Laura has just returned from the doctor with a clear diagnosis: at 51, more than a year after her last period, she has just begun postmenopause. Doubts attack him, but most of all he is worried about osteoporosis. Your doctor has told you about the characteristics of this period and the importance of physical exercise and an active life, but how does it affect your bones and what can you do to offset the negative impact of menopause on your health?
In this phase there is a decrease in the production of female sex hormones (estrogen and progesterone). In particular, estradiol has a beneficial effect on bone health and, therefore, menopause contributes to the loss of bone mineral density in an accelerated manner. This is called osteopenia and, in more advanced stages, the bone may lose more density and its structure may deteriorate until it causes osteoporosis (porous bone), or even bone fractures. Don’t become.
For this reason, the role of physical exercise as a tool to prevent and reverse osteoporosis is essential. Studies show that physical exercise is favorable when it comes to preventing fractures and reducing the number of falls, especially when its monitoring is focused on the bone areas most affected by bone mineral density loss in the lumbar region. Is: head and neck. Femur and hip area; These, in turn, are the areas most likely to suffer from osteoporotic fractures.
Scientific research has shown moderate benefits of physical exercise on bone mineral density in the lumbar region, femur, and hip in postmenopausal women, regardless of bone status or menopause stage. Similarly, when it comes to improving bone mineral density levels there is a favorable effect regardless of the type of exercise (aerobic, strength or combined).
The effect of exercise on bone mineral density loss may be more beneficial in the early stages of menopause than in the later stages. In this sense the studies are clear: people who do impact activities and strength training have 1% to 3% less loss in bone mineral density than people who do not exercise; And if progressive strength exercises are incorporated, especially in the lower body, the benefits will be greater.
However, there are some physical activities that are not as favorable due to the lack of stimulation on the bone, so they will not provide the same benefits as the activities mentioned above. Although aerobic training can be beneficial for other aspects of health, swimming or cycling is not recommended if the goal of training is to improve bone health.
On the other hand, current scientific evidence is indicating potential negative effects associated with long-term use of contraceptives, especially those based solely on progestogens. If you have reached menopause and have been taking birth control for a long time, exercise is essential for bone health.
For all those reasons, these are the most recent recommendations set out in the UK Consensus Statement on Physical Activity and Exercise for Osteoporosis 2022:
To increase the strength of your bones:
Introduce impact practice.
- Type of activity: Progress from activities that involve light impact (walking, marching, climbing stairs, Nordic walking, etc.) to those involving moderate impact (low jumps). Skipping, jogging, zumba, racket sports, team sports, etc.). It is important to include a variety of activities (changes of direction, speed, etc.).
- Frequency and quantity per week: Most days. 20 minute sessions are enough. If you are already starting with medium impacts (jumping, running or changing direction), 50 impacts are enough.
Introduce strength exercises:
- Type of activity: You should start with strength training, preferably with weights, for both upper and lower limbs. Spine and hip extension exercises are particularly important, and a great deal of progress is also made.
- Frequency and volume per week: 2-3 times per week and 3-4 sets per exercise are sufficient. Building muscle will benefit bone health.
- Exercise intensity: Progress in weight. First, prioritize technique and try to work with loads up to 80-85% (high load).
Introduce exercises that challenge balance
Specific strength and balance training can prevent falls, which is a very important factor in avoiding fractures.
- Type of activity: Specific balance exercises or activities such as tai chi, dance, yoga or Pilates.
- Frequency and quantity per week: 2-3 times a week. But if you have fallen, it is recommended to do these daily.
Introduce postural exercises and strength exercises to the abdominal area (‘core’):
- Activity Type: Exercise main, focused specifically on the spinal erectors. Other types of activities that contribute to this goal are swimming, yoga and Pilates.
- Frequency and quantity: 2-3 days per week.
However, the level of bone mineral density of the person starting a training program must be taken into account to include certain exercises or others, as the training design is different for a person who already has osteoporosis or for such a person. Which has the right level of bone mineral density. Therefore, a physical activity and exercise professional is always recommended for proper guidance and supervision of the program.
Exercising is a fundamental part of our health, especially as we enter that new stage of life where menopause tests us. We must respond with movement and life.
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