Mastering menopause: a physiotherapist on how to move and lift

The menopause is one of the biggest events in any woman’s life and yet it is also one of the least talked about.

Most women cope with this confusing rite of passage by keeping quiet or making a joke of it. It doesn’t help, of course, that it occurs at one of the busiest stretches of a woman’s life. According to Annemarie Byrne, a nutritional therapist and coach, “Most of the women who come to me have the foot on the pedal. They have young kids, a career, ageing parents who need care. Stress levels are high. They are slow to realise they are in this period of change because they are last on their own list.”

Loretta Dignam is the founder of The Menopause Hub, a clinic for women going through the menopause that offers, among other things, GP assessments, nutritional guidance, physio and acupuncture. “I give menopause education and awareness training in the workplace and when I present the 40-odd symptoms women can get during the menopause, I see women connect the dots often for the first time. Because most know about hot sweats and loss of periods, but how many of us know about anxiety, panic attacks, joint pain, brain fog and memory loss? They are hugely relieved when they understand what’s going on because many of them thought they were going mad.”

Why do we know so little? “We are simply not educated about it,” says sexologist Emily Power Smith. “It should be taught in schools. This is a huge event in a woman’s life. It’s also inevitable. It will happen to you. Why don’t we know more?” In her experience, women don’t seek help until the symptoms have become overwhelming. This is why Annemarie likes to catch women in their late thirties. “Catch them later, and they tell me they don’t have time for self-care. And then I have to tell them that getting out of the downward spiral is going to take a lot more time than the self-care ever would have done.”

But attitudes are changing. In 2020, Vodafone announced its own employee commitment on the menopause, providing awareness training, sick leave and flexible hours. And there was the Joe Duffy show. Since it covered the menopause over five days last May, menopause clinics and mentors around the country found themselves inundated with calls. And last September 25th saw The Menopause Success Summit, a live online event featuring some of the top menopause experts (menopausesuccesssummit.com).

So what do you need to know? “Don’t suffer in silence,” says Loretta. “Get the right help from the right people.” With this in mind, we’ve assembled some of Ireland’s leading voices – meet physiotherapist Christine Gioia, who says to;

Move and lift

By Christine Gioia, physiotherapist, Pilates instructor and founder of Freedom Physio, freedomphysio.org

“When women reach menopause, oestrogen levels start to drop and this affects bone density and muscle mass. Lower bone density, or osteopenia, is the precursor to osteoporosis, which can leave us with a higher risk of fracture if we slip; while loss of muscle mass, sarcopenia, leaves us weaker and more vulnerable to injury. Women often come to me with doctors’ notes, having been diagnosed with osteopenia or sarcopenia. They are a little scared, a little overwhelmed. Some of them may not have exercised in a long time and so the classes can feel quite daunting at the beginning, especially if they believe that their body is fragile or damaged. I find that lack of information about the body leads to lack of trust. But the good news is that bone density and muscle mass can be drastically improved through regular exercise. I tell women to start by getting to a healthy weight and I recommend a mix of exercise – something that makes them happy such as walking and also Pilates and weight training. Nothing builds bone and muscle like resistance training. I tell them to start with a personal trainer if they can to get the technique down and then to do it three times a week. It makes a huge difference.”

Christine has developed a series of six, 20-minute videos, created especially to support women during perimenopause and menopause. Find them at freedomphysio.org. Ideal for those who have been sedentary for a while.

For more from Ireland’s leading experts on mastering menopause, see Loretta Dignam, founder of The Menopause Hub on speaking out here, Annemarie Byrne, nutritional therapist and coach on nourishing yourself here, sexologist Emily Power Smith on loving yourself here,  Sallyanne Brady on finding a community of support here, gynaecologist and women’s health doctor Dr Shayi Dezayi on seeking an expert medical opinion here, stylist and personal shopper Michelle Kilroy on feeling confident here, Dr Nina Bing Liu of AcuPlus on rebalancing here or see the full series here.

Illustration by  Anne O’Hara. This article originally appeared in the Autumn 2021 issue of IMAGE Magazine.