Case Study: Personal Training with a Menopausal Woman

Menopause is not a new phenomenon. The recent interest in this life stage highlights differences in advice and practices by health and wellness professionals across personal training, manual therapy, psychology and more.

Health and wellness professionals urgently need to have a deeper and more uniform understanding of menopause. Practice protocols also need to be standardised to improve the health of clients and patients.

A menopausal individual might not know what all of the symptoms are, so it’s important to know when to continue care, when to adapt the practice, and when to refer to another practitioner for support.

Having the confidence to refer (or ‘signpost’) a client/patient to a menopause specialist demonstrates awareness and knowledge of the condition. Your client/patient will feel reassured to receive the appropriate treatment.

Case Study:
Personal Training with a Menopausal Woman

Sally is a 46 year old lawyer who is experiencing night sweats, lethargy, increased weight and fluctuating periods. She has a history of anxiety and was recently diagnosed with osteopenia. Sally is feeling anxious about her increased weight gain and signs up for a block of personal training sessions to lose the weight.

During her introductory session Sally filled in a basic health questionnaire that did not include asking about her bone health or current psychological state, had her body measurements taken and her male trainer suggested a 1200kcal diet to complement her 2 x training sessions a week. He printed off some example meal plans for Sally to follow and they started the training.

On arrival at the gym Sally was feeling exhausted from a broken night's sleep and a heavy work day but she told herself she needed to do the session to feel and look better. Her trainer told her that it would be hard but worth it. Sally agreed and kept going. After the session her trainer reinforced the importance of the low calorie diet to compliment the training session.

At her next session Sally explained that she found it hard to follow the 1200kcal diet as she was hungry all the time. Her trainer explained that it was necessary to follow to see results and made Sally feel like a failure. Sally started to cry. She was feeling low from poor sleep, exhaustion and now feeling like a failure.

Questions to consider

How can we find out about peri/menopause symptoms without asking embarrassing questions, making assumptions and causing everyone to feel uncomfortable?

A simple menopause symptom checker within a questionnaire for any woman over 40 will identify symptoms your client/patient is experiencing. It can also prompt you to delve deeper into some areas that may need to be addressed.

When you’re more aware, you can tailor a treatment plan to specifically meet their needs or signpost (direct) them to a practitioner if an issue is not within your scope of practice.

In Sally’s case, if she identified that she was having night sweats, lethargy and anxiety, this could have indicated to the trainer that a medical check up might be appropriate before starting the training programme.

If a woman is over 40, can they follow the same training and nutrition plan as a woman in their 20 or 30’s?

Technically, yes. However, due to the fluctuation of sex hormones estrogen, progesterone and testosterone, this population can be affected by a flurry of symptoms unique to each individual.

A tailored approach to training and nutrition is the best option for anyone, regardless of age.

What types of body measurements should be considered for a woman over 40?

More than just body mass, waist circumference, body composition and bone mineral density are key indicators of health for a woman over 40.

The change in body shape and body composition (due to the fall of estrogen) are associated with health risks such as insulin resistance, heart disease and some cancers.

The number on the scale is less relevant than body composition and waist circumference.

Anxiety can be hard to identify by the trainer and the individual. How can mental health be assessed during client onboarding?

There can be reasons other than menopause for poor mental health. Leaning on the menopause symptom checker will assist in identifying any mental health flags within the context of menopause.

Demonstrating that anxiety is showing up alongside other symptoms will assist with signposting a client/patient to a psychologist or doctor for further support

Can a personal trainer provide a meal plan for their perimenopausal or menopausal client?

Although many of the same ‘healthy eating’ principles apply to this group, the nutrition requirements can differ.

A registered dietician or nutritionist is best placed to offer advice to this special population group. The priority (over any weight change) is to ensure that the gut, heart, bones and overall wellbeing are well supported during this often turbulent time for women.

How could a low calorie diet affect a woman (of any age)?

Low calorie diets generally cause restriction in important food groups, minerals and vitamins that support women’s hormones. This can lead to the loss of a woman’s menstrual cycle and cause damage to gut health, reduce bone mineral density, increase the risk of heart related issues, cause thinning of the hair and can lead to mental health issues.

Low calorie diets are not recommended unless for a specific health reason and under the supervision of a registered dietitian or nutritionist.

What should be considered for a woman over 40 recently diagnosed with osteopenia?

A woman recently diagnosed with osteopenia may need to check with her doctor about the type of training she intends to do. The level of impact in the training and nutritional support should be taken into account. For example, her protein, vitamin and mineral intake are essential for bone health.

Perimenopause can be an emotional time. How can a trainer support a client in this instance?

The more you know about a particular condition, the easier it will be to empathise with an individual going through that condition. For that reason, menopause accredited trainers will be able to draw on their training to understand, support, signpost and manage the training of any woman during the menopause transition.

Conclusion

With an overall goal to improve the health and wellbeing of the individual, an understanding of the menopause transition is essential for anyone working with women 40+.

The Certified Menopause Advocate Course provided by The Menopause Space, in partnership with Menopause Experts Group, gives health and wellness professionals the knowledge and the skills to set the standards for menopause practice within their field.

It also gives practitioners the confidence to refer women to those who can provide optimal menopause-related healthcare outside of their scope of practice.

The ultimate goal is to ensure any woman experiencing the menopause transition gets the best-practice menopause care for optimal health and wellbeing.

To find out more about the training get in touch.