High Impact vs Low Impact Exercise During Perimenopause: What Your Body Actually Needs
Should you do high or low impact exercise during perimenopause? Compare the benefits and risks of each to build the right routine for your body.
Why Impact Level Matters During Perimenopause
Perimenopause is a period of significant physiological change. Declining estrogen affects bone density, joint health, cardiovascular function, muscle mass, and mood regulation. The type of exercise you choose can either support or undermine these systems depending on how well it matches your current health status, fitness level, and symptoms. High-impact exercise and low-impact exercise both have genuine, evidence-backed benefits during perimenopause, but they are not interchangeable. Understanding what each type does to your body helps you build a routine that supports your health rather than creating new problems.
What Counts as High Impact Exercise?
High-impact exercise involves movements where both feet leave the ground simultaneously or where significant force is transmitted through the joints during landing. Running, jumping rope, aerobics classes, HIIT with jumping movements, basketball, and court sports all qualify. High-impact exercise generally burns more calories per session, provides a stronger cardiovascular stimulus, and delivers mechanical loading to the skeleton. The bone-loading effect is particularly important during perimenopause because weight-bearing, impact-generating exercise is one of the most effective ways to slow the accelerated bone loss that accompanies estrogen decline. Women who do regular high-impact weight-bearing activity have measurably better bone density outcomes than those who avoid it.
What Counts as Low Impact Exercise?
Low-impact exercise keeps at least one foot on the ground at all times or reduces the force transmitted through the joints. Walking, cycling, swimming, yoga, Pilates, elliptical training, and rowing are all low-impact. These activities can be performed at moderate to vigorous intensity and deliver excellent cardiovascular and muscular benefits without the joint stress of high-impact movement. For women experiencing joint pain, pelvic floor weakness, or recovering from injury, low-impact options provide a way to remain active and gain the mental and physical benefits of exercise without aggravating symptoms. Low-impact does not mean low effort, and many low-impact modalities can be performed at intensities that drive significant fitness improvements.
Bone Health: Where High Impact Has the Edge
The evidence on bone density is clear. Activities that generate ground reaction forces and mechanical loading of the skeleton, including jumping, running, and dancing, stimulate osteoblasts (bone-building cells) and help maintain bone mineral density. Walking is weight-bearing and better than nothing, but its lower impact stimulus means it produces more modest bone-protective effects than higher-impact activities. Swimming and cycling, while excellent for cardiovascular health, are non-weight-bearing and provide very little bone stimulus. Women who are significantly concerned about bone density should aim to include some higher-impact weight-bearing activity in their routine, even if they also do low-impact modalities for the majority of their training.
Joint Health: Where Low Impact Protects You
Perimenopause is associated with increased joint pain and stiffness due to estrogen's role in maintaining cartilage and joint fluid. For women already experiencing significant joint symptoms, high-impact exercise can exacerbate pain and lead to injury if volume is not carefully managed. Low-impact alternatives allow continuous training without adding mechanical stress to already-sensitised joints. If you have knee osteoarthritis, hip problems, or significant musculoskeletal symptoms, beginning with low-impact exercise while addressing the hormonal root cause through HRT is a sensible approach. As symptoms improve, higher-impact activities can be gradually reintroduced.
Pelvic Floor Considerations
Declining estrogen affects the pelvic floor tissues, and many women in perimenopause experience urinary leakage or pelvic organ prolapse symptoms for the first time. High-impact exercise, particularly running and jumping, increases intra-abdominal pressure and can worsen these symptoms if the pelvic floor is not adequately supported. This does not mean high-impact exercise should be avoided entirely, but it does mean that pelvic floor health should be assessed before progressing to high-impact activity. A pelvic floor physiotherapist can assess your capacity and give specific guidance. Low-impact alternatives provide a safe way to maintain fitness while pelvic floor function is being addressed.
Building the Best of Both Worlds
For most perimenopausal women, the most effective exercise approach is not a choice between high and low impact but a thoughtful combination of both. A weekly routine that includes two to three low-impact sessions for joint health and recovery, one to two higher-impact sessions for bone loading, and two resistance training sessions for muscle mass and metabolic rate covers the key physiological priorities of this life stage. Starting where you are and progressing gradually is more important than hitting any specific intensity target immediately. Listen to your body, manage joint symptoms proactively, support your pelvic floor, and prioritise consistency over intensity to build a sustainable, health-promoting exercise habit through perimenopause and beyond.
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