Understanding VO₂ Max During Perimenopause and Menopause
Written and edited by Sarah Bonza MD, MPH, MSCP, FAAFP, DipABLM, NBC-HWC
The menopausal transition brings a significant shift that impacts every aspect of a woman’s life. As hormones ebb and flow, many women experience changes that can feel both foreign and challenging. Amid these shifts, understanding the role of exercise — specifically your endurance capacity — becomes increasingly important. It’s not just about maintaining a certain physique; it’s about bolstering health, vitality, and a sense of well-being during this time to enhance and prolong your healthspan.
You may have heard of VO₂ max, a term that might have appeared in fitness articles or been mentioned by a trainer at the gym. But what exactly does it mean, and why should it hold a special place in the heart of women navigating perimenopause or menopause?
Understanding VO₂ Max
VO₂ max, or maximal oxygen consumption, is essentially a measure of the maximum amount of oxygen your body can use during intense exercise. Think of it as a litmus test for your cardiovascular and respiratory systems’ efficiency in delivering oxygen to your muscles when they need it most. In simpler terms, it tells you how well your body can perform during high-intensity workouts and serves as a gauge of your aerobic endurance — the untapped reservoir of energy that fuels sustained physical activity.
The concept might sound technical, but at its core, VO₂ max is about how effectively your body utilizes oxygen, which is critical for generating the energy needed for movement. A higher VO₂ max indicates a greater ability to intake and use oxygen, which often translates to better overall fitness and endurance.
Why VO₂ Max Matters During Perimenopause and Menopause
As women approach menopause, hormonal changes can lead to a decrease in muscle mass, an increase in fat mass, and a reduction in metabolic rate. These physiological shifts can affect how the body uses oxygen and responds to exercise. Studies have shown that there is a significant decline in VO₂ max with age, and this decline can be more pronounced during the menopausal transition [1].
Understanding and monitoring VO₂ max during this period can offer valuable insights into cardiovascular health. Cardiovascular disease risk increases after menopause due to changes in lipid profiles, blood pressure, and body composition. Improving VO₂ max has been associated with reduced risk of cardiovascular disease and mortality [2].
Moreover, focusing on enhancing VO₂ max can help counteract some of the weight gain and loss of muscle mass often experienced during menopause. It supports better metabolic function, aids in weight management, and can improve overall quality of life.
Measuring VO₂ Max
In the past, accurately measuring VO₂ max meant visiting a laboratory, where you would run on a treadmill or pedal a stationary bike while wearing a mask to analyze your oxygen intake and carbon dioxide output. While this remains the most precise method, advancements in technology have made VO₂ max estimation more accessible.
High-end fitness trackers and smartwatches now offer VO₂ max estimations based on heart rate data and activity levels. While these devices may not be as accurate as lab tests, they provide a practical way to monitor changes over time.
Field tests like the Cooper Test, which measures how far you can run in 12 minutes, or the Rockport Walking Test, which involves walking a mile as quickly as possible, can also provide estimates of VO₂ max. These methods consider factors like age, weight, heart rate, and distance covered to calculate an approximate VO₂ max.
Understanding Normal VO₂ Max Levels in Women
Knowing typical VO₂ max values for women can help you interpret your own measurements more effectively. VO₂ max levels naturally vary with age, fitness level, and individual physiology. Generally, younger women and those who engage in regular aerobic exercise tend to have higher VO₂ max values. As part of the aging process, these levels may decline, but staying active can slow this progression. The chart titled “VO₂ Max Norms for Women” illustrates average VO₂ max ranges across different age groups. By comparing your own VO₂ max to these averages, you can gain insight into your cardiovascular fitness and set realistic goals for improvement during perimenopause and menopause.
It’s important to remember that VO₂ max scores are relative. They vary based on age, gender, and fitness level. For women in perimenopause or menopause, these benchmarks serve as a personal progress tracker rather than a means of comparison with others.
Improving VO₂ Max During and After Menopause
Menopause isn’t the destination; it’s a segment on the path of your life’s journey. Maintaining or improving VO₂ max during this time is like fine-tuning your engine for the miles ahead.
Research indicates that aerobic capacity, as measured by VO₂ max, declines with age but that regular physical activity can mitigate this decline [3]. Engaging in targeted exercise routines can not only slow down the reduction in VO₂ max but can also improve it, leading to enhanced endurance and cardiovascular health.
High-Intensity Interval Training (HIIT)
One of the most effective ways to boost VO₂ max is through High-Intensity Interval Training (HIIT). This form of exercise alternates short periods of intense activity with recovery periods. For example, you might sprint for 30 seconds and then walk for a minute, repeating this cycle multiple times.
HIIT has been shown to significantly improve VO₂ max in various populations, including middle-aged and older adults [4]. For women in menopause, HIIT can be particularly beneficial. A study published in the Journal of Women & Aging found that postmenopausal women who participated in HIIT programs improved their cardiovascular fitness and experienced favorable changes in body composition [5].
The benefits of HIIT extend beyond cardiovascular health. It can also improve insulin sensitivity, reduce abdominal fat, and enhance muscle strength — all areas of concern during menopause.
Hill Training
If the idea of HIIT seems daunting, hill training offers a gentler introduction to high-intensity exercise. Walking or running uphill naturally increases the intensity of your workout without requiring you to move at high speeds.
