Last checked September 2026 against 18 sources · Editorial policy
Best exercise and workouts for perimenopause and menopause
The best workout for menopause and perimenopause combines aerobic activity with strength training. US guidelines advise 150 minutes of moderate activity a week plus muscle strengthening on at least 2 days. In a meta-analysis of trials in 5,697 postmenopausal women, exercise reduced fat mass, waist size and visceral fat and built muscle. Aerobic exercise hasn't cut hot flashes in trials, but one trial of strength training did.
Strength training plus cardio cut fat, protect bones and help sleep. How much to do, a sample perimenopause workout week, and the one trial where lifting cut hot flashes.
Exercise for perimenopause and menopause: expectation vs reality
What people often expect
“Working out harder will make my hot flashes go away”
What the evidence shows
Aerobic exercise hasn't reduced hot flashes in trials, and the North American Menopause Society doesn't recommend it as a hot flash treatment. One randomized trial is the exception: 15 weeks of strength training cut moderate to severe hot flashes by 43.6%, against 2.0% in women who kept their usual activity. Exercise matters most for other reasons in menopause: it counters fat gain and muscle loss, protects bones and improves sleep.
Free: week 1 of the strength plan (PDF)
Two full-body sessions, a walking target and four simple strength tests, with versions for no equipment and for dumbbells.
What exercise does in menopause
Exercise for menopause weight and belly fat
A meta-analysis of randomized trials in 5,697 postmenopausal women found exercise increased muscle mass and fat-free mass and decreased fat mass, body fat percentage, waist circumference and visceral fat. Aerobic and combined training did most for fat loss, while resistance and combined training did most for muscle.
Learn more →Strength training in menopause
A review of 12 randomized trials in postmenopausal women found resistance training of up to 16 weeks seemed to improve physical function and bone mineral density, with no serious adverse events, though evidence certainty was very low to low. The British Dietetic Association recommends resistance exercise two to three times a week to keep muscles strong.
Learn more →A perimenopause workout routine: sample week
A perimenopause workout routine that meets US guidelines can look like this. Monday: full-body strength session. Tuesday: 30 minutes of brisk walking. Wednesday: strength. Thursday: 30 minutes of walking, or yoga or Pilates. Friday: strength. Saturday: a longer walk or bike ride. Sunday: rest. That gives 3 strength sessions, the dose that built the most muscle in trials of women aged 40 to 60, and at least 150 minutes of moderate activity. After a bad night, swap a strength day for a walk rather than skipping the week.
Learn more →Exercise for bones
Falling estrogen speeds up bone loss. Resistance exercises stimulate bone building, the British Dietetic Association says, and it recommends regular moderate exercise, especially weight-bearing activity. The NHS advises regular exercise to keep bones as strong as possible.
Learn more →Does exercise help hot flashes? Aerobic vs strength training
A Cochrane review of 5 trials with 733 women found insufficient evidence that exercise reduces hot flashes and night sweats, and the MsFLASH trials found no improvement in hot flash frequency or bother with aerobic exercise. Strength training is the exception so far: in a Swedish trial, 15 weeks of resistance training three times a week cut moderate to severe hot flashes by 43.6%, against 2.0% in a control group. It is one trial of 58 women, so it is promising rather than proven.
Learn more →Exercise and sleep in menopause
In pooled MsFLASH data from 546 women with insomnia and hot flashes, aerobic exercise improved insomnia scores by 2.1 points relative to control, similar to venlafaxine. CBT for insomnia had the largest effect, at 5.2 points, and is the first-line treatment.
Learn more →Pilates for menopause
In an 8-week trial of 30 postmenopausal women, Pilates improved menopause symptom scores, quality of life and sexual function compared with information sessions. In another trial of postmenopausal women with stress incontinence, Pilates worked as well as pelvic floor muscle training when women actively contracted their pelvic floor muscles.
Pelvic floor exercises in perimenopause
Urine leakage becomes more common around menopause. The Office on Women's Health says Kegel exercises for the pelvic floor muscles are among the things you can do at home, and losing extra weight reduces pressure on the bladder.
Menopause exercise by the numbers
From the studies on this page
fewer moderate to severe hot flashes after 15 weeks of strength training, in the one trial that tested it
43.6%
150 minutes
2 days
5,697
Vigorous activity counts double: 75 minutes of jogging or running equals 150 of brisk walking.
Best workouts for perimenopause and menopause
Aerobic exercise, 150 minutes a week
Strong evidenceBrisk walking, cycling or swimming; best for fat loss and improves sleep scores.
Strength training 2 to 3 times a week
Strong evidenceBuilds muscle and helps bones; work legs, hips, back, abdomen, chest, shoulders and arms.
Related guide →Combined aerobic and resistance program
Strong evidenceThe combination is a viable strategy to improve body composition after menopause.
Related guide →Pilates
Limited evidenceSmall trials show better symptom scores and pelvic floor strength.
Yoga
Some evidenceImproved physical, urogenital and total menopause symptoms in reviews.
Related guide →Kegel exercises
Some evidencePelvic floor training for urine leakage.
Aerobic exercise to stop hot flashes
No good evidenceTrials of aerobic exercise found no reduction in hot flashes, and The North American Menopause Society does not recommend exercise as a hot flash treatment. HRT and several non-hormonal medicines are proven to work. Keep walking, cycling or swimming for your heart, weight and sleep instead.
Related guide →Strength training for hot flashes
Limited evidenceIn one randomized trial, postmenopausal women who did strength training three times a week for 15 weeks had 43.6% fewer moderate to severe hot flashes, against 2.0% in women who kept their usual activity. It needs confirming in larger trials, but it is a reason to lift.
