Resistance training improves hip strength, balance and flexibility during menopause and may also improve lean body mass, research suggests.

A study of 72 active women aged 46 to 57 found those who completed a 12-week supervised programme saw greater gains than those who kept to their usual exercise routines.

None of the participants were taking hormone replacement therapy.

The supervised, low-impact resistance exercise programme focused on strength at the hip and shoulder, dynamic balance and flexibility.

Participants used Pvolve equipment, including resistance bands and weights around the hips, wrists and ankles, and also lifted dumbbells of varying loads.

Women in the resistance training group showed a 19 per cent increase in hip function and lower-body strength, a 21 per cent increase in full-body flexibility and a 10 per cent increase in dynamic balance, meaning the ability to stay stable while moving.

Those in the usual activity group did not show any significant improvements.

Previous studies have assessed the decline in lower limb strength and flexibility during menopause, but this is said to be the first study to compare the effect of resistance training on muscle strength and mass before, during and after menopause.

This was done by including participants in different phases of menopause rather than following the same participants over a long timeframe.

Francis Stephens, a researcher at the University of Exeter Medical School in the UK, said: “These results are important because women appear to be more susceptible to loss of leg strength as they age, particularly after menopause, which can lead to increased risk of falls and hip fractures.

“This is the first study to demonstrate that a low-impact bodyweight and resistance band exercise training programme with a focus on the lower limbs, can increase hip strength, balance, and flexibility.

“Importantly, these improvements were the same in peri- and post-menopausal females when compared to pre-menopausal females, suggesting that changes associated with menopause do not mitigate the benefits of exercise.”

Although one of the researchers sits on Pvolve’s clinical advisory board, the researchers said the company did not sponsor the study or influence its results.

Stephens added that any progressive resistance exercise training focused on lower-body strength is likely to yield the same results.

He said: “The important point is for an individual to find a type of exercise, modality, location, time of day etc., that is enjoyable, sustainable, and improves everyday life.

“The participants in the present study reported an improvement in ‘enjoyment of exercise,’ and some are still using the programme since the study finished.”

Kylie Larson, a women’s health and fitness coach and founder of Elemental Coaching, who was not involved in the study, said the results were compelling.

She said: “This is particularly exciting for those that tend to think of menopause as ‘the end’. The study proves that if you incorporate strength training you can still make improvements to your muscle mass and strength, which will also have a positive ripple effect to your ability to manage your body composition.

“In addition, staying flexible and being able to balance are both keys to a healthy and functional second half of life.”

Participants in the study did four classes a week for 30 minutes each session, but Larson said even half that amount of strength training can go a long way, particularly if you emphasise progressive overload, which means gradually increasing muscle challenge through more weight.

Larson said: “Gradually increasing the challenge is what drives real change.

“Lifting heavier over time is what builds strength, protects your bones, and keeps your body resilient through menopause and beyond.”

Brain fog in menopause is common but still poorly understood, with researchers calling for more work to explain the link and how best to support women.

For a new perspective article published in The Lancet Obstetrics, Gynaecology, & Women’s Health, researchers based in the UK and Australia reviewed the evidence on menopause-related cognitive symptoms. They found that symptoms such as forgetfulness, reduced concentration and brain fog are common during the menopause transition, but are still poorly recognised and under-researched.

More than two-thirds of women report difficulties with memory or concentration over the menopause transition. Multiple factors may contribute to these cognitive symptoms, including hormonal changes, sleep disturbances and psychological and psychosocial stress. Yet, because cognitive symptoms are not widely discussed, they can cause considerable worry, with some fearing they are signs of dementia or undiagnosed neurodevelopmental conditions.

The review paper emphasises that overall cognitive performance for women experiencing menopause-related brain fog typically remains within expected ranges and, importantly, that cognitive symptoms are not linked to an increased risk of dementia.

Professor Aimee Spector of UCL Division of Psychology and Language Sciences, co-author on the paper, said: “Cognitive symptoms such as forgetfulness and ‘brain fog’ are incredibly common during menopause, yet they are often overlooked. Our findings highlight just how complex menopause-related cognitive symptoms are, and how much we still don’t know about what drives them. More targeted research is essential if we are to identify which biological, psychological or lifestyle factors contribute most, and what types of support or treatment are likely to be effective.”

The authors argue that clinicians can play a key role in understanding and validating women’s experiences by asking about the duration of cognitive symptoms, impacts on day-to-day functioning and any other medical or psychosocial factors that could be contributing to cognitive symptoms.

The review also discusses a range of approaches that may ease cognitive symptoms, such as improving sleep quality, engaging in regular aerobic exercise and eating a balanced diet. There is also little but promising research into the impact of psychological therapies targeting cognitive symptoms, with a recent meta-analysis of three cognitive behavioural therapy-based studies showing significant improvements in memory and concentration. The evidence is more mixed for the benefits of hormone therapy on cognitive symptoms during menopause.

The authors identify cognitive symptoms as a major area of unmet need in menopause research. They call for a unified definition of menopause-related cognitive changes and for prospective, longitudinal studies that can track women from pre- to post-menopause. Better understanding of the biological, psychological and social factors that contribute to cognitive symptoms will be crucial for developing effective treatments.

Lead researcher Dr Caroline Gurvich of Monash University said: “There’s a lot of pressure to use objective measures of cognitive decline, like a memory test, for example, in a clinical trial, but the key symptom of brain fog is a subjective experience. So having a definition that acknowledges the key cognitive symptom is critical.”

This is not without precedent – we already use subjective or self-report measures for depression, anxiety and other mental health conditions with great success.

Dr Gurvich said the proposed definition would also validate women’s individual experiences while empowering them through the reassurance that any objective decline in their cognitive ability is subtle.

She added: “This is a decrease in cognitive or learning efficiency, not functionality or capacity. For many women, the perception they are losing capacity is what drives them to stop work or lose the confidence to live fulfilling lives during and after menopause. I hear all the time from women who have gone through menopause that validation would have made a significant difference to their resilience and the approach they took to living with menopause.”

Co-author Professor Martha Hickey of the University of Melbourne and Royal Women’s Hospital said: “Our analysis of the best available research shows that many women experience some degree of cognitive symptoms, such as brain fog, during the menopause transition.”

“But there’s a lack of long-term data, which means that there’s a gap in our knowledge about how the brain fog symptom develops and changes from peri-menopause to after menopause ends. It’s a real gap in our understanding.”

Professor Spector added: “We increasingly see women, typically at the peak of their careers, losing confidence in the workplace, often translating to leaving work or reducing work hours. Having simple strategies to support and retain them at work is also a broader economic issue.”