Right, let’s talk about something that’s often completely ignored until you’re living through it: perimenopause and exercise. If you’re in your late 30s or 40s and suddenly finding that your usual workout routine isn’t working the way it used to, you’re not imagining it. Your body genuinely is responding differently, and it’s not because you’ve suddenly become lazy or lost your fitness.

Welcome to perimenopause – the years leading up to menopause when your hormones start doing whatever they bloody well fancy. It’s like puberty in reverse, except nobody prepares you for it, and people still expect you to function like a normal human being.

So let’s talk about why exercise feels different during perimenopause, what actually works, and how to adjust your routine without feeling like you’ve “given up.”

Updated: June 2026

What Is Perimenopause, Actually?

Perimenopause is the transition period before menopause, when your ovaries gradually start producing less oestrogen. It typically starts in your 40s but can begin in your late 30s (lucky us). It can last anywhere from a few months to 10 years, with the average being about 4 years.

You’re officially in menopause when you haven’t had a period for 12 consecutive months. Everything before that? That’s perimenopause, and it’s often worse than actual menopause because your hormones are all over the place.

Common symptoms include:

• Irregular periods (heavier, lighter, more frequent, less frequent – basically chaos)
• Hot flushes and night sweats
• Sleep problems
• Mood changes (hello, rage and tears)
• Brain fog
• Weight gain, particularly around your middle
• Joint pain
• Reduced energy and stamina
• Changes in body composition (losing muscle, gaining fat)

And here’s the kicker: these symptoms can make exercise feel completely different to how it used to feel.

This is one of those topics I write about partly because my readers are often at this life stage, and partly because I’m paying close attention to it myself. I’m in my 30s and perimenopause feels abstract right now, but I’ve spoken to enough women in their 40s who were completely blindsided by how much it changed their training — doing more and getting less — that I think it’s worth understanding well before you’re in it.

Why Your Usual Routine Isn’t Working

Declining Oestrogen Changes Everything

Oestrogen isn’t just about your reproductive system – it affects your muscles, bones, metabolism, recovery, and even how your body stores fat. When oestrogen levels drop, several things happen:

Muscle loss speeds up: You naturally lose muscle mass as you age, but oestrogen decline accelerates this. Less muscle means slower metabolism and less strength.

Fat distribution changes: Even if you don’t gain weight, you might notice more fat around your middle (the dreaded “menopause belly”). This is partly because declining oestrogen changes where your body prefers to store fat.

Recovery takes longer: Oestrogen helps with muscle repair and recovery. Lower levels mean you don’t bounce back from workouts as quickly as you used to.

Metabolism slows down: Thanks to muscle loss and hormonal changes, your metabolic rate decreases. The same amount of food that maintained your weight before might now lead to weight gain.

Insulin sensitivity decreases: Your body doesn’t handle carbohydrates as efficiently, which can lead to blood sugar issues and fat storage.

Higher Cortisol Makes Things Worse

Perimenopause is stressful on your body, which increases cortisol (your stress hormone). High cortisol:

• Promotes fat storage around your middle
• Breaks down muscle tissue
• Interferes with sleep
• Increases inflammation
• Makes you crave sugary foods

If you’re doing loads of high-intensity exercise on top of perimenopausal stress, you might be making things worse by keeping cortisol chronically elevated.

What Doesn’t Work Anymore (Or Works Less Well)

Excessive Cardio

I know this might be controversial, but hear me out: if you’re doing hours of cardio per week and wondering why you’re not losing weight or feeling better, this might be your problem.

Long cardio sessions can:

• Increase cortisol
• Break down muscle tissue (especially if you’re not eating enough)
• Increase appetite without building the metabolic muscle you need
• Leave you exhausted

This doesn’t mean you should stop cardio completely, but “more cardio” is rarely the answer during perimenopause.

Exercising Every Single Day

What worked in your 20s and 30s might be too much now. Your recovery time is longer, and pushing yourself every day can lead to:

• Chronic fatigue
• Increased inflammation
• Worse sleep
• Stubborn weight that won’t budge despite all your efforts

Rest days aren’t optional anymore – they’re essential.

Only Doing What You’ve Always Done

If you’ve been a runner for 20 years and that’s all you do, you might be losing muscle mass without realising it. If you’ve only ever done yoga, you might not have enough bone density or metabolic muscle to protect you as oestrogen declines.

Perimenopause is when you need to diversify your exercise routine, even if it means stepping outside your comfort zone.

What Actually Works During Perimenopause

Strength Training Is Non-Negotiable

If I could shout this from the rooftops, I would: LIFT WEIGHTS.

I feel strongly about this specifically because the messaging around perimenopause tends to focus on what stops working rather than what helps. Strength training is the positive intervention. It addresses muscle loss, bone density, insulin sensitivity, and body composition all at once — and the evidence base for it in this context is genuinely solid. This is also why I keep coming back to strength training as the foundation of my own training: the long-term case for it gets stronger as you age, not weaker.

Strength training is the most important thing you can do during perimenopause. Full stop. Here’s why:

Maintains and builds muscle: This keeps your metabolism higher and helps with weight management.

Protects bone density: Weight-bearing exercise is crucial as oestrogen declines and bone loss accelerates.

Improves insulin sensitivity: Muscle tissue helps regulate blood sugar.

Boosts confidence: Feeling strong physically can really help when everything else feels like it’s falling apart.

Reduces fall risk: Stronger muscles and better balance matter as you age.

Research consistently shows that resistance training is more effective than cardio alone for managing body composition during perimenopause.

