Physical Activity As We Age: Why Staying Active Becomes Harder for Women

We hear it all the time: exercise is one of the best things we can do for our health. Physical activity helps reduce the risk of chronic disease, supports heart health, improves blood sugar management, preserves muscle mass, strengthens bones, boosts energy, and enhances mental well-being. In many ways, movement is our most powerful tool to fight aging.

Yet despite knowing these benefits, many women still struggle to stay physically active consistently.

According to Health Canada guidelines, adults aged 18–64 should aim for at least 150 minutes of moderate-to-vigorous aerobic activity each week, along with resistance training at least twice weekly to maintain muscle and bone health. However, only 42.2% of women meet these recommendations compared to 57.8% of men.

So why does this happen?

The Hidden Barriers Women Face

Women often carry a disproportionate share of childcare responsibilities, cooking, household management, and caregiving roles. After spending their time and energy caring for others, many are simply exhausted. Financial barriers can also make gym memberships or fitness classes inaccessible. Some women may feel uncomfortable in gym environments or intimidated by unfamiliar equipment.

But one major barrier to exercise is rarely discussed openly: pelvic health concerns.

Research by Dakic et al. found that 1 in 2 women stop being physically active because of pelvic health symptoms. These concerns may include:

  • Fear of leaking urine during exercise
  • Pelvic pain
  • Vaginal tissue discomfort
  • A sensation of heaviness or bulging caused by pelvic organ prolapse

These symptoms can make exercise feel stressful, embarrassing, or even impossible.

How Aging and Hormones Affect Physical Activity

As women age, estrogen levels naturally begin to decline, especially during perimenopause and menopause. Estrogen is a highly protective hormone that influences many systems throughout the body. When estrogen decreases, women often experience physical changes that can directly impact their ability and motivation to exercise.

Bladder and Pelvic Changes

Lower estrogen levels affect the bladder and pelvic tissues. The bladder becomes less elastic and more sensitive, making it harder to hold urine for long periods. Foods and drinks that were once tolerated—such as caffeine—may suddenly become irritating.

The vulva, vagina, and bladder contai abundant estrogen rec ptors. D clining estrogen can lead to:

  • Vaginal dryness
  • Thinning tissues
  • Reduced elasticity
  • Loss of collagen

These changes are part of Genitourinary Syndrome of Menopause (GSM), a chronic but highly treatable condition affecting the vulva, vagina, and lower urinary tract. GSM impacts up to 84% of postmenopausal women and can significantly affect comfort during exercise and daily life.

Sleep, Mood, and Energy Changes

Declining estrogen also disrupts the body’s temperature regulation system, contributing to hot flashes and night sweats. These symptoms often lead to:

  • Poor sleep
  • Anxiety
  • Palpitations
  • Fatigue
  • Reduced motivation

Estrogen also supports brain metabolism and serotonin regulation. Lower levels can contribute to mood swings, irritability, and “brain fog,” all of which can make exercise feel more difficult.

Muscle Loss and Bone Health

Estrogen is essential for maintaining musculoskeletal health. As estrogen declines, bone breakdown accelerates, increasing the risk of osteopenia and osteoporosis.

Normally, estrogen helps maintain balance between bone building and breakdown.

Without sufficient estrogen, bone resorption speeds up while bone formation cannot keep pace, resulting in rapid bone density loss.

Muscle mass is also affected. Reduced estrogen contributes to sarcopenia—the age-related loss of muscle mass and strength. Unfortunately, women often begin losing muscle mass as early as their 30s, while men typically experience more significant declines later in life.

Nutrition and Sleep Matter More Than We Think

Poor sleep creates physiological exhaustion, impairs muscle recovery, and reduces motivation. Sleep is essential for restoring energy, regulating dopamine, and helping the body recover from physical effort. Without adequate rest, workouts feel harder and endurance declines.

Nutrition also plays a major role. Poor utrition can lead to low nergy r serves, fatigue, and impaired muscle recovery, creating a cycle of inactivity. As we age, adequate protein and energy intake becomes increasingly important for preserving muscle mass and supporting recovery.

What Can We Do About It?

The good news is that many of these barriers are treatable and manageable.

Address Pelvic Health Concerns Early

If you notice leaking, pelvic pressure, pain, or other symptoms, it’s important to seek help early. A pelvic floor physiotherapist can assess and treat issues involving the pelvic floor muscles, ligaments, and connective tissues.

Pelvic floor physiotherapy can help with:

  • Incontinence
  • Pelvic organ prolapse
  • Chronic pelvic pain
  • Constipation
  • Prenatal and postpartum recovery

Seeking treatment can dramatically improve confidence and comfort during exercise.

Talk to Your Healthcare Provider About GSM

A nurse practitioner or physician can help determine whether declining estrogen levels are contributing to symptoms. Vaginal estrogen therapy is considered the gold standard treatment for GSM and can significantly improve tissue health and urinary symptoms.

Pelvic floor physiotherapy and vaginal moisturizers may also provide relief.

Start Small and Build Consistency

You do not need to become a marathon runner overnight. Small steps matter.

I often encourage patients to start with what I call “exercise snacks”—small bursts of movement throughout the day that feel manageable and sustainable. These bite-sized movements may not seem like much, but they add up and help build consistency.

Consistency creates habits.

One strategy that works well is “habit stacking,” which means pairing a new habit with an existing one. For example, most of us brush our teeth twice a day. Try adding 10 squats after brushing your teeth each morning and evening. These small movements can become powerful over time.

Strength Training Is Essential

Resistance training becomes increasingly important as we age because it helps preserve muscle mass, improve balance, and support bone density.

Strength training does not have to mean lifting heavy weights in a gym. This could include bodyweight exercises, resistance bands, Pilates, Yoga and plyometric training. Plyometric exercises, such as gentle jump training, can be especially beneficial for bone health.

Our bones get bored after 50 steps. So walking is excellent for overall health, but bones require varied and higher-impact loading to stimulate growth and maintain strength.

Choose Movement You Enjoy

One of the most important factors for long-term success is enjoyment. If you dislike an activity, you are far less likely to stick with it.

Find movement that feels good for your body and your lifestyle. Walking with a friend, dancing, yoga, hiking, swimming, or group fitness classes all count. Exercise does not need to look a certain way to be beneficial.

Another helpful strategy is to “buddy up.” Exercising with a friend, family member, or coworker can improve accountability, motivation, and enjoyment.

Final Thoughts

Physical activity truly is one of the best “medicines” we have to support healthy aging. But for many women, the barriers are real—and often deeply connected to hormonal, pelvic, emotional, and lifestyle changes that occur with aging.

The key is recognizing that these challenges are common, treatable, and not something you simply have to “push through.”

At Coastal Sports and Wellness, our team of dedicated healthcare professionals can help address many of these barriers. Our pelvic health physiotherapist, Gillian Lirette, BSc PT, can help manage your pelvic health concerns. Our dietitian, Mikaela Henderson, can support nutrition and energy needs. Our registered nurse, Jennifer Lawton, can help provide hormonal support and/or pessary fittings.  Our clinical counsellors and acupuncturists can also assist with sleep, stress management, and overall wellness.

Aging is inevitable.  Losing our ability to move confidently and comfortably does not have to be.