The Seven Pillars of a Healthy Menopause #3

May I introduce you to NEAT. NEAT stands for non-exercise activity thermogenesis. This means all the things we do in our everyday lives that we don't think of as exercise, but which burn energy. Walking, housework, gardening, DIY, the many miles we do walking round our own classrooms.

Research shows that we do less NEAT when we reach perimenopause. Not surprising really as we're often tired, sweaty and fed up. This is thought to be the main reason we put on weight at this time. It is not thought to be the case that our metabolism changes - research shows that our metabolic rate doesn't slow until we're in our sixties. However our hormonal changes do mean that we become more likely to put weight on around our middle.

That's why this article is about exercise and activity, rather than just exercise. It's important to try not to give up on our NEAT. The more we can do to stay active, the happier and healthier we'll be.

But exercise is also important, for several reasons - of which weight is only one. Let's talk muscles and bones. Oestrogen stimulates the cells of our muscles and bones to make more muscle and bone tissue. So we can lose muscle and bone mass when we reach menopause.

You'll often hear talk of bone density loss - or osteopenia to give it the correct term. As osteopenia becomes severe and the risk of breaking bones increases we call it osteoporosis. We need to stimulate the cells of the bones to make more bone tissue - and we do that by tugging on them.

You'll also hear talk of weight bearing exercise. Exercise such as yoga, pilates and walking has been shown not to be quite enough to pull on those bones and stimulate the cells that make bone. Running and work with weights works - and it's been shown that jumping 20 times a day is enough to prevent loss of bone density. However if our bones have already become brittle we need to avoid these kinds of exercise.

Working with weights also helps build the muscle we tend to lose (we call this sarcopenia). They don't need to be massive weights. We don't need to do it for hours. A few exercises a day will make a difference. There are some great videos on YouTube designed especially for perimenopausal and menopausal women.

But please don't think I've got a downer on pilates and yoga. I love them both. They're both really useful in partnership to weight-bearing exercise to keep us supple and to maintain the core strength that supports us through those other exercises. They also have an impact on overall wellbeing. They can help us manage the stresses of menopause - and the breathing techniques of yoga in particular can help us be calm and help us through a hot flush.

I'd recommend a combination of exercise. My own routine involves a mixture of running, weights and yoga - but only for about 20 minutes each day.

And whether you're getting going after being sedentary or upping your current exercise routine, it's important to work up to it gradually. There's no value in putting too much stress on our bodies. We get injured more easily and it takes us longer to recover - and that means we have to go back to resting, which is precisely what we don't want.

And lastly, please don't commit to an exercise routine you hate. That won't work. Of course we can dislike all exercise to start with and come to love it - I certainly have with running. But I wouldn't be carrying on if I didn't. We don't stick to an exercise routine that's miserable - and whatever routine we chose, consistency is the most important thing.

So find what you love. Care for your muscles and bones. Stretch and be calm. Keep active. And be consistent.

And have fun!