Perimenopause

How to keep lifting through perimenopause symptoms

By Jill McCracken, ISSA-certified personal trainer · October 15, 2026 · 5 min read

You know lifting is the right move in perimenopause. The hard part is doing it on the mornings after you were up at 3 a.m. soaked in sweat, when your knees ache for no reason, or when you just feel flat. This is how to train through those days instead of losing weeks to them.

The rule: keep the habit, adjust the dose

Perimenopause symptoms come and go, often with no pattern you can plan around. If every bad night or achy morning means skipping, a few rough weeks turn into a month off, and the muscle and bone you were protecting start slipping. So before each session, pick one of three gears:

The minimum session isn’t about building muscle that day. It keeps the habit alive, and on most days, once you’re warmed up, you’ll feel better than you expected and do more.

After a bad night’s sleep

Night waking is one of the most common perimenopause complaints, and it is the one that most often derails training. The good news: a review of 17 studies found that a single night with no sleep had little effect on strength. What did reduce strength was several nights in a row of short sleep, and mainly in big multi-joint lifts like squats and deadlifts, not smaller single-joint moves.

• One bad night: train as planned, or drop to the reduced gear if you feel foggy.
• Several bad nights in a row: take about 10% off your squat and hinge weights and keep the rest of the session as written.
• Train earlier in the day if you can. The same review suggests lifting before long stretches of being awake, rather than at the end of a long day.

Over weeks, lifting is part of the fix. A systematic review of randomized trials found that regular resistance training improved every aspect of sleep it measured, with the biggest effect on sleep quality. If evening workouts leave you wired, move them earlier.

When your joints ache

Achy joints are not in your head. A 2024 review in Climacteric estimated that more than 70% of women have musculoskeletal symptoms through the menopause transition, including joint pain, and about 25% are disabled by them. The authors named it the musculoskeletal syndrome of menopause.

Resting doesn’t make joints happier. Loading them sensibly does: in a Cochrane review of 44 trials, exercise reduced knee osteoarthritis pain and improved function. To train around sore joints:

• Warm up longer. Give yourself ten minutes, with light sets of your first exercise, not just a walk on the treadmill.
• Swap the variation, keep the pattern. A box squat instead of a deep squat, a dumbbell deadlift from blocks instead of the floor, an incline press instead of a flat one.
• Use a simple pain rule. Mild discomfort that stays at 3 out of 10 or below and is settled by the next morning is fine to train through. Sharp pain, or pain that builds set after set, means change the exercise or stop.

Hot flashes and night sweats

You don’t need to stop lifting because of hot flashes. In a randomized trial, women with moderate-to-severe hot flashes who lifted three times a week for 15 weeks had about 44% fewer of them, compared with almost no change in women who didn’t train. That trial was in women after menopause, but there’s no reason to think the training only works afterwards.

Day to day, keep it practical: train in a cool room or with a fan, wear layers you can peel off, keep water close, and rest a little longer between sets if a hot flash hits mid-session.

Low energy and low mood

Some days the problem isn’t a symptom you can point to; you just feel flat. A meta-analysis of 33 randomized trials with 1,877 people found that resistance training reduced depressive symptoms by a moderate amount, and it didn’t matter how much training people did or whether they got much stronger. Showing up was what counted.

On flat days, use the ten-minute rule: start the minimum session, and decide after the warm-up whether to keep going. Most days you will. If you don’t, you still kept your streak.

Irregular periods and heavy days

You may have read that you should plan training around your cycle. In perimenopause, when cycles become unpredictable, that isn’t possible, and the evidence doesn’t require it anyway. A meta-analysis of 78 studies found only a trivial dip in performance in the days around a period, too small to plan around, and recommended going by how you feel.

So on a heavy day, pick your gear like any other day. Dark leggings, a longer warm-up and the reduced gear are usually all it takes.

A rough week, or something to change?

Log your sessions: the weights, the reps and a one-word note on how you felt. One bad session means nothing. If your lifts have gone down for two weeks running, or everything feels harder than it should, take an easier week with half the sets, then build back up. If that doesn’t help, look at sleep, food and stress before you change the program.

If you’re new to lifting in perimenopause, start with strength training for perimenopause: what is changing, and how to train and eat for it. And if you’d rather have someone adjust your sessions with you week by week, around how you’re actually sleeping and feeling, book a free consultation call with Jill.

Very heavy bleeding, bleeding after sex, periods that come back after a year without one, joints that are swollen, hot or red, or low mood that lasts more than a couple of weeks: these belong with your doctor. This guide is about training, not medical treatment.