With regard to cardiovascular disease,
the main culprit is, again, oestrogen. Low
oestrogen has an effect on the sympathetic
nervous system, specifically the blood
pressure-lowering receptors that control
vaso-dilation and calcium channel opening
in smooth muscle cells. Low oestrogen
causes this mechanism to be lost. Put
this alongside diaphragmatic weight gain,
and blood pressure starts to rise in postmenopausal women, increasing their risk of
heart disease in older age.
Insulin sensitivity is another concern for
post-menopausal women. It is known to
worsen with advancing age and increasing
central obesity (diaphragmatic obesity in
menopausal women), thereby making it
difficult for some women who are already
overweight or obese to tease out the effects
of menopause.
Some studies show that an increase
in body fat, low exercise, loss of muscle
and poor sleep (which drives up another
hormone, cortisol) sends many menopausal
women spiralling into ‘metabolic syndrome’.
This is the name given to the cocktail of
clinical disorders, including obesity, insulin
resistance (the inability of muscle cells to
allow insulin to move glucose into them),
high blood lipids (hypertriglyceridemia)
and high levels of low-density lipoprotein.
These symptoms seem to be exacerbated in
women who are already overweight or obese
as they head into menopause and who have
what naturopaths often refer to as a ‘fatty
liver’. The change in levels of circulating
FSH has been positively correlated with the
change in central fat mass.
As fitness professionals, it is important
therefore to understand that some women
who have exercised regularly in the past
and maintained a healthy weight could
gain weight as they transition through
and into menopause. Not only does this
diaphragmatic weight gain increase their
risk of cardiovascular disease three-fold, but
low oestrogen also causes the loss of bonebuilding calcium, thus increasing their risk of
developing osteoporosis.
Managing menopause in your
training clients
When it comes to managing menopause
in your clients, it is a case of ‘different
strokes for different folks’. For some of your
menopausal clients, you might not have to
change a thing. For them, menopause is
a breeze and they are asymptomatic. For
others who are having a hard time of it,
however, the following strategies may be
useful. By no means are these definitive,
20 | NETWORK SUMMER 2015
but they can allow
you to empathise
with and support
your menopausal
clients in ways
that may make a
difference to how
they feel, how they
look and how they stay
healthy.
1. Put sleep strategies in place
If your client says she is tired, she is. You
can’t train a tired client effectively. It’s that
simple. While your client may not tell you
that she is having difficulty sleeping due to
hot flushes and night sweats, it’s your job to
at least ask. Try to set in place some sleep
strategies. Advise her to use a fan by the
bed at night; to avoid caffeine before bed;
to keep the room dark; to go to bed earlier
and get up earlier to re-adjust her natural
diurnal rhythm (melatonin supplements
may also help); and demonstrate some
pre-bedtime deep breathing strategies
to alleviate sympathetic nervous system
activity (especially palpitations).
2. Focus on food
There is a host of information about dietary
choices available, but without going into too
much depth, your symptomatic menopausal
client needs to focus on nutrition.
Specifically, a Mediterranean-style diet,
which is known to be anti-inflammatory, is
beneficial. This means no refined foods,
high protein (up to 30 per cent of daily
intake) and low-glycaemic foods (e.g. low
sugar and white-starch). This type of diet
supports the maintenance of normal blood
glucose levels, keeping insulin secretion by
the pancreas low. By