Exercise for Blood Sugar Balance During Menopause: What Research Shows

Clinically reviewed by Holistic Nutritionist Beth Bollinger

Menopause brings many changes to your body, and one of the less talked about, but increasingly important, effects is how it impacts your blood sugar. As estrogen levels decline, your body's ability to manage glucose can shift, potentially increasing your risk of insulin resistance and type 2 diabetes.

The good news? Exercise offers a research-backed solution that can help you maintain healthy blood sugar levels throughout this transition and beyond.

Why Menopause Affects Blood Sugar

The decline in estrogen around menopause may cause insulin resistance, making it harder for your cells to respond properly to insulin. This hormone is crucial for moving glucose from your bloodstream into your cells where it can be used for energy.

Menopausal women are at greater risk of insulin resistance as a result of declining estrogen levels. When cells become less sensitive to insulin, your pancreas has to work harder to produce more insulin to get the same effect on blood sugar control.

Several factors combine during menopause to create challenges for blood sugar management:

Hormonal changes: Estrogen helps protect against insulin resistance, and this protection tends to disappear with the onset of menopause

Body composition shifts: Less muscle means lower energy expenditure, and muscle weight tends to go down while fat increases during perimenopause. This muscle loss occurs because estrogen plays a crucial role in maintaining muscle protein synthesis - the process by which your body builds and repairs muscle tissue. As estrogen levels decline during menopause, this protective effect diminishes, leading to accelerated muscle breakdown.

Additionally, growth hormone and testosterone (yes, women produce small amounts too) also decrease with age, further contributing to muscle loss. The reduction in physical activity that often accompanies menopause compounds this problem, as the "use it or lose it" principle means that inactive muscles atrophy more quickly. This muscle loss typically begins in perimenopause and can result in losing 3-8% of muscle mass per decade after age 30, with the rate accelerating after menopause.

Visceral fat accumulation: Gaining weight, especially around your waistline after menopause, is associated with insulin resistance

Reduced physical activity: Many women in perimenopause tend to exercise less, not more, with some research suggesting a 40% decline in physical activity

How Exercise Improves Blood Sugar Control

Exercise works through multiple mechanisms to help your body manage glucose more effectively:

Immediate Effects

When we use our muscles during exercise, they require more glucose for energy, which helps clear glucose out of the bloodstream. This effect can last up to 48 hours after a single workout session.

Prolonged sitting interrupted by brief (≤5 min) bouts of standing or light-intensity ambulation every 20-30 min improves glycemic control in sedentary overweight/obese populations and in women with impaired glucose regulation.

Long-term Adaptations

Regular exercise creates lasting improvements in how your body handles glucose:

Increased insulin sensitivity: Postmenopausal women increased peripheral insulin sensitivity and skeletal muscle insulin-stimulated glucose uptake after 3 months of high-intensity exercise training

Better muscle glucose uptake: Exercise helps muscles become more efficient at taking up glucose, even without insulin

Improved body composition: More muscle mass leads to a higher metabolism and more calories burned, even when resting

The Best Exercise Types for Blood Sugar Control

Research reveals that different types of exercise offer unique benefits for glucose management during menopause.

Exercise for blood sugar balance in menopause

1. Strength Training

Building and maintaining muscle is important for post and peri-menopausal women to combat the loss of muscle mass that often occurs with aging, and strength training may help prevent metabolic diseases like diabetes.

The evidence:

• Dietary weight loss with or without exercise significantly improved insulin resistance in a study of 439 postmenopausal women

• Strength exercises showed improvements in metabolic and hormonal changes in menopausal women

• Resistance training had positive effects on body adiposity and metabolic risk in postmenopausal women

Recommendations:

• Strength train 2 to 3 times weekly, working all major muscle groups

• Increase resistance as you get stronger, so you fatigue between 8 and 15 repetitions

• Start with body weight resistance exercises such as squats and sit-ups without weights if you're new to strength training

Important note: Post-menopausal women may require more than two training sessions and more than six to eight sets per muscle group per week to see changes in body composition.

2. Aerobic Exercise and Walking

While HIIT and strength training get a lot of attention, don't overlook the power of consistent aerobic activity.

Walking benefits:

• A 15-minute walk after meals improves your body's ability to regulate blood sugar, which can help stave off the development of diabetes

• Data show that moderate exercise such as brisk walking reduces risk of type 2 diabetes, and all studies support the current recommendation of 2.5 h/week of moderate aerobic activity

• 12-week moderate intensity walking exercise program significantly decreased body mass index and vascular inflammatory factors in postmenopausal women with obesity

Guidelines:

• Aim for two hours and 30 minutes of moderate aerobic activity each week

• Brisk walking at 5-6 kilometres per hour is recommended on alternate days from strength training

• Interrupting prolonged sitting with 15 minutes of post meal walking improves glycemic control

3. High-Intensity Interval Training (HIIT)

HIIT has emerged as particularly effective for menopausal women dealing with blood sugar challenges.

What the research shows:

• HIIT training interventions are effective for reducing postprandial glucose and insulin with small but consistent effects, particularly in participants with impaired glucose

• High-intensity training increases expression of proteins that allow glucose to enter cells without the need for insulin, meaning sugar won't be stored as fat

• Postmenopausal women increased peripheral insulin sensitivity, skeletal muscle insulin-stimulated glucose uptake, and skeletal muscle mass to the same extent as premenopausal women after 3 months of high-intensity exercise training

How to get started:

• Begin with 2-3 sessions per week

• Try 10 intervals of 1 minute at high intensity with 1-2 minutes of recovery

• As little as 2 weeks of training three times per week was effective for reducing 24-hour mean blood glucose in previously inactive participants with type 2 diabetes

• Work with a fitness professional initially to ensure proper form and intensity

Benefits of Exercise During Menopause

Exercise during menopause offers benefits that extend far beyond glucose control:

Cardiovascular health: Women who do strength training exercises two to three days a week have a 30% reduction in cardiovascular mortality

Bone health: Weight-bearing and resistance exercises help maintain bone density

Mental health: Walking for 30 minutes three times a week was found to be as effective as antidepressants in one study

Sleep quality: Regular exercise can help improve sleep, which is often disrupted during menopause

When to Seek Professional Guidance

Consider working with healthcare professionals, such as The Blood Sugar Method, if you:

• Have been diagnosed with prediabetes or type 2 diabetes

• Take medications that affect blood sugar

• Have cardiovascular conditions or other health concerns

• Experience unusual symptoms during exercise

• Need help designing a safe, effective program

The Bottom Line

Strength training is one of the most effective forms of exercise for improving metabolic health. By increasing muscle mass, it enhances insulin sensitivity, helping the body use glucose more efficiently, something that becomes especially important during and after menopause. Aerobic activity and even short bursts of high-intensity exercise (HIIT) can add additional benefits, but strength training lays the foundation. When combined, these forms of movement create a powerful approach to managing blood sugar and supporting long-term metabolic health.

Always consult with your healthcare provider before starting a new exercise program, especially if you have existing health conditions or take medications that affect blood sugar.

Ready to take control of your blood sugar during menopause?

Our comprehensive Blood Sugar Method provides you with a complete roadmap to managing glucose levels through this transition and beyond. Get personalized exercise plans, meal strategies, and expert guidance designed specifically for menopausal women.

[Learn More About the Blood Sugar Method →]