Supporting Physical Activity During Menopause

Abstract

Menopause is associated with physiological, psychological, and social changes that can limit women’s participation in physical activity, despite regular exercise being one of the most effective non-medical strategies for managing menopausal symptoms and reducing long-term health risks. Existing interventions predominantly focus on individual behaviour change, often overlooking the complex interaction of personal, social, organisational, and societal factors that shape physical activity engagement. This study investigates how individual and systemic factors create challenges to engaging in physical activity during menopause and explores intervention strategies that support women in sustaining an active lifestyle while accommodating diverse needs and life circumstances.

A community-based, participatory design approach was employed, integrating the Socioecological Model, Intersectionality theory, and the Health Action Process Approach (HAPA). The research consisted of a literature review, interviews with experts and menopausal women, and two co-creation workshops. The workshops explored barriers and opportunities for physical activity, informed intervention development, and evaluated behavioural determinants related to HAPA through pre- and three-week follow-up questionnaires.

The findings demonstrate that barriers to physical activity extend beyond individual motivation and emerge across multiple socioecological levels. Participants identified menopause symptoms, competing work and caregiving responsibilities, limited menopause-specific knowledge, fragmented healthcare support, financial constraints, and inaccessible exercise environments as key challenges. These barriers were experienced differently depending on intersecting factors, such as health condition, employment status, caregiving responsibilities, socioeconomic position, and cultural background. While participants generally recognised the health benefits of physical activity, sustaining behaviour depended on personalised planning, confidence in overcoming barriers, flexible routines, and ongoing social and professional support.

Drawing on these findings, this research proposes MidRhythm, a program that combines menopause and exercise education, personalised physical activity planning, and behaviour change support to help women integrate movement into their daily lives. MidRhythm enables women to discover activities that align with their preferences, symptoms, and lifestyles while connecting healthcare providers, community organisations, and local exercise opportunities. A strategic roadmap further outlines how the intervention could evolve from a local pilot to broader integration alongside systemic efforts through collaborations with healthcare
providers, municipalities, community organisations, insurers, sports facilities, tech providers, and workplaces.

This research contributes an intersectionality-informed framework for designing physical activity interventions for menopausal women by integrating behavioural science, participatory design, and systems thinking. Although the intervention was not implemented or evaluated in practice, the proposed service concept and implementation strategy provide a foundation for future pilot testing and demonstrate how design can support equitable, sustainable physical
activity participation during menopause.