Do Women Need to Exercise Differently After 40?

A recent article in The Guardian (https://www.theguardian.com/lifeandstyle/2026/may/07/do-women-need-to-exercise-differently-from-men-and-ease-up-on-cardio-after-40?CMP=oth_b-aplnews_d-5) explored whether women should exercise differently as they get older - particularly during perimenopause and menopause - and whether women over 40 should start easing up on cardio.

It’s a conversation we’re hearing more and more often here in our Natural Balance Physiotherapy clinic.

Many women reach their 40s and 50s feeling frustrated that the exercise routines which once made them feel strong and energised now seem to leave them exhausted, stiff or prone to injury. Others notice changes in their body composition, recovery time or energy levels and begin to wonder whether they are doing something wrong.

From a physiotherapy perspective, there’s definitely some truth behind the discussion - but the answer is far more balanced than the headlines sometimes suggest.

Do Women Need To Exercise Differently After 40?

Why Exercise Can Feel Harder in Midlife

During perimenopause and menopause, hormonal changes can affect everything from muscle mass and bone density to sleep quality, tendon health and recovery. As oestrogen levels fluctuate and gradually decline, many women notice they don’t bounce back from intense exercise quite as easily as they used to.

That can understandably feel unsettling, especially for women who have always been active.

But it’s important to recognise that this doesn’t mean the body is failing, nor does it mean exercise suddenly becomes harmful after 40. In fact, staying active becomes even more important during this stage of life.

What often needs to change is not whether women exercise, but how they exercise.

Cardio Isn’t the Enemy

One of the biggest trends in recent years has been the suggestion that women over 40 should avoid “too much cardio”. Social media is full of warnings that running, spinning or high-intensity classes increase stress hormones and make menopause symptoms worse.

As physiotherapists, we’d be cautious about taking such an extreme view. Cardiovascular exercise still plays a hugely important role in long-term health. It supports heart health, stamina, mobility, mental wellbeing and metabolic function, all of which become increasingly important as we age. The issue is usually not cardio itself, but balance.

If someone is doing intense exercise every day while also juggling poor sleep, work stress and inadequate recovery, their body may begin to struggle. That doesn’t mean they need to stop cardio altogether - it may simply mean they need more variation, more recovery and a more sustainable overall approach.

For many women, introducing a better mix of strength work alongside cardiovascular exercise can make a significant difference in how they feel.

Why Strength Training Matters More Than Ever

One area where the evidence is becoming increasingly clear is the importance of resistance training during midlife and beyond.

Strength training helps preserve muscle mass, supports bone density and improves resilience in joints and tendons. It can also help reduce the risk of injury and maintain independence and mobility later in life.

Importantly, strength training doesn’t have to mean lifting extremely heavy weights or spending hours in a gym. For some people it may involve gym-based programmes, but for others it could be Pilates-based strength work, resistance bands, bodyweight exercises or functional training incorporated into everyday life.

The most effective exercise programme is always the one that feels realistic, enjoyable and sustainable.

What We See in Clinic

At Natural Balance Physiotherapy, we regularly see women who feel confused by how much their body seems to have changed in a relatively short space of time. Some are dealing with recurring tendon pain, joint stiffness or persistent fatigue after exercise. Others have stopped exercising altogether because they no longer feel confident in what their body can tolerate.

Very often, the solution is not exercising less - it’s exercising more intelligently.

That might involve improving strength gradually, allowing better recovery between sessions, addressing mobility restrictions or simply adapting expectations and training loads to suit the body’s current needs rather than comparing themselves to how they exercised 20 years ago.

There’s also an important psychological side to this conversation. Many women feel pressure to find the “perfect” type of exercise during menopause when, in reality, consistency matters far more than perfection.

The Bigger Picture

Women may well benefit from slightly different approaches to exercise at different stages of life, particularly because hormonal fluctuations can influence recovery, connective tissue health and energy levels. Historically, much of the research around exercise was based predominantly on men, so it is positive that more attention is now being paid to women’s health specifically. However, the fundamentals haven’t changed.

Our bodies still need movement, strength, cardiovascular fitness and recovery. The goal is not to fear exercise after 40, but to adapt it in a way that supports long-term health rather than pushing through exhaustion or pain.

From a physiotherapy perspective, one of the most important messages is this: midlife is not a reason to stop exercising. If anything, it’s a reason to prioritise it more thoughtfully than ever before.

If you’re struggling with pain, recurring injuries or uncertainty around exercise during perimenopause or menopause, here at Natural Balance Physiotherapy, we can help you find an approach that works for your body and your lifestyle.

Book your first assessment here: https://naturalbalance.connect.tm3app.com/