there is
heterogeneity of physical function responses to exercise train-
ing in older adults and some may not improve as much as
others.66 In addition, although a moderate intensity physical
activity intervention may improve physical function in older
adults, the positive benefits may be attenuated with obesity.67
Fractioning exercise regimens into multiple shorter daily
regimens is feasible and effective in postmenopausal
women.68
LONG-TERM BENEFITS OF EXERCISE
Reduced mortality
There is a linear relationship between greater amounts of
sedentary time and mortality risk in older women.69 Analysis
of NHANES data elucidates that the most sedentary age group
of the population is composed of adults older than 60 years:
sedentary time is 8.5 h/d in adults aged 60 to 69 years and
9.4 h/d in adults 70 to 85 years.70 Postmenopausal women
studied in the Women’s Health Initiative’s Observational
cohort, who reported greater amounts of sedentary time
had an increased risk of all-cause mortality (hazard
ratio¼1.26; 95% CI 1.19, 1.34), which remained statistically
significant, but was somewhat lower after controlling for
physical activity, physical function, and other relevant cova-
riates (hazard ratio ¼ 1.12; 95% CI 1.05, 1.21).69 Similar
results were found for cardiovascular and cancer mortality.69
Mortality risk rose in a dose-dependent manner with seden-
tary time and was consistent across all causes of death
examined.69
Weight maintenance and other chronic conditions
In postmenopausal women, higher habitual physical
activity while participating in aerobic training is associated
with greater reductions in central adiposity, and is supportive
Menopause, Vol. 22, No. 12, 2015 1353
 GRINDLER AND SANTORO
of weight loss, compared with lower activity levels.71 In
addition, regular exercise has been associated with improved
participant outcomes in chronic disorders, including mood
disorders, dementia, chronic pain, congestive heart failure,
stroke, constipation, and sleep disorders in older adults.17,72-74
There is a dose–response relationship between exercise
duration and numerous health outcomes in postmenopausal
women, including cardiorespiratory fitness, body mass, body
composition, waist circumference, and high-density lipopro-
tein cholesterol, although no comparison has been done with a
premenopausal group.75 Declines in cardiorespiratory fitness
in postmenopausal women are associated with an increase in
central adiposity and a decrease of the basic metabolic rate.
Moderate-intensity exercise programs have been found to
improve cardiorespiratory fitness and to positively modify
other major risk factors for cardiovascular disease in post-
menopausal women.76 Regular exercise also reduces the risk
of the following chronic diseases: cardiovascular disease,
thromboembolic stroke, hypertension, type 2 diabetes melli-
tus, osteoporosis, obesity, colon cancer, breast cancer,
anxiety, depression, and cognitive decline in older adults.77
Prevention of heart disease
Perhaps the most important benefit to be gained by regular
exercise in postmenopausal women is its protective effect on
endothelial function and in prevention of heart disease. This is
especially important to postmenopausal women because the
benefits of estrogen on the vascular endothelium seem to be
limited to the reproductive and (perhaps) early postreproduc-
tive years, and thereafter there are few studies that indicate a
demonstrable protective effect of estrogen on the vasculature.
Aerobic exercise specifically promotes healthy endothelial
function and is therefore a logical, nonpharmacologic, inex-
pensive way for women to maintain cardiovascular health.
Cardiovascular disease is the most common cause of death in
women, accounting for the greatest proportion of deaths over
the age of 50 years.78 The overall prevalence of coronary
artery disease is estimated to be 5.1% in women.79 Women
generally face a worse prognosis than men after a primary
coronary event: 18% of women develop heart failure within
the first 5 years after a myocardial infarction.79 The decline in
vascular function in women is accelerated during the post-
menopausal period,80 and is accompanied by additional
unfavorable changes in cardiovascular risk factors.81-83 As
little as 12-weeks of exercise has been shown to have a
positive impact on vascular function, as indicated by a marked
improvement in the biomarker profile, in both premenopausal
and postmenopausal women of a similar age.84 Similarly,
previously sedentary, overweight, or obese postmenopausal
women experience a dose–response change in fitness across
levels of exercise training over a 6-month period.85 In a recent
trial, 16 weeks of aerobic exercise improved body com-
position, sex hormone binding globulin, insulin levels,
and metabolic syndrome factors in obese postmenopausal
women.86 Regular aerobic exercise for a 12-week period
results in clinically important reductions in resting blood
1354 Menopause, Vol. 22, No. 12, 2015
Copyright @ 2015 The North American Menopause Society. Unauthorized reproduction of this article is prohibited.