Related guide →
When to check with a doctor about exercise in menopause
Urgent: Chest pain, fainting or severe breathlessness during exercise
Stop and get urgent medical help; call 911 for chest pain.
More →Diagnosed osteoporosis or a past fracture
Ask which exercises are safe and whether you need a bone scan or treatment.
More →Urine leakage that doesn't improve with Kegels
Ask about physical therapy, devices or other treatment.
Exercise and menopause: questions women ask
What is the best exercise for menopause?
A mix of aerobic exercise for fat loss and strength training for muscle and bone. The combination works best for body composition.
What is the best exercise for perimenopausal women?
Strength training plus aerobic exercise. Muscle starts to decline and fat gain doubles at the start of the menopause transition, and resistance training is the main way to keep muscle. Brisk walking, cycling or swimming add the fat loss and help sleep.
Related →What is a good perimenopause workout routine?
Three full-body strength sessions a week on non-consecutive days, brisk walking on two or three other days for at least 150 minutes in total, and one rest day. Three strength sessions a week built the most muscle in trials of women aged 40 to 60.
Related →Does exercise help menopause symptoms?
It helps sleep, weight and bones. Yoga improved some symptoms in reviews, but exercise hasn't been shown to reduce hot flashes.
How much exercise do I need during menopause?
At least 150 minutes of moderate activity or 75 minutes of vigorous activity a week, plus muscle strengthening on 2 or more days.
Is Pilates good for menopause?
Small trials found Pilates improved menopause symptom scores, sexual function and pelvic floor strength. Larger studies are needed.
Is strength training good for menopause?
Yes. Resistance training builds muscle, may improve bone density and physical function, and had no serious side effects in trials.
Can exercise reduce menopause belly fat?
Yes. Exercise reduced waist circumference and visceral fat in trials of postmenopausal women; aerobic work did most for fat.
Does exercise help hot flashes?
Aerobic exercise hasn't reduced hot flashes in trials. In one randomized trial, though, 15 weeks of strength training three times a week cut moderate to severe hot flashes by 43.6%, against 2.0% in women who kept their usual activity. HRT and non-hormonal medicines remain the proven treatments.
Related →Does walking count as exercise for menopause?
Yes. Brisk walking counts toward the 150 minutes of moderate activity a week the CDC recommends, and aerobic exercise reduced fat mass in postmenopausal women.
What is a good menopause exercise plan?
Aim for 150 minutes of moderate cardio, such as brisk walking, plus strength exercises for all major muscle groups on 2 or more days a week.
Sources
- CDC. Adult Activity: An Overview. Physical Activity Basics.
- Khalafi M, Habibi Maleki A, Sakhaei MH, et al. The effects of exercise training on body composition in postmenopausal women: a systematic review and meta-analysis. Front Endocrinol (Lausanne). 2023;14:1183765.
- Daley A, Stokes-Lampard H, Thomas A, et al. Exercise for vasomotor menopausal symptoms. Cochrane Database Syst Rev. 2014;2014(11):CD006108.
- Berin E, Hammar M, Lindblom H, et al. Resistance training for hot flushes in postmenopausal women: A randomised controlled trial. Maturitas. 2019;126:55-60.
- The North American Menopause Society. The 2023 nonhormone therapy position statement of The North American Menopause Society. Menopause. 2023;30(6):573-590.
- Guthrie KA, Larson JC, Ensrud KE, et al. Effects of Pharmacologic and Nonpharmacologic Interventions on Insomnia Symptoms and Self-reported Sleep Quality in Women With Hot Flashes: A Pooled Analysis of Individual Participant Data From Four MsFLASH Trials. Sleep. 2018;41(1):zsx190.
- Sá KMM, da Silva GR, Martins UK, et al. Resistance training for postmenopausal women: systematic review and meta-analysis. Menopause. 2023;30(1):108-116.
- British Dietetic Association. Eating well for the perimenopause and menopause (food fact sheet).
- Tan TW, Tan HL, Hsu MF, et al. Effect of non-pharmacological interventions on the prevention of sarcopenia in menopausal women: a systematic review and meta-analysis of randomized controlled trials. BMC Womens Health. 2023;23(1):606.
- NHS. Osteoporosis.
- Guthrie KA, LaCroix AZ, Ensrud KE, et al. Pooled Analysis of Six Pharmacologic and Nonpharmacologic Interventions for Vasomotor Symptoms. Obstet Gynecol. 2015;126(2):413-422.
- Yiğit Kocamer M, Atilgan E. Investigating the effects of Pilates exercises on menopausal symptoms and sexual dysfunction in postmenopausal women: A randomized controlled trial. Medicine (Baltimore). 2025;104(23):e42689.
- Gonzaga S, de Oliveira RG, Dutra LL, et al. Comparative analysis of pelvic floor muscle training and Pilates in managing urinary incontinence among postmenopausal women: a randomized controlled trial. Int Urogynecol J. 2024;35(3):561-569.
- Office on Women's Health, US Department of Health and Human Services. Menopause symptoms and relief.
- Money A, MacKenzie A, Norman G, et al. The impact of physical activity and exercise interventions on symptoms for women experiencing menopause: overview of reviews. BMC Womens Health. 2024;24(1):399.
- NHS. Heart palpitations.
- US Preventive Services Task Force. Osteoporosis to prevent fractures: screening. 2025.
- Greendale GA, Sternfeld B, Huang M, et al. Changes in body composition and weight during the menopause transition. JCI Insight. 2019;4(5):e124865.
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