“I’m alive. I’m happy. I’m here without any injuries, and I can stand on my own!” [Oksana Chusovitina]
There she was, a diminutive figure clad in her sequinless leotard, on my TV screen. Such a different leotard from the other gymnasts I was seeing as I vaguely looked up from the work I was doing to see her standing at the runup to the vault. ‘She looks a bit older than the others’ I thought. Then the announcer spoke. “At 46 years old, Oksana Chusovitina, is ending her Olympic Games gymnastics career after 30 years from making her first Olympic debut.” How incredible. I stopped my multi-tasking and took more notice of her form, her speed on the runup and of course, the height she got to, as she tumbled and twisted in the air over the vault.
You see, she wasn’t just hurtling over the vault, she is also hurtling into mid-life – the beginning of her peri-menopause years – at 46 years she had reached midlife.
As such, her muscles, cardiovascular system, mitochondrial cells (where energy is produced), her liver, which turns over glucose in order to help her muscles contract at speed, and her oestrogen and progesterone levels are changing. Furthermore, she is small framed. There isn’t a lot of size in that tiny frame to generate the same power as she used to have, for pushing off the board to propel her over the vault. I wasn’t surprised that the height she reached wasn’t the same as the younger athletes – they have oestrogen in their tendons – and for Oksana, she may have less.
This affects the contractile nature of her ability to jump and propel herself forward. It’s why many of you may have noticed that as you transition into peri-menopause, you have had problems with plantar fasciitis – the ligament that generates the ‘spring in your step’. It’s a well known issue in menopausal women who find that they can hardly walk, let alone sprint!
It’s a tough time when calling ‘time’ on a long career of athletic success and when your self-identity is firmly entrenched in being an athlete. As New Zealand’s Radio NZ news site reported, in 2020, Oksana Chusovitina was named Uzbekistan’s Best Athlete of the Decade – an award voted for by the public. But the newspaper also reported something else. Something that many of you have had to cope with too – and that is supporting a loved one into better health. When Chusovitina’s young son was diagnosed with leukaemia, it was her status in the gymnastics world in Uzbekistan, which enabled her to move to Germany, where her son could get treatment.
While living there, she competed in international competitions and the prize money went towards her son’s medical bills – there she was, a working mother doing whatever she could for her child. How extraordinary, because not only did she have to manage the emotional stress of a sick child, but the stress of competitions and of course, the travelling. I wondered how her sleep was (or is) with all the stress she has been through.
It’s well known that stress – both emotional and physical, impacts the production of progesterone. Stress increases cortisol levels and when these are higher than they should be, women can’t sleep. For a professional athlete, this can be disastrous and an easy slide into health challenges which affect hormones, including stress and thyroid hormones. What she told media about this past experience was no surprise to me.
“If I had to go back in time I would not want to repeat the time when my child was ill,” she said. “But all of the other moments, I would gladly repeat.”
At 46 years old, Chusovitina has reached mid-life. Today on average, midlife is commonly considered to be between 40 and 60 years. Notably this is the age range referred to as senescence, the term given to the loss of a cell’s ability to reproduce and grow and the deterioration of cells that occurs from mid-life onwards. In women these changes are driven hormonally too. When we reach our biological gateway into our ageing years, our peri-menopause to post-menopause years, the changes to cells and organs occur all around the body.
Our muscles, joints, gut, liver and skin are starting to change and peri-menopause is the gateway for this. It’s why I’m often telling you that menopause isn’t ‘just’ about hot flushes, which has prevailed as a common theme in medicine and pharmacology. Changes to our muscles and our energy-producing mitochondrial cells commence in midlife. Around 45-46 years in fact. That’s why I was watching Chusovitina’s vaulting performance with a critical eye.
Ageing has become an important topic for scientific research, including muscular and strength research because life expectancy and the number of men and women in older age groups have increased dramatically in the last century. As part of this topic, muscle strength and function is an increasingly important area of research, because by 2050, the world’s population over 60 years will double from about 11% to 22%. This means that there will be 2 billion people aged 60 or older living on this planet. Approximately 400 million will be 80 years or older, over half of them women. Understanding how much your muscle strength and function change as you age matters.
My coaching community is full of women enjoying being active again. I say ‘again’ for a reason – so many of them tell me that they have enjoyed activity all their life, but when peri-menopause arrived, aching muscles, insomnia and sore joints, left them unable to do the exercise that they used to do.
