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Your symptoms are real-get menopause care
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Key Takeaways:
Celebrity trainer Antonietta Vicario of Pvolve recommends prioritizing resistance training to preserve muscle, protect joints, and support metabolism through perimenopause and menopause.
Incorporating multi-directional, functional movements and short bursts of cardio is also key for overall health and daily life.
Combine exercise with proper nutrition and, when appropriate, medical support like HRT to maintain overall health and vitality.
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Menopause affects every woman during midlife, yet many of us feel unprepared to navigate this complex transition. As estrogen levels begin to decline during perimenopause, new challenges arise — from hot flashes and mood swings to changes in body composition to an increased risk of chronic conditions like heart disease and osteoporosis.
“Taking a holistic approach [to menopause therapy] allows women to support both their physical and emotional health throughout this transition,” says Dr. Jessica Shepherd, board-certified OB/GYN and chief medical officer at Hers.
Fitness, she explains, is a key component of the equation. “Exercise is imperative during the perimenopause and menopausal transition, as muscle mass is significantly declining during these years.”
But Dr. Shepherd notes that the goal isn’t just to move more — it’s to move in a way that’s right for your body. That’s why she recommends Pvolve, a science-backed fitness method that offers a smarter, low-impact approach to building strength and supporting long-term health.
“Strength training, mobility work, and adding progressive [weight] load is what I recommend for a strong foundation,” says Dr. Shepherd. “Pvolve’s programming specifically focuses on these areas and is designed to support bone density and muscle mass.”
To learn more, Dr. Shepherd put us in touch with Antonietta Vicario, the chief training officer at Pvolve and the mind behind their Menopause Strong program.
“In perimenopause and menopause, exercise can help to mitigate some of the symptoms that people experience, and it sets us up for long-term functionality later in life,” Vicario explains.
Vicario says that understanding how hormonal shifts affect strength, endurance, and recovery helps women train more effectively during this stage of life.
As estrogen declines, we lose muscle mass, insulin sensitivity, bone mineral density, and lubrication of our joints. Incorporating a new fitness routine may help combat some of these changes.
“Menopause requires us to develop a new relationship with our changing bodies. Often, the former ways we used to keep ourselves fit don't yield the same results, and that can be frustrating. However, leaning into science and tweaking our routines can greatly impact our success.”
“If people ask me the number one thing to do during the menopause transition, I tell them: ‘Prioritize strength training,’” says Vicario.
The science supports this. Research shows that resistance training is one of the most effective ways to counteract the muscle-depleting effects of menopause.
“Muscle is our most metabolically active tissue,” Vicario explains. “It’s a powerhouse for so many of our body's functions. It helps us manage blood sugar and maintain insulin sensitivity, which keeps our hearts healthy. It also surrounds and supports our bones and joints, so we move with less wear and tear. It can even improve our bone density.”
While strength training might conjure images of giant dumbbells and heavy free weights, it’s really about building functional strength — the kind that translates to everyday life.
“I do think this can be intimidating for people who have never weight trained before,” acknowledges Vicario. “At Pvolve, it’s not about beginning weight training with crazy heavy loads. A strong, resilient body is one that can move daily — so we start small, building a mind-body connection, which is the foundation for good form.”
As estrogen levels shift, your energy, endurance, and cardiovascular health can change. Short, strategic bursts of cardio can be an effective alternative to impact-heavy workouts.
“We always say people need to train smarter and not harder,” Vicario notes. “In the menopause transition, the grueling workouts that people may be used to can actually increase inflammation, exhaust the body, and can even lead to overuse and injury.”
“For bone and heart health, I recommend SIT training, or short high-intensity intervals to stimulate your heart muscle, followed by periods of rest and recovery.”
These quick intervals don’t just boost metabolism and stamina — they can also help protect long-term brain health.
“When we shunt blood quickly into our brain through cardiovascular intervals,” Vicario explains, “we help improve mental focus, memory, and cognitive health in the near and long-term.”
As you age, training your body for how you actually move in daily life — not just how you move in the gym — becomes essential. That’s the idea behind Pvolve’s functional, three-dimensional movement method.
“If you think of running or cycling, which are both great for your heart, you’re using certain muscles repetitively,” Vicario explains. “But we move in all directions, 360 degrees, so our workouts should mimic that too.”
By twisting, reaching, bending, and rotating rather than sticking to repetitive back-and-forth motions, women in midlife can strengthen stabilizing muscles, protect their joints, and improve balance and coordination.
“It also helps us maintain our agility and sharpens our reflexes, which both decline with age if we aren’t proactively training them,” Vicario adds.
While strength training and multi-directional movement are key pillars of a solid midlife workout routine, dedicated mobility work deserves its own spotlight.
“Your muscles are the support system for your joints. Strengthen them, and they’ll protect you,” Vicario explains. “But even with strength training, it’s not all equal. What I love about our functional movements at Pvolve is that we are also working on mobility to keep our joints supple and healthy.”
Gentle mobility drills — think hip circles, shoulder rolls, and controlled stretches — keep joints moving through their full range of motion and may help prevent the joint pain and stiffness that can accompany menopause.
