Movement in Midlife: Why it Matters during the Menopause

There’s something powerful about moving your body in midlife - not just for strength, but for sleep, energy, mood and feeling like yourself again. 

In this latest Pausa interview, Abi chats to Dr Ginny Ponsford, GP, registered menopause specialist, and co-founder of The Women’s Hormone Clinic, about why movement matters more than ever in your 40s and 50s, how to move without burnout or guilt, and what really works when it comes to midlife strength and energy. 

“Movement’s not just about weight - it’s your mood, your metabolism, your muscle, your mojo.” 

Abi: Welcome Ginny, tell us, why is movement such a big deal during perimenopause and menopause? 

Dr Ginny: Honestly, it’s essential. There’s a lot going on under the surface - fluctuating hormones, metabolic changes, muscle loss, sleep disruption. Movement helps on every front: 

• Cardiometabolic health: oestrogen drops can increase cholesterol and insulin resistance 

• Muscle & metabolism: we lose lean muscle (called sarcopenia), which slows our metabolism 

• Bone density: movement helps slow the onset of osteoporosis 

• Mood, energy, sleep: movement boosts endorphins and helps us feel more balanced and calmer 

"Here comes a scientific bit, ladies - concentrate!" Abi 

During menopause, our oestrogen levels start to drop, which affects our lipid profile - that’s the balance of cholesterol in your blood. The 'bad' cholesterol tends to go up, and the 'good' goes down. Plus, oestrogen plays a role in insulin sensitivity. When it drops, we can become more insulin resistant, meaning your body processes sugar less effectively. Add in muscle loss, which slows your metabolism, and suddenly your old habits aren’t working the way they used to. 

We don’t need to punish our bodies - we need to support them. And movement is one of the most powerful ways to do that. 

Abi: What kind of movement is best at this life stage? 

Dr Ginny: A blend is best. And research backs that up, you want a mix of: 

• Cardio or aerobic movement (walking, jogging, cycling, 80s Pilates) 

• Strength or resistance work (bodyweight training, resistance bands, Pilates) 

• Calming, breath-led movement (yoga, Pilates, stretching, breathwork) 

  
  

Each type has its own benefits. The real win is combining them. And importantly, doing something that you enjoy. That’s how you stay consistent. 

“I don’t even like using the word 'exercise'. Movement feels inclusive. It’s about doing what works for your body - not what haunted you in PE class.” 

I know loads of women who hear "exercise" and immediately tense up - flashbacks to school sports day, not being picked for the team, feeling like exercise wasn't for them. That's why I say "movement." It can be a walk, a stretch, a laugh in a group class. If it gets your blood flowing and your joints moving, it counts. 

Abi: I hear from a lot of women who say, "I’m exercising loads but still gaining weight." What's happening? 

Dr Ginny: That’s really common, and it’s usually women who’ve always been active and doing lots of cardio like running or spin. But suddenly it stops working. The scale creeps up, energy dips, and they feel stuck. 

The big shift? It’s about doing different, not necessarily more. Our hormones change, and so should our approach. We need to think about moving in a way that supports our metabolism, joints and recovery - for example something like Pilates can help here if it’s not been explored before. 

Pilates blends strength, stability and breath-led movement in a way that gently builds muscle and supports the joints. That helps boost metabolism without pushing the body into stress mode. 

“When your hormones shift, your body’s rules change. You’re not doing anything wrong - your body just needs something different.” 

I get women saying, "I'm doing all the same things and gaining weight!" and my response is always, "Yes, because your body's changed. Let’s meet it where it is now, not where it used to be." 

Abi: Can movement ever be the wrong kind during this phase? 

Dr Ginny: It’s less about wrong and more about how you do it. 

If you’ve had a break from movement and jump into high-intensity or heavy weights too quickly, that’s a fast track to injury. Or if you’re stressed and doing loads of high cortisol movement (HIIT, for example) with no recovery, that can mess with blood sugar and fat storage. 

So yes, some adjustments matter: 

• Ease in gradually 

• Listen to your body 

• Save intense movement for mornings, calming movement for evenings 

"Start slow and low. Build up. Don’t let comparison push you faster than your body wants to go.” 

And if you’ve ever hurt for days after a class because you pushed too hard too soon - you know exactly what I’m talking about. Be kind to your body. 

Abi: I see a lot of wrist and shoulder issues in class, is that hormonal too? 

Dr Ginny: 100%. There’s actually a recognised thing called musculoskeletal syndrome of menopause. Joint pain, frozen shoulders, tendinopathies (elbows, wrists, Achilles) are all more common. Why? Because oestrogen helps keep our connective tissue healthy. 

I see women with frozen shoulders all the time - sometimes it starts with something small like tendonitis in the rotator cuff, and over time it stiffens to the point where you can barely move. It can take two years to fully recover. But the good news is, gentle strength work can really help. 

“Aches and pains aren’t just 'getting old', they’re often hormonal. And there are things we can do.” 

Abi: What about mood, brain fog and sleep? Can movement help there too? 

Dr Ginny: Big time. Movement boosts your serotonin and endorphins - those feel-good chemicals that keep you calm and balanced. 

It also helps regulate your internal thermostat. That’s a big deal because temperature fluctuations (like hot flushes) can wake you up at night. Better regulation = better sleep = clearer head the next day. 

"Here comes another science bit!" 

Your hypothalamus is the part of your brain that regulates body temperature. It gets a bit wonky when oestrogen drops, which is why many women get night sweats or hot flushes.

Movement can stabilise that system by boosting endorphins and beta-endorphins that help regulate temperature. Better sleep means clearer thinking. 

Think of movement as medicine. Not just for your body, but your brain. 

“Move your body, calm your brain, sleep deeper. It all starts with movement.” 

Abi: And what if you’re just too tired? 

Dr Ginny: That's totally normal. My advice? Ditch the all-or-nothing mindset. 

• Just start - even five minutes of movement helps 

• Reframe it as something you get to do, not have to do 

• Set yourself up for being in the right mindset – some people don’t like come back from work and get relaxed before they start moving, as they find it harder to get back up once they’re on the sofa. Others may need a small rest to in between to recharge and get going 

You never regret movement. Even a short walk counts. 

“Too tired doesn’t mean do nothing. It means do what your body can manage today.” 

I’ll often say to patients: if you had a long run or class planned and you're just not feeling it, switch it up. Just do a small run or go for a walk. Do some gentle stretching. That’s still movement. It still counts. And you’ll feel better for it. 

Abi: Let’s talk about community - how does moving with others help? 

Dr Ginny: It makes everything easier. Accountability, laughter, motivation. You’re more likely to show up. You feel supported, seen, connected. And it makes it fun, which is the secret sauce to staying consistent. 

“Community turns movement from a chore into a joy. It’s not just exercise - it’s connection.” 

Personally, I run with a few friends twice a week. If no one else can make it, I’m less likely to go. But when I know they’re waiting for me, I show up. We chat, we move, we grab a coffee. It’s social as much as it is physical, and it keeps me going. 

Dr Ginny Ponsford is a registered menopause specialist and founder of the Women’s Hormone Clinic. Learn more at womenshormoneclinic.co.uk. 

For midlife movement that lifts your strength, mood and motivation - speak to Abi about joining a Pausa class at Saltdean Lido. We’re here to support your strongest chapter yet.