October marks World Menopause Month, a time to raise awareness of the changes women experience during the transition through perimenopause and menopause. As Pilates teachers, we are uniquely positioned to support women in navigating this stage of life with strength, confidence, and resilience.

Common Health Concerns During Menopause

Declining oestrogen during menopause is linked to several health challenges that affect both short-term wellbeing and long-term health. According to the International Menopause Society (2023) and the World Health Organization (WHO, 2021), the most common conditions include:

• Osteoporosis –oestrogen loss accelerates bone resorption, increasing fracture risk.
• Cardiac conditions – cardiovascular disease becomes the leading cause of death in postmenopausal women.
• Diabetes and Hypertension – Hormonal shifts contribute to higher blood sugar levels and elevated blood pressure.
• Arthritis & Musculoskeletal Changes – Joint stiffness, sarcopenia (muscle loss), and reduced mobility are common.
• Mental Health – Anxiety, depression, and mood fluctuations often intensify.
• Obesity – Menopause is linked to central fat distribution and metabolic changes.
• Chronic Back Pain – Often exacerbated by bone and postural changes.

These conditions impact millions of women globally, with 1 in 2 women over 50 experiencing an osteoporosis-related fracture in their lifetime (Osteoporosis Australia, 2022).

The Pilates Teacher’s Role

Pilates is ideally placed to support women at this stage of life, offering adaptable, evidence-informed strategies that promote healthy ageing:

• Building Bone and Muscle with Resistance – Research highlights that working against resistance is critical for slowing bone loss and preserving muscle strength. Pilates, with springs, bands, and small equipment, provides accessible resistance options. I always ask my clients if they have had a DEXA scan and if so, what the results were. Always good to know the density of the bones when programming. If they have not had a DEXA scan, I ask them if they would consider having one.
• Supporting the Pelvic Floor – While loading is vital for bone, menopause also weakens the pelvic floor due to hormonal changes. Heavy or high-impact loading may increase pelvic floor symptoms such as incontinence or prolapse. This is a fine line for instructors to navigate — but one we are well equipped to handle through graded, tailored programming, and the help of a Pelvic Health Physio. I often ask my clients if they would see a Pelvic Health Physio to check the function of their pelvic floor, and address programming accordingly. 
• Improving Posture and Back Health – Core and spinal strengthening can reduce chronic back pain and improve stability.
• Cardiovascular & Weight Management Support – Dynamic flows raise heart rate, aiding in cardiovascular health and weight management.
• Enhancing Mental Wellbeing – Mindful breathing, body awareness, and movement restore energy, reduce stress, and improve mood. Also doing exercises that are fun and playful can impact mood and mental health such as ball catching!

Exercise Examples for Menopause Support

Here are a few Pilates-based strategies and exercises that can be adapted for clients in menopause:

• Bone Health, Strength & Balance
• Standing Leg Press and Lunges on the Wunda Chair
• Scooter or Standing Side Splits on the Reformer
• Arm Springs on the Cadillac for upper-body loading

• Pelvic Floor & Core Support
• Supine pelvic tilts, bridges and adductor press with breath connection
• Bridge with chi ball between knees
• Gentle Kegel integration with exhalation integrated into various Pilates exercises in sitting, standing and 4-point kneeling

• Mobility & Joint Health
• Mermaid on the Wunda Chair
• Rising swan on the Reformer
• Standing hip stretch on the Reformer

• Mental Wellbeing & Stress Relief
• Seated or supine breathing
• Gentle rolling and release work with foam roller, chi ball or massage balls
• Mindful movement flow for relaxation eg. Circumduction on the Cadillac with the Push through bar, Scapular series on the Cadillac supine, side lying, and in child pose.

The key is to individualise programs, balancing bone-loading benefits with pelvic floor friendly exercises and progressively adapting intensity to each woman’s needs. This is why I like to have information from a DEXA scan and a pelvic health assessment with a pelvic floor physio, so that I can work with a complete picture for full body programming. Not too heavy for Pelvic floor issues, but heavy enough to build bone, or finding different positions to build muscles without compromising the pelvic floor. So supine footwork with heavy springs may be a better option than deep squats under load with legs wide.

Special Offer

To help you expand your expertise in this area, 20% and 25% off the following online courses:

• Pilates for Osteoporosis & Osteopenia - Use code BUILDBONE20 for 20% off

• Harnessing Hormonal Harmony: Pilates for Perimenopause and Menopause - Use code HOTFLUSH25 for 25% off

About the Author

Louise Taube is the founder of Taube Pilates and a leading educator in specialised Pilates training for pregnancy, postnatal, menopause, osteoporosis, and active ageing. She is a Therapeutic Pilates Practitioner with over 25 years of teaching experience and a background in contemporary and clinical Pilates, Louise is passionate about empowering Pilates teachers with the tools to confidently work with women through every life stage. She is a regular presenter at industry conferences and runs nationally recognised online teacher training courses.