I Thought Menopause Was Just Hot Flashes… I Was Wrong
I’ll be honest — before menopause happened to me, I didn’t fully understand it.
I thought menopause meant hot flashes. That was it.
I had no idea it could also bring brain fog, low mood, irritability, feeling overwhelmed, sleep disturbances, fatigue, dry skin — and in my clinical world — an increase in urinary incontinence and pelvic organ prolapse.
One statistic that truly stopped me in my tracks?
The years when most women transition through menopause also coincide with the highest suicide rates in a woman’s life. Research is now exploring the connection between hormonal changes and mental health. This transition is far more complex than we were ever taught.
The good news?
We know more than ever before — and research strongly supports exercise as medicine during menopause.
Here’s what the evidence shows:
Cardiovascular exercise (3–5 days/week)
20–40 minutes of brisk walking, cycling, swimming, or dancing
✔ Helps reduce hot flashes
✔ Improves brain fog
✔ Boosts mood
Strength training (2–3 days/week)
✔ Preserves muscle mass and metabolism
✔ Maintains bone density
✔ Improves mood and confidence
Mind-body movement (2–5 days/week)
10–30 minutes of yoga, Pilates, tai chi, breathwork
✔ Reduces stress
✔ Improves sleep
If we simplify it:
• Walk 20–25 minutes most days
• Strength train 2–3 times per week
• Add 10–15 minutes daily of stress-reducing movement or breathing
And here’s something many women don’t realize:
Walking is actually an indirect way to strengthen your pelvic floor.
With every step, the gentle ground reaction force stimulates your pelvic floor muscles to respond and support your bladder and pelvic organs. Consistent walking can help reduce the risk of urinary incontinence and prolapse.
Menopause is a transition — not a decline.
And movement is one of the most powerful tools we have.
In my next post, I’ll share specific strategies to reduce the risk of prolapse and incontinence after menopause. Stay tuned.
Mia Dang, PT, is a pelvic physiotherapist with extensive supplementary training in pelvic floor physiotherapy and perinatal care