Perimenopause: The Most Underrated Strength Window in a Woman’s Life

You’re in your 40s. Your periods are changing, you feel tired, achy, maybe heavier around the middle, and workouts you used to enjoy feel harder. If that sounds familiar, you’re likely in perimenopause — and your body is asking for a different kind of care.

What is Perimenopause?

Perimenopause, or the menopausal transition, encompasses that period of time during which physiological changes mark progression toward a woman’s final menstrual period. This phase begins with the onset of menstrual irregularities and continues until a woman reaches menopause.

Women usually present with symptoms like:

1.      Irregular/missed periods, heavy/lighter bleeding.

2.      Hot flashes, night sweats, and palpitations.

3.      Generalized joint pain and stiffness, reduced muscle strength.

4.      Urinary urgency, stress incontinence, and vaginal dryness.

5.      Fatigue, reduced exercise tolerance, and low energy levels.

6.      Increased abdominal fat and difficulty losing weight.

7.      Anxiety, irritability, mood swings, brain fog, and reduced concentration.

How does it affect the body?

Perimenopause is a critical window. The changes happening now determine your muscle strength, bone health, and metabolic health in your 50s and 60s.

Waiting until menopause to act means playing catch-up.

How does Physical activity and Strength training help?

Research shows that staying physically active, especially through strength training, can ease many of the physical and metabolic changes associated with perimenopause.

1.      Builds strength and preserves muscle mass:

a)      Stimulates muscle growth.

b)      Improves muscle tone.

c)      Enhances joint support.

d)      Improves daily activities (Stair climbing, lifting, getting up from the floor).

Stronger muscles = better stability + better metabolism + better confidence.

2.      Improves Bone Mineral Density:

a)      Stimulate bone cells.

b)      Slow bone loss.

c)      Reduces risk of osteoporosis and fractures.

3.      Improves Metabolic Health & Insulin Sensitivity:

a)      Increases lean muscle mass.

b)      Improves glucose uptake.

c)      Enhances insulin sensitivity.

d)      Boosts resting metabolic rate.

Stronger muscles → better blood sugar control → lower long-term metabolic risk.

4.      Improves Pelvic Floor Function:

a)      Maintains pelvic floor muscle strength and endurance.

b)      Reduces urinary leakage and urgency.

c)      Supports pelvic organ stability.

d)      Improves confidence during lifting, running, and daily activities.

Where does a Physiotherapist make the difference?

Knowing that strength training helps is one thing.

Doing the right kind of training — at the right intensity, with the right progression — is another.

This is not the time to “slow down.” It is a time to train intelligently.

A physiotherapist bridges the gap between hormonal changes and safe performance by providing:

        1. Detailed musculoskeletal and movement assessment

        2.Tendon load management strategies

        3. Individualized strength programming

        4. Progressive overload with tissue tolerance in mind

        5. Injury prevention and long-term joint protection

        6. Pelvic Floor–Integrated Strength Training

One of the most overlooked aspects of perimenopausal care is pelvic floor health.

A physiotherapist ensures that strength training is not just about lifting weights, but about integrating:

        1. Pelvic floor activation with breathing mechanics

        2. Core–pelvic floor coordination during lifting

        3. Intra-abdominal pressure regulation

       4. Functional strength for real-life demands

Perimenopause is a turning point — not a decline.

It is the beginning of intentional strength. With the right physiotherapy guidance, what you build now determines how you move, feel, and function for decades to come.