When I went into menopause, I had no idea how much the strength and power in my normally strong leg muscles would affect me and how my joints would become sore and painful affecting my ability to ski and remain active. I felt my future dreams of staying active as I aged fading away and it’s what drove me to un-tangle our joint health and muscle changes during our menopause transition. If this is you as well, then here’s what happens.
Our Type 2 power and strength muscle fibres decrease in size as oestrogen production naturally declines.
There are numerous changes to our power-fibres in our skeletal muscles as we move into and through menopause. These are our Type-2 muscle fibres – the fibres that enable power, speed and jumping. Along with the loss of oestrogen in menopause, Type 2 power and speed muscle fibres diminish the fastest. It’s why many of you see your muscle tone and size decrease with age. For those of you who are skiers, or runners or you like the harder, faster activity in your gym classes, then this is why your recovery may be taking longer afterwards, or your legs and muscles ache all the time. This happened to me as well.
It took me a long time to figure out why I wasn’t able to do the harder, more powerful skiing that I used to be able to do. But as soon as I looked at menopause through the lens of our biological ageing, I knew I would find the answer when I better understood what happens to our muscles as we age.
As we go through menopause and into post-menopause, one of the most important issues to address and prevent is the progressive decline in our muscle function, balance and strength.
Whilst a muscle wasting condition called Sarcopenia is partly responsible for the decline in strength as we age it’s not the only thing we need to be aware of. There are other changes to muscles and as I have discovered with my own exercise, these changes relate to the progressive loss of muscle mass and force-generating capacity of our Type-2 skeletal muscles.
Women’s muscle fibres comprise different ratios of fibres compared to males. There are two general types of fibres – slow twitch and fast twitch. Slow twitch fibres are our endurance fibres and are known in muscle physiology terminology as ‘Type 1’ fibres. Fast twitch fibres are our power and speed fibres and these are known as ‘Type 2’ fibres.
Losing oestrogen means that we lose Type-2 muscle fibres faster than Type-1 fibres. It’s why many of us lose our ability to jump and turn as quickly as we used to. Especially those of you who are skiers or who enjoy your sports or fitness activities which involve faster movements, jumping, turning or sprint-like movements. It’s why, when you do the wrong exercise during menopause, it can make many of your symptoms worse.
As we transition through menopause and we biologically age and go into our next life-stage, there is a 30-40% decline in muscle fibre number and size. I think many of us notice the loss of tone don’t we? If you’re an athlete however, it’s important to understand that your muscles are ageing and changing, so with all my ageing athletes, I get them to focus more on their recovery. Afterall, ageing muscles take longer to recover from strenuous activity.
For women used to being active, this is important to note because this reduction in muscle fibre number and size is fibre type specific. We can lose anywhere between 10%–40% of our smaller Type-2 fibres and as I said earlier, this loss in these fibres, means that we also lose our power and speed fibres more than the Type 1 fibres that help us with our stamina and endurance.
It’s possibly the reason that many physical activity studies looking at older women’s exercise participation reports that walking (not running, jumping or sprinting) is the most popular activity as they age. Furthermore, women in their 50’s are also the highest cohort to drop out of activity as they age and I’m not surprised that lack of energy, lack of time and lack of motivation are often cited as reasons to their decreasing participation. [Women’s Midlife Health, 2015].
But there’s more to understand about our muscle function as we go through menopause too. And it’s to do with our beautiful mitochondria.
Researchers are finding that when it comes to our metabolism, energy production, immune health repair and regeneration, our tiny mitochondria matter. And the problem is, that as we move through menopause and age, we are losing muscle. When we lose muscle, we also lose our powerful little mitochondria. It’s no wonder, millions of women end up with immune health concerns as the age.
The natural death of our mitochondria has been postulated as one of the mechanisms associated with muscle fibre loss with ageing.* In other words, we need to retain our mitochondria in muscle cells to help to prevent muscular weakness and loss of function as we get older.
For those of you, like me, who also want to retain your ability to enjoy physical recreational activities such as skiing or running, then you need to sleep well, improve your liver and gut health (this is so you absorb the nutrients that your muscles need to heal and repair overnight) and do the correct exercise that helps you to not only prevent muscle loss which in turn, helps you to prevent your mitochondria loss too.