Incorporating inclines into your walking or running routine challenges your cardiovascular system similarly to HIIT but with a lower impact on your joints. It can be an excellent way to elevate your heart rate and stimulate VO₂ max improvements without the potential risks associated with more intense workouts.
Strength Training
While often associated with building muscle, strength training also plays a crucial role in improving VO₂ max. Resistance exercises enhance muscle mass, which in turn can increase metabolic rate and improve oxygen utilization during exercise.
A study in the European Journal of Applied Physiology demonstrated that combining strength training with aerobic exercise led to significant improvements in VO₂ max among older adults [6]. For women experiencing menopause-related muscle loss, strength training can be particularly beneficial.
Getting Started with a VO₂ Max Improvement Plan
Embarking on a new fitness regimen during perimenopause or menopause might feel overwhelming, but starting slowly and listening to your body can make the process more manageable.
Improving your VO2 max during perimenopause
Consult a Professional
Before beginning any new exercise program, it’s wise to consult with a healthcare provider or a certified fitness professional, especially if you have existing health concerns. They can help tailor a program that considers your current fitness level, any medical conditions, and your personal goals.
Start Slow and Build Gradually
If you’re new to high-intensity workouts, start with moderate-intensity exercises and gradually increase the intensity. For HIIT, this might mean starting with shorter intervals of intense activity and longer recovery periods.
For example, begin with 15 seconds of higher-intensity exercise followed by 45 seconds of rest. As your fitness improves, you can increase the duration of the intense intervals and decrease the rest periods.
Incorporate Variety
Mixing different types of exercises can keep your routine interesting and work different muscle groups. Consider combining aerobic activities like walking, cycling, or swimming with strength training and flexibility exercises like yoga or Pilates.
Listen to Your Body
Pay attention to how you feel during and after workouts. It’s normal to experience some muscle soreness when starting a new exercise program, but persistent pain or discomfort is a signal to adjust your routine. Rest is also a crucial component of any fitness plan, allowing your body time to recover and adapt.
Stay Consistent
Consistency is key when it comes to improving VO₂ max. Aim for at least 150 minutes of moderate-intensity or 75 minutes of high-intensity aerobic exercise per week, as recommended by the American Heart Association. Regular activity over time leads to the best results.
The Emotional Impact of Exercise During Menopause
Beyond the physical benefits, engaging in regular exercise and working to improve your VO₂ max can have significant emotional and psychological benefits. Menopause can bring about mood swings, anxiety, and feelings of decreased self-worth due to the various changes happening in the body.
Physical activity has been shown to reduce symptoms of depression and anxiety [7]. It releases endorphins — natural mood lifters — that can help mitigate some of the emotional challenges during this life stage.
Moreover, setting and achieving fitness goals can enhance self-esteem and provide a sense of control during a time when many aspects of life might feel unpredictable.
Incorporating Mindfulness
Combining exercise with mindfulness practices can amplify these benefits. Activities like mindful walking, yoga, or tai chi not only improve physical fitness but also promote mental well-being by encouraging present-moment awareness and stress reduction.
Embracing Community
Joining group fitness classes or clubs can provide social support, which is valuable for emotional health. Sharing experiences with others who are going through similar life stages can foster a sense of camaraderie and motivation.
Conclusion
Understanding and actively working on your VO₂ max isn’t about chasing athletic records; it’s about embracing a proactive approach to your health during a transformative period of life. As a perimenopausal or menopausal woman, focusing on cardiovascular fitness empowers you to take charge of your well-being.
Each step you take, each workout you complete, contributes to a foundation of strength and resilience. The path to improving VO₂ max is not a sprint but a steady, intentional process that honors your body’s capabilities and needs.
Your menopausal transition is a unique chapter in your life story — one that can be enriched by prioritizing your health and embracing the power of movement. By integrating strategies to enhance your VO₂ max, you’re not only supporting your physical health but also nurturing your spirit.
Remember, it’s about finding what works best for you, celebrating small victories along the way, and acknowledging the strength that comes from facing changes head-on. Your journey is personal, and every effort you make is a testament to your enduring vitality.
References
- Slater J, Brown R, McLay-Cooke R, Black K. Low energy availability in exercising women: historical perspectives and future directions. Sports Med. 2017;47(Suppl 1):207–220.
- Kodama S, Saito K, Tanaka S, et al. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA. 2009;301(19):2024–2035.
- Hawkins SA, Wiswell RA. Rate and mechanism of maximal oxygen consumption decline with aging: implications for exercise training. Sports Med. 2003;33(12):877–888.
- Weston KS, Wisloff U, Coombes JS. High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: a systematic review and meta-analysis. Br J Sports Med. 2014;48(16):1227–1234.
- Trilk JL, Singhal A, Bigelman KA, Cureton KJ. Effect of sprint interval training on circulatory function during exercise in sedentary, overweight/obese women. Eur J Appl Physiol. 2011;111(8):1591–1597.
- Vincent KR, Braith RW, Feldman RA, Kallas HE, Lowenthal DT. Improved cardiorespiratory endurance following 6 months of resistance exercise in elderly men and women. Arch Intern Med. 2002;162(6):673–678.
- Mikkelsen K, Stojanovska L, Poljski C, Roach D, Brennan L. Exercise and mental health. Maturitas. 2017;106:48–56.