“Just moving [your joints] promotes blood flow and lubrication,” she adds.
Mobility work also focuses on building those critical stabilizing muscles.
This, Vicario says, helps “future-proof ourselves from falls later in life. It really is this trifecta of strength, stability, and mobility that will help us move better long-term.”
For years, cardio was treated as the gold standard for weight loss. “There’s still this notion of like, ‘I need to be sweating and doing high-impact exercises to lose weight,’” Vicario says.
But Vicario advises midlife women to shift their perspective and make strength training a key component of their weight management journeys.
It’s a common misconception, she explains. Women often believe that “weight training ‘bulks you up,’ and that you need to endure intense, long cardio sessions to see body composition changes. When in fact, prioritizing muscle leads to more effective body composition changes.”
The science here is clear — a combined approach is the key. Research shows that combining cardio with strength training is more effective for weight management than either type of exercise alone.
Between demanding jobs, families, and busy schedules, finding time to move can feel impossible. The key, Vicario says, is to start small, stay steady, and find something you enjoy doing.
“My biggest advice would be to start small and know that over time, you will create an amazing habit. You need to enjoy the workout you are doing for it to resonate and become a habit. I think often people wait until they have hours of their day carved out for movement. Start with 20 minutes! Building an exercise habit can be about starting small and then stacking on as you grow.”
She notes that consistency, not intensity, is what creates lasting results.
“When you consistently just schedule those routines in, it almost does the work for you — you start to chase the high of the feeling you get when you're exercising.”
Studies suggest that it takes about 7 weeks to build a new habit.
To get yourself over that hump, Vicario advises, “Making it manageable with bite-sized workout routines. If it's 20 minutes, just start with 20 minutes. That counts!”
Movement is just one piece of the puzzle. From hormone support to mental health to fitness, menopause care should meet women where they are with empathy and expertise.
As your body changes, so do your nutritional needs. Pairing regular strength training with a protein-rich diet helps preserve lean muscle, maintain energy, and support overall vitality. Adequate calcium and vitamin D are crucial for bone health as we age. And staying hydrated helps support weight management and skin health.
Midlife is a chance to shift the narrative from loss to evolution. The goal becomes resilience, energy, and confidence — not chasing an ideal.
“Your body might not look like it did in your 20s and 30s, and that’s okay,” says Vicario. “You’re building your body for the decades to come.”
So take a moment to reevaluate your motivations.
“People come to exercise for physical results, but often what they get is strength, confidence, and empowerment,” she adds.
There’s empowerment in accepting that your body will change, but that’s a blessing; it carried you through life and met your unique needs at the time. Now, you can take steps to keep it strong and capable, supporting you as your needs continue to evolve.
Many women experiencing challenging symptoms of perimenopause and menopause benefit from additional support. Hormone replacement therapy (HRT) effectively restores hormone levels and helps alleviate symptoms.
There are two main types of HRT:
Systemic HRT. This delivers estrogen (and usually progesterone) throughout the body to ease symptoms like hot flashes, mood swings, vaginal dryness, and mood changes. Research also shows that HRT helps protect against bone loss (osteoporosis) and suggests it may help maintain muscle health.
Local vaginal estrogen therapy. This form of HRT delivers a low dose of estrogen directly to vaginal tissues via a cream, ring, or tablet. It effectively treats genitourinary symptoms like vaginal dryness and recurrent UTIs, but it doesn’t help with full-body symptoms like hot flashes and night sweats.
If you’re interested in learning more about HRT for menopause or perimenopause, you can connect with a menopause-friendly provider on the Hers platform. They can walk you through your treatment options and help you find a solution that works for you.
“There’s so much we can do — movement, nutrition, mindset, even HRT. It’s about building strong foundations for long-term strength and energy,” Vicario explains.
Pvolve and Hers are two brands dedicated to providing personalized support for women in midlife. Together, they show that menopause care can be practical, approachable, and confidence-building — not overwhelming.
Yes. As women age, especially during perimenopause and menopause, hormone shifts can affect energy, metabolism, joint health, and muscle mass. Adapting workouts — focusing on strength training, short bursts of cardio, and functional movement — helps maintain fitness, balance, and mobility.
A balanced routine that combines resistance training, functional movement, short bursts of cardio, and mobility work is ideal. Strength training supports muscles and bones, functional movement improves real-world mobility, and cardio helps heart health and metabolism. Consistency matters more than intensity.
Pvolve is a science-driven, low-impact, multi-directional fitness program designed to strengthen muscles, improve joint stability, and enhance overall functional fitness. It emphasizes movements that translate to everyday life, supporting energy, balance, and resilience, particularly for women in midlife.
Jennifer Aniston discovered Pvolve organically during COVID. Her assistant found the program and shared it with her, and she started streaming the workouts online. “When Jen saw her assistant, she was like, ‘What are you doing? You look amazing,’” Pvolve’s chief training officer, Antonietta Vicario, recalls.
Jennifer loved the program so much that she asked to be part of it herself — a mix of good timing, enthusiasm, and what Vicario calls “Kismet, good luck, and a lot of hard work.”