I get it.
It can feel uncomfortable to ask personal questions of your clients.
Especially when it might allude to ageing. And especially when you have no lived experience because you are a) young or b) not female.
However, starting conversations around menopause, really need to start before perimenopause. Why? Because how women enter menopause, will dictate how women age post menopause. The biggest change during this life transition is the loss of oestrogen. Look at the diagram below and see how dramatically the oestrogen* drops between the ages of 50 - 60.
And oestrogen has a huge impact on all parts of the body.
Some of the most significant changes that occur in an ageing woman’s body is due the loss of oestrogen. And the effects it has on bones and muscles. If bones and muscles are strong heading into menopause, women can avoid conditions such as osteoporosis or osteopenia. Your female clients must have resistance training to build those strong bones and muscles to prepare for this transition. You will know that it takes time and commitment to lay down the foundations of strong bones.
So, when should these conversations with your female clients start?
Well, let’s work backwards.
The average age of menopause (when women are exactly 1 year free from menstruating) happens around 52. And perimenopause (the name given to this hormonal transition) can start anywhere between 7 and 10 years before this. Early menopause (when you complete the transition before the age of 45) can happen to around 5% of women.
These conversations need to start happening for women in their late 30’s to early 40’s. Pre-menopausal women will lose bone strength, about 0.5 to 1% per year. After menopause, when the protection of oestrogen is gone, bone loss can speed up to 2 – 3 % each year.
For many women in this age group, they may still be getting their heads around giving birth or raising families. And may dismiss this as something icky that is way ahead in their future, that they don’t need to worry about now. Yet, preparing your clients with information and a goal of bone strengthening is the gift that you can give.
As a trainer, I am pretty sure that you are including weight training into your exercise prescription with all your clients. But here are conversation starters for you to have with your clients who are aged 37+. Not only is it in your scope of practice to talk about this stuff, but it is also easy to do, even if you have no shared or lived experience.
Caution: Don’t use this information to scare your clients – instead frame your conversation starters around training for menopause as a motivator for women to be strong and powerful. The sooner they start strengthening their bones, the better they will be later in life.
1. Talk DEXA scan. Osteoporosis has the name "silent killer". Because many women do not know they have it, until they have a fall and break a hip. Women who have calorie restricted (dieted) for long periods of their lives, carry a higher risk of osteoporosis. A DEXA scan can give an accurate diagnosis of bone density.
2. Talk bone bank robbers. Just as diet and lifestyle can help build bones, they can also break them down. These include alcohol, fizzy drinks – particularly cola. I know many women who are addicted to diet coke. This drink influences the absorption of calcium and phosphorus.
3. Talk changes to menstruation. Periods that become heavy can be a sign of entering into perimenopause and deplete iron stores. Periods that stop due to over training or calorie restriction is equally problematic to bone density. You don’t have to diagnose or solve the problems, but you can be instrumental in your clients seeking the correct help and guidance.
4. Talk importance of twice weekly progressive strength training. This is the most comprehensive way to improve bone strength and see your clients strong as they enter into the last third of their lives.
5. Talk sleep hygiene. Yes, oestrogen decline and general life stresses can affect our sleep. But there are things that you can control. Check in with your clients at the beginning of your session. How was their sleep the night before. Be prepared to change up your programming depending on their answer. Check in with them as they leave – they should be fist pumping you, not limping out. Sleep, rest and recovery are key to training strong bones.
With all effective conversations that coaches have with clients – remember you have 2 ears and 1 mouth for a reason. Ask open ended questions and then pause. Allow the space for your clients to share. You don’t need to know the answers or jump in with your own experience. Empathetically listening will build the trust for them to make the first steps in the direction that will best support them.
*You may see oestrogen spelled as estrogen. These are both the same things. Estrogen is the American spelling.
Want to upskill in Training Women Aged 50+?
If you’d like to upskill in Training Women Aged 50+, Fitness Education Online have partnered with Mish Wright to create a CEC course “Training Women Aged 50+”. This course provides Fitness Professionals with the knowledge and a better understanding of how to safely train this demographic.
Training Women Aged 50+ is registered with
- AUSactive / Fitness Australia: 8CECs
- Physical Activity Australia: 3PDPs
- REPS New Zealand: 4CPDs