The Exercise Prescription for Perimenopause

A Root Cores guide to training smarter, not harder

Perimenopause is not a time to stop exercising — but it is a time to change how you train.

Many women reach this stage of life feeling confused. The exercise routines that once worked suddenly feel exhausting, ineffective, or even counterproductive. Motivation is often blamed, but the real issue is far simpler:

The exercise prescription has changed.

At Root Cores, we work with women who are active, capable and committed — yet stuck in a cycle of doing more and feeling worse. The solution isn’t to quit exercise. It’s to apply the right dose of the right type of movement, supported by recovery.

This is the exercise prescription for perimenopause.

Why Exercise Needs a New Prescription in Perimenopause

Perimenopause is characterised by fluctuating oestrogen and progesterone, which influence how your body responds to stress — including training stress.

Common physiological shifts include:

• A heightened cortisol response to hard training

• Slower recovery between sessions

• Reduced tolerance to frequent high-intensity exercise

• Increased sensitivity to poor sleep and under-fuelling

• Gradual loss of muscle mass if strength training is neglected

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This doesn’t mean your body is “failing”.It means it is asking for a more intelligent approach.

Exercise in perimenopause works best when it is targeted, intentional and well-supported.

The Problem with the “More Is Better” Mindset

Many women respond to midlife changes by trying to outwork them:

• More sessions

• More intensity

• Less rest

Initially, this can feel effective — adrenaline masks fatigue and effort creates a sense of control. But over time, this approach often leads to:

• Poor sleep

• Persistent fatigue

• Plateaued fitness

• Increased niggles or injury

• A growing sense that exercise “isn’t working anymore”

In perimenopause, exercise must support the nervous system, not constantly challenge it.

The Core Principles of the Perimenopause Exercise Prescription

At Root Cores, we view exercise like medicine: the right type, at the right dose, at the right time.

Here are the foundations.

1.Low-Intensity Movement as the Base

Low-intensity exercise should make up the majority of weekly movement.

This includes:

• Walking

• Easy running

• Cycling

• Hiking

• Gentle swimming

Benefits include:

• Improved cardiovascular health

• Better fat metabolism and metabolic flexibility

• Lower cortisol load

• Support for mental health and stress regulation

If your week is busy or stressful, this type of movement becomes even more important — not less.

2. Strength Training Is Non-Negotiable

From our mid-30s onwards, women begin to lose muscle mass unless it is actively maintained.

In perimenopause, strength training becomes a cornerstone, not an optional extra.

Well-structured strength training:

• Preserves and builds muscle mass

• Supports bone density

• Improves joint health and resilience

• Enhances insulin sensitivity

• Improves posture, balance and confidence

Two to three strength sessions per week, focused on progressive but manageable loads, is an excellent prescription for most women.

3. High-Intensity Exercise: Use Sparingly, Use Well

High-intensity exercise is not harmful, but it is physiologically expensive.

Used strategically, it helps to:

• Maintain VO₂ max

• Preserve fast-twitch muscle fibres

• Support long-term health and functional capacity

The key is containment.

For most women in perimenopause:

• One to two structured high-intensity sessions per week is sufficient

• These sessions should be planned — not accidental

• They should be supported by good sleep and adequate fuelling

Intensity should be a tool, not the foundation of your training.

4. Recovery Is Part of the Prescription

Recovery is not passive.It is an active component of training adaptation.

In perimenopause, recovery includes:

• Sufficient sleep

• Adequate protein and carbohydrate intake

• Rest days or very easy days

• Managing overall life stress, not just training stress

Without recovery, even the best-designed exercise plan will fail to deliver results.

5. Exercise Must Fit Real Life

The most effective exercise plan is one that works within the context of your life.

Perimenopause often coincides with:

• Career pressure

• Parenting or caring responsibilities

• Reduced time and energy

• Increased cognitive load

Your exercise prescription must be flexible, forgiving and adaptable. Consistency over time matters far more than perfection in any given week.

What the Perimenopause Exercise Prescription Is Not

It is not:

• All HIIT

• Punishment-based training

• Exercising through exhaustion

• Ignoring recovery signals

• Chasing calorie burn or “earning” food

Instead, it is about building capacity, not draining it.

The Root Cores Approach

At Root Cores Health Coaching, we help women move away from reactive, all-or-nothing exercise patterns and towards data-informed, sustainable training.

We teach women how to:

• Understand effort and recovery

• Balance intensity with restoration

• Build strength without burnout

• Use exercise to support hormones, not fight them

Because exercise in perimenopause isn’t about doing less —it’s about doing what works now.

The Bottom Line

The exercise prescription for perimenopause is not complicated — but it does require a shift in mindset.

Move often, but not always hard.Lift weights to protect muscle and bone.Use intensity deliberately.Treat recovery as essential.Adapt training to real life.

When exercise is prescribed correctly, it becomes one of the most powerful tools women have to feel strong, capable and confident through perimenopause and beyond.