pressure in postmenopausal women with mild to moderately
elevated initial levels.87 Even low physical activity levels
improve vascular function in overweight and obese postme-
nopausal women.88 Habitual physical activity, specifically
walking 6,000 or more steps per day, was associated with
decreased risk of cardiovascular disease and diabetes in
middle-aged women, independent of menopause status.89
Future studies like the WalkMore RCT will be important
to our understanding of the relative benefits that walking
volume and/or intensity may have on blood pressure in a
population at risk for cardiovascular disease.90
Prevention of bone resorption
Osteoporosis is a systemic skeletal condition of deterio-
rating bone strength and predisposes women to an increased
risk of fractures. Up to 70% of women have osteoporosis by
the age of 80.91,92 Osteoporotic fracture causes considerable
morbidity and indirect mortality because of problems
related to immobility. Weight-bearing exercise is beneficial
to bone development and maintenance through mechanical
loading of bone.93 Walking as a singular exercise therapy
has no significant effects on bone mineral density at the
lumbar spine, radius, or the whole body in perimenopausal
and postmenopausal women, although significant and
positive effects on femoral neck bone mineral density are
evident with interventions more than 6 months.94 Exercising
more than two to four times per week compared with less
than two sessions per week is also associated with more
favorable bone adaptive response in postmenopausal osteo-
penic women.95
Three specific types of exercise are helpful for postmeno-
pausal women who have osteopenia or osteoporosis. The
overall purpose of exercises to help osteopenic or osteoporotic
women need not be simply to build bone or prevent bone
resorption. There is also value in mitigating falls and the
consequences of falling, which can be fractures. First, it is
important to consider which exercises are truly ‘‘weight-
bearing’’ to avoid confusion. These are generally high-impact
exercises such as jogging, running, and brisk walking. Bicycle
riding, use of an elliptical trainer, and cross-country skiing are
not considered weight-bearing, and exercises such as swim-
ming provide no weight-bearing benefit at all. The second
form of exercise is weight training, or resistance exercise.
Muscle strengthening through resistance exercise serves sev-
eral purposes. It increases muscle mass and thereby forms a
physical cushion against bony surfaces, reducing their like-
lihood of fracture on impact. It also transmits pressure signals
to bone, even if it is not in weight-bearing muscle groups, that
stimulate bone formation. Furthermore, increased muscle
strength is likely to contribute to a better ability to avoid
falling, through collateral muscle strengthening. Finally, the
third form of exercise, stretching and balancing, which
improves mobility and balance, can help women with low
bone density avoid high-impact falls that can cause fractures
by increasing their gait stability and ability to recover when
being thrown off balance.
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 MENOPAUSE AND EXERCISE
Cognitive benefits of exercise
Dementia and cognitive decline are major concerns for
women and society. Alzheimer’s disease is the most common
cause of dementia and more than 36 million people suffer
worldwide from Alzheimer’s disease or other dementia.96
Physical activity may help maintain or even improve cogni-
tive functioning and reduce apathy throughout life, especially
in older age.97-99 In addition, exercise programs may improve
physical and cognitive function, as well as decrease caregiver
burden with individuals with existing dementia.100
RISKS OF EXERCISE
The benefits of physical activity far outweigh the possible
associated risks in the majority of participants.101 Musculos-
keletal injury is the most common risk of exercise. More
serious, but much less common risks include arrhythmia,
sudden cardiac arrest, myocardial infarction, rhabdomyolysis,
and bronchoconstriction. There is a general consensus that a
screening medical evaluation before exercise is not necessary
for asymptomatic participants at low risk for coronary artery
disease. Other risk factors to identify in a preexercise medical
evaluation include the following: age, general physical con-
dition, exercise history, medication use, history of pulmonary
disease, anticipated type of exercise, orthopedic history and
musculoskeletal risks, and handicaps or disabilities.