One way to achieve this, is to improve your energy and motivation for exercise as well as make the time to do it!
A lack of exercise decreases the efficiency and number of mitochondria in skeletal muscle, while exercise promotes mitochondrial health. So, if you want to retain some of your power and strength fibres (Type-2 fibres) as well as improve your Type 1 endurance fibres, then a combination of aerobic endurance and strength/ resistance exercises matter.
Mixing up the variety of exercise that you do is important as we get older. This is because different types of exercise can trigger variable but specific responses in the muscle. For example, the most important activity to do for improving mitochondrial function is actually steady-state aerobic exercise. This is also important for fat-burning. Steady-state aerobic exercise is the type of exercise which you can do rhythmically for 30-60 minutes.
Strength training is also important as we age and is important for building or retaining the muscle that you do have. Then, once you are sleeping and have restored your energy levels, doing a little bit of high intensity interval training [HIIT] within aerobic exercises such as cycling and walking also has a positive effect at the cellular level at combating age-related muscle loss and weakness. This is why the 12 week Rebuild My Fitness programme takes you through a progressive improvement in your fitness levels over the 12 weeks (or longer) and numerous women stay on with me to do this programme after they have their symptoms, sleep, weight and sore joints sorted!
Age-related muscle loss and weakness is a combination of all of these factors, but more and more research is showing that muscle and mitochondria can be re-trained and retained through exercise. Active elderly people have more of these mitochondrial cells than more-sedentary individuals do. This is also the reason why exercise prior to hip and knee surgery can speed up recovery in the elderly too.
The good news for women is that exercise can stave off and even reverse muscle loss and weakness with age. Physical activity can promote mitochondrial health, increase protein turnover in muscles, thus aiding repair, and staying active restores nerve signaling involved in muscle contraction and function. And for many of you who don’t have the time to exercise, you don’t need to do as much as what was once thought – 30-60 minutes around 4 times a week is enough to help you age healthily.
When I felt too exhausted to do the exercise that I loved to do and it was no longer helping my weight management, I was so pleased that I had undertaken my doctoral studies on women’s healthy ageing.
It lead me down the path towards better understanding about how our body changes when we don’t have the production of oestrogen and progesterone any more. The effect of losing these two hormones on our muscles, tendons and joints as well as our heart is more important that we’ve known in the past.
But as the first generation of women to be enjoying exercise and sports right into our menopause years, I also began to understand that everything that is being taught to exercise professionals in many exercise and sports courses has to date, been targeted towards younger populations, athletes and males. Very little is taught about exercise that is specifically aimed at women’s hormonal health, especially in menopause. I realised that this is because women in their 50’s today, are the first generation to have aged alongside the modern fitness industry, so exercise prescription messages (and research) are lacking.
This is why I designed and developed the 12 week online Re-Build My Fitness Programme which you can do as a stand-alone programme or if you aren’t sleeping and/or have weight concerns, then I recommend you do the foundation programmes (either Circuit Breaker or Transform Me) first.
There’s never been a better time to focus on our health as we get older, and all my programmes are on sale for you with NZ$50 off. If you are in post-menopause though and have weight concerns, then please check your email inbox for my July promotion for you which ends in 4 days.
For those not in post-menopause, with savings of $50 for you, this makes it only NZ$249 (monthly payments for 3 months are available too). If you are keen to come on board on any of the programmes, then please enter the PROMO code, ATHOME21 into the link on the image below which takes you to my website and there is a description of the programmes and videos.
Brunner, F., Schmidt et.al. (2007). Effects of aging on Type II muscle fibers: a systematic review of the literature. Journal of Ageing & Physical Activity, July;15(3):336-48.
Butler-Browne, G., Mouly V., et al, (2018). How Muscles Age, and How Exercise Can Slow It. The Scientist Online Edition.
Lachman, M. (2015). Midlife as a pivotal period in the life course: Balancing growth and decline at the crossroads of youth and old age. Int J Behav Dev. January 1; 39(1): 20–31.
Miljkovic N., Lim J., Miljkovic I., Frontera W. (2015). Aging of skeletal muscle fibers. Ann Rehabil Med. Apr;39(2):155-62. doi: 10.5535/arm.2015.39.2.155.
Pierre, T. & Pizzo, P. (2018). The Ageing Mitochondria, Genes, 9, 22; doi:10.3390/genes9010022