What to do:

• Aim for 2-4 strength training sessions per week
• Focus on compound movements (squats, deadlifts, presses, rows)
• Lift challenging weights – you need to actually stress your muscles
• Progressive overload is key (gradually increasing weight or reps over time)

High-Intensity Interval Training (But Less of It)

HIIT can be brilliant for perimenopausal women because it:

• Improves insulin sensitivity
• Maintains cardiovascular fitness
• Takes less time than long cardio sessions
• Can help preserve muscle mass

BUT – and this is crucial – you need to limit it. Too much HIIT will spike cortisol and make everything worse.

What to do:

• 1-2 HIIT sessions per week maximum
• Keep sessions short (15-25 minutes)
• Make sure you’re properly recovered between sessions
• If you feel constantly exhausted, you’re doing too much

Walking (The Underrated Hero)

Walking doesn’t spike cortisol, supports recovery, helps manage blood sugar, improves mood, and you can do it every day without issues.

A daily walk – especially after meals – can genuinely help with weight management and insulin sensitivity. It’s low-stress exercise that supports your overall routine rather than adding to your body’s stress load.

I run partly for the same reason. The steady-state, non-spiking nature of walking and easy running is valuable in a way that’s easy to underestimate when you’re thinking in terms of ‘calorie burn.’ But as a tool for managing blood sugar and stress hormones without adding to the cortisol load, it’s genuinely hard to beat.

What to do:

• Aim for 7,000-10,000 steps daily (or whatever feels manageable)
• Walk after meals to help with blood sugar
• Use it as active recovery on rest days
• Don’t underestimate this – it genuinely helps

Yoga and Mobility Work

Perimenopause often comes with joint pain and stiffness. Yoga, stretching, and mobility work can help maintain flexibility and reduce pain.

Plus, yoga can help manage stress, improve sleep, and give you a mental break from high-intensity stuff.

What to do:

• Include 1-2 yoga or stretching sessions per week
• Focus on poses that open up tight areas (hips, shoulders, back)
• Consider yoga specifically for stress management

A Week of Exercise During Perimenopause

Here’s what an effective week might look like:

Monday: Strength training – lower body focus (45 minutes)
Tuesday: Walking (30-45 minutes)
Wednesday: HIIT or challenging cardio (20-25 minutes)
Thursday: Yoga or mobility work (30 minutes)
Friday: Strength training – upper body focus (45 minutes)
Saturday: Walking or gentle activity
Sunday: Rest day or restorative yoga

This gives you adequate strength work (crucial), some high-intensity work (but not too much), plenty of lower-intensity movement, and proper rest.

The Nutrition Connection

I can’t talk about exercise during perimenopause without mentioning nutrition, because they work together.

Key points:

• Eat enough protein: You need more protein now to maintain muscle (aim for 1.2-1.6g per kg of body weight)
• Don’t under-eat: Chronic calorie restriction tanks your metabolism and increases cortisol
• Time your carbs: Having carbs around your workouts can help with performance and recovery
• Stay hydrated: Dehydration worsens hot flushes and affects exercise performance

Extreme calorie restriction combined with excessive exercise is a recipe for disaster during perimenopause. Your body needs fuel, especially if you’re doing strength training.

Managing the Symptoms That Affect Exercise

Hot Flushes

• Exercise in cooler environments or times of day
• Wear layers you can remove
• Keep water handy
• Don’t be embarrassed if you need to take breaks

Sleep Problems

• Exercise earlier in the day if evening workouts affect your sleep
• Avoid intense exercise right before bed
• Use gentle yoga or stretching before sleep

Joint Pain

• Warm up thoroughly
• Focus on low-impact options on painful days
• Swimming or cycling might feel better than running
• Don’t push through sharp pain

Fatigue

• Adjust intensity based on energy levels
• Some movement is always better than none
• Walking counts, even when you’re exhausted

Brain Fog

• Write down your workout plan so you don’t have to think
• Follow along with videos rather than creating your own routine
• Be patient with yourself when learning new exercises

When to Ask for Help

If you’re doing everything right – strength training, managing stress, eating well – and still struggling with symptoms or weight gain, see your GP.

Hormone replacement therapy (HRT) can be genuinely life-changing for many women. It’s not just about hot flushes; HRT can help with energy, mood, sleep, body composition, and exercise performance.

Other options include:

• Seeing a specialist menopause doctor
• Working with a nutritionist who understands perimenopause
• Getting a personal trainer experienced with perimenopausal clients

The Bottom Line

Your body is changing, and that’s not your fault. The exercise routine that worked brilliantly in your 30s might not be right anymore, and that’s completely normal.

Strength training needs to become your priority. Reduce the chronic cardio. Include rest days. Manage stress. Eat enough food, especially protein.

You’re not “letting yourself go” – you’re dealing with significant hormonal changes that affect every system in your body. Be kind to yourself, adjust your expectations, and focus on what actually works rather than what used to work.

And remember: getting older is a privilege, and staying strong through perimenopause sets you up for a healthier, more active menopause and beyond.

Now if you’ll excuse me, I’m off to lift some heavy things and then have a lie down. Perimenopause is exhausting. Take care! x

Ready to Learn More?

Explore the complete guides:

• Women’s Health and Hormones

Understanding Your Cycle:

• How to Exercise During Your Menstrual Cycle: A Week-by-Week Guide
• Can Exercise Really Help With PMS? Here’s What the Science Says
• Which Painkillers Work Best for Periods?

Managing Hormonal Conditions:

• PCOS and Exercise: What Actually Works (And What Doesn’t)
• Endometriosis and Fitness: How to Stay Active When Everything Hurts

Life Stage Changes:

• Menopause and Fitness: The Importance of Exercise for Women’s Health

Supporting Your Hormones:

• The Best Foods for Hormonal Balance (That Don’t Involve Eating Like a Rabbit)
• Birth Control and Your Workouts: What You Need to Know