DISCUSSION
Based on the above data, exercise is a near-ideal interven-
tion for prevention of many of the morbidities to which
postmenopausal women are prone, and should be encouraged
and maintained whenever possible. It promotes longevity, and
maximizes a woman’s functional life span and quality of life.
It should be part of every medical evaluation, and specific
barriers to exercise should be addressed. This need not take up
much of the clinician’s time, as many office and participant
tools exist to estimate physical activity. Here are a few
general recommendations.
Help your participant set realistic goals
A general rule of thumb is to achieve at least 10,000 steps
per day. There are a number of smartphone apps, pedometers,
and actigraphy instruments, such as the Fitbit, that can be used
to estimate daily activities and proximity to the fitness goal.
Women who have disabilities, are confined to wheelchairs, or
need assistive devices for walking are unlikely to be able to
achieve these targets and will need other methods to estimate
and track activity. Some women will rebel against tracking
activity, and should be directed toward other ways of fulfilling
a daily fitness goal. Parking the car farther away in the parking
lot to achieve more steps, avoiding the elevator whenever
possible, and even having ‘‘walking meetings’’ or a standing
desk may all be helpful in maintaining activity during the day.
Work with existing preferences
Some women are able to unfailingly keep to a daily
exercise routine, and do not feel completely well without
Copyright @ 2015 The North American Menopause Society. Unauthorized reproduction of this article is prohibited.
doing so. These women are unlikely to pose problems for the
clinician. Others do not like to experience sweatiness, especi-
ally a problem during the menopausal transition. Help your
patient by directing her toward activities that are compatible
with her preferences. A more meditative person may select a
yoga workout over an aerobic workout, and be able to stick
with a regimen that may give her less overall aerobic benefit
but great improvements in flexibility, muscle strengthening,
and balance. The woman who hates to sweat may enjoy taking
up swimming.
Monitor progress
It is helpful to record the current exercise regimen in the
participant’s medical record and follow up with her at sub-
sequent office visits to assure she is maintaining the habit.
This allows for the clinician to address barriers that may arise.
It is equally important to point out that the participant is
reaping the benefits of her exercise regimen, by reporting
back results like weight, waist circumference, blood pressure,
lipid profile, and glycosylated hemoglobin results.
Encourage cross-training
Participants who are lifelong exercisers in one single area
may actually risk their health over the long term. Cross-
training can help participants touch upon all of the aspects
of physical fitness and give them an alternative exercise to do
in the event of injuries, which are inevitable.
Address recidivism
All habits must be learned and incorporated into the
individual’s life style over time. Most women will stray from
their existing regimen because of injury, boredom, or other
reasons (eg, lack of time) at one point or another. It is
important for the clinician to reinforce the benefits of exercise
and how it has helped the participant’s health in the past.
Offering alternative forms of exercise or changes in the
exercise environment (more social interaction vs running
along in the predawn hours, etc) can help remotivate your
patient to get started again.
When all else fails, bargain
In the end, the clinician should take whatever can be gotten
from the patient: a commitment to start, or a commitment to
contemplate an exercise regimen. Anything is better than
nothing!
CONCLUSIONS
The most common barrier middle-aged women describe as
interfering with adhering to regular exercise is attributed to
the demands that this stage of life places on their personal time
for themselves.102 Having an established daily structure that
incorporates exercise, anticipated positive feelings associated
with exercise, and accountability to others are the most cited
factors enabling adherence of middle-aged women to their
regular exercise.102 Healthcare professionals should consider
a narrative approach to assessing these barriers and focus on
Menopause, Vol. 22, No. 12, 2015 1355
 GRINDLER AND SANTORO
enablers to overcoming identified barriers to support women
to adhere to regular exercise.102
The onset of menopause provides a unique opportunity to
improve the quality of life and enhance the longevity of a
woman’s life. Some physical activity is better than none.
Participation in any amount of physical activity will result in
some health benefit.101 Even small amounts of physical
activity are protective against health decline in older adults.55
Activities do not have to be done at one time, but can be
spread throughout the day in shorter time allotments.
Reduction in sedentary behavior (sit less, move more) in
addition to the addition of light activity should be emphasized
as a goal for older adults.
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