Women’s Midlife Fitness

I am a semi-proud card carrying member of AARP. It’s an odd feeling to open that application shortly after blowing out the inferno of candles on the half-century cake; but as un-sexy as AARP publications are, the reading is pretty good, and at least I get a periodic reminder that there’s good reason I don’t bounce like I did 25 years ago. Many of my fitness clients are like me; middle age healthy women juggling careers and sandwich-generation parenting / elder care. It can feel like a lot to handle; but I haven’t gotten to the fun part yet: menopause. There, I said it aloud through part of me still feels like it should be whispered. Every woman has a different experience with symptoms ranging from hot flashes to weight gain, mood disturbances, itchy skin, trouble sleeping and loads of other super-duper fun stuff, but there are some considerations with menopause that are more serious and apply to all of us: Heart health and bone health.

Heart health
Cardiovascular disease (CVD) remains the leading cause of death in the U.S. and according to American Heart Association is responsible for 1 of 3 women’s deaths. Rates in men are higher than women, but it’s still the leading cause of death for women. Risk factors for CVD are well known including obesity, high blood pressure, sedentary lifestyles and smoking. Additionally, getting older is also a risk factor, and there’s only one way around that. For women, the risk factors for CVD increase with menopause. In pre-menopausal women, higher estrogen levels benefit blood vessels by keeping them flexible accommodating lots of healthy blood flow. The menopausal drop in estrogen causes blood vessels to lose elasticity. It’s common to notice less flexibility in joints and muscles as we age, so that stiffness could serve as a reminder about blood vessels, too. I wonder if we could feel arterial stiffness, would we be less resistant to getting heart-pumping exercise necessary to benefit cardiovascular health? If one’s back and hips are stiff after sitting for a long time would it help to remember the aorta needs exercise to loosen up? Motion is lotion. Remember, risk factors are not requirements. Non- smoking, healthy-weight physically active women have less risk of CVD, but still need to be mindful of this reduction in estrogen protection as we age.

Bone Health
Imagine if you could save money only until you were 30 and thereafter only maintain or withdraw funds. That’s the parallel with bone density. Our bodies create bone density until about 30, then need to maintain it. Reduced estrogen means reduced protection for bones, and accelerated loss of bone density. According to data published in Geriatric Orthopedic Surgery and Rehabilitation in September 2010 by Gerontologist Scott Schnell, MD., an estimated 1 in 3 women over 65 will suffer a hip fracture. The overwhelming majority of these fractures are caused by falling sideways; and everyone occasionally wipes out, so this is sobering.

I’m self-conscious that I’ve highlighted this grim-but- critical news, so let’s turn it around. What protects against all of this? Vigorous exercise. Yes, I said vigorous, not to be maniacal but rather to be realistic. We need regular, frequent heart-pumping, wind-sucking exercise to keep our cardiovascular systems strong and healthy, and we need regular, frequent strength training that strengthens muscles, builds balance and protects bone density. Vigorous strength training will protect and possibly build bone density. Nota bene: it is site specific so strengthening the spine and pelvis requires strengthening the back and hips. A superb exercise routine would be to daily alternate an hour of cardiovascular exercise with about 45 minutes of rigorous strength training. Three cardio and three strength workouts.... And one day off. Everyone can strength train safely and effectively, because what’s important is that you challenge your muscles in a way that’s appropriate for you. We need to take our joints through normal range of motion with resistance, ie weights of bands, that becomes meaningfully fatiguing after several repetitions. Everyone benefits from exercise and it’s never too late to begin. Many effective strength training exercises need no equipment at all and can be done almost anywhere. Naturally it’s important to check in with your doctor about appropriate exercise for you, but in 30 years of working as a fitness instructor I’ve never met someone who’s doctor advised against exercise. We make it appropriate for each individual, and watch the benefits stack up. Happy summer everyone. See you out there.