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Finding time for exercise is one of the best things you can do as you age © Shutterstock

7 doctor-approved tips for feeling your best during perimenopause

The exercises and habits to introduce in midlife, according to a doctor

Donna Francis
Contributing Editor US
January 24, 2025
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"There is no better anti-aging drug than exercise," says Dr. Cilenti, a board-certified doctor in internal medicine and pediatrics with a Master's in public health. "Staying active, healthy and strong will contribute more to longevity than almost anything else you can do for your health, and it's never too late to start exercising, even if you've never enjoyed exercising or had a regular exercise routine.

"The first thing to do is find a time in your schedule that works, put it on your calendar, and honor it like you would any other commitment," Dr. Cilenti suggests, while emphasizing the importance of choosing activities you genuinely enjoy. 

"The best exercise may vary from person to person, and it's usually the exercise you enjoy that keeps you engaged and interested in continuing it. If you think it's a chore or something you dislike, it's much easier to fall out of that habit."

Finding time for exercise is one of the best things you can do as you age © Shutterstock
Finding time for exercise is one of the best things you can do as you age

Start with stretching

Once you've decided on your exercise, Dr. Clienti explains that we must incorporate stretching to address achy joints - a common complaint among women during perimenopause due to lower estrogen levels. 

"We spend so much time sitting either at desks during work or at home after work, so making sure you're moving frequently throughout the day can help. Stretching exercises such as yoga or tai chi can also help keep joints moving and the range of motion healthy. We all lose some of the natural flexibility of our tissues with age, but much of that can be offset by keeping active."

The importance of balance and strength training

"Balance training is important to incorporate as we age to help prevent falls. Falls are a major contributor to disease risk in older adults, so maintaining balance is vital," explains Dr. Cilenti.

Stretching at the beginning and end of a fitness session is just as important as the workout itself © Shutterstock / Prostock-studio
Stretching at the beginning and end of a fitness session is just as important as the workout itself

"A big part of balance is muscular strength, so strength training will help preserve both muscle mass and the rapid-acting type two muscle fibers that kick in if you begin to fall so you can catch yourself before you go down."

READ: Why desk-dwellers really need to try assisted stretch 

Tai chi, yoga, and pilates are excellent options for improving balance, flexibility, and core strength. "Pilates is a great way to strengthen your core, which can help with stability and balance," Dr. Cilenti says.

Balance training through pilates and yoga helps to prevent falls in later life © Shutterstock / BearFotos
Balance training through pilates and yoga helps to prevent falls in later life

Cardio and heart health are important too

Cardio plays a crucial role in overall health during menopause. "There's been a lot of research that says heart disease risk increases during menopause due to the decline in estrogen, which normally protects from this kind of chronic illness," says Dr. Cilenti.

When it comes to choosing the right cardio, she advises finding activities you love: "The most important thing is finding something you like that you can do sustainably over many years. Most cardiac activities, including running, haven't been shown to increase the risk of arthritis in the joints as we age, but some people will find that it takes longer to recover after a more intense run as they age."

Cardio is important for heart health during perimenopause too © Shutterstock / oatawa
Cardio is important for heart health during perimenopause too

RELATED: What a 51-year-old PT wants you to know about exercise in menopause

Building in recovery time is as important as the workout itself

"It's important to allow time to recover after exercise. That's when our muscles actually rebuild themselves, particularly after strength training, which is so important for women in menopause and perimenopause," Dr. Cilenti explains.

She also highlights the role of stretching: "Stretching can help with injury prevention, and it's important to make sure you are well warmed up with some dynamic stretches or dynamic warmups before you begin exercising."

INSPIRATION: I'm in the best shape of my life at 44 - these are my 7 daily habits 

How much exercise is enough?

Dr. Cilenti follows CDC guidelines, which recommend 150 minutes of moderate-intensity activity or 75 minutes of vigorous-intensity activity every week. "You can spread these out four to five days a week or even daily. It's more important to think about ramping up the intensity slowly rather than the time," she says.

"Suppose you are setting out to begin jogging again and not walking at all. In that case, it's reasonable to start a walking program first to get moving and establish the habits before beginning to work in some jogging or running periods to prevent injury," Dr. Cilenti suggests.

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