Pilates guide
Pilates is a good fit for your 50s: it trains balance, posture and the muscles along your back, it works on a mat, at a wall or on a reformer, and the UK osteoporosis consensus counts it among the strength and balance activities to do at least twice a week. What it hasn't been shown to do is build bone or replace strength training, so it works best paired with weights, some impact if your spine is healthy, and walking.
This guide covers what changes around and after the menopause, what Pilates does for bone, muscle, balance, menopause symptoms and the pelvic floor, how it compares with lifting, which moves to change until you know your bones are healthy, mat, wall or reformer, and the classes and weekly plan to follow. Our Pilates for women over 40, older women and over 50 guides cover the neighbouring ages. Chest pain, feeling faint or unusual breathlessness during exercise means stop and get help: the warning signs are below.
The UK osteoporosis consensus counts Pilates among the balance and strength activities to do at least twice a week, and the NHS counts it as strength activity if you work until you need a short rest. Canada's 2023 osteoporosis guideline puts it plainly: in addition to, not instead of, balance, functional and strength training.
Pooled trials found no clear change in bone density with Pilates in women after the menopause. In one trial of women about 65 with thin bones, supervised heavy lifting and jumps raised spine bone density by 2.9% over 8 months while it fell 1.2% with gentle home exercise. The UK consensus asks for strength work 2 to 3 days a week and, if your spine is healthy, about 50 small impacts on most days.
In older adults, Pilates was no better than other exercise for strength. Weights and Pilates build different kinds of strength, and strength training raised muscle and strength in women aged 40 to 60. Do both.
Pilates improves balance tests, but no trial has shown it cuts falls. Exercise that challenges your balance, 3 or more times a week, does.
Pelvic floor training is the first treatment for leaking, and it cures or improves it for many women. Pilates isn't the same thing: in the newest trial, direct pelvic floor training did better than Pilates, even with squeezes added.
The Royal Osteoporosis Society says most people with osteoporosis can exercise safely, and suggests swaps for the roll-down, curl-ups, rolling like a ball and the rollover. The evidence behind the caution is thin, so treat the swaps as a precaution, not a reason to stop.
In 862 women followed through the menopause, bone loss began about a year before the last period and slowed, but didn't stop, about 2 years after it. Over 10 years they lost 10.6% of their spine bone density, 7.38% of it in those few years around the last period. Osteoporosis usually has no symptoms, the NHS says, so most women in their 50s don't know their bone density.
Through the menopause transition, lean mass fell by about 0.2% a year in 1,246 women, and fat mass rose by about 0.45 kg a year; both changes levelled off about 2 years after the last period. In Finnish women followed through the transition, the more active ones kept more muscle. Estimates of how many women have low muscle mass and strength (sarcopenia) vary hugely with the definition, so take any single figure with care.
About 37% of women over 55 leak urine, in a review of 29 studies; in one Norwegian county, 28% to 30% of women aged 50 to 64 reported some leaking. Many women stop exercising because of it: 46% in a survey of women with symptoms. A prolapse, a bulge or heaviness in the vagina, also becomes more common with age. Both are worth talking to a GP about, and neither is a reason to stop moving.
These are common around the menopause. Exercise helps some of them a little (below). HRT (hormone replacement therapy) can help several symptoms and can also reduce the risk of osteoporosis, the NHS says; whether it's right for you is a decision with your GP. NICE (the National Institute for Health and Care Excellence) asks clinicians to explain the importance of keeping muscle mass and strength through physical activity around the menopause.
Mostly lying, kneeling and seated work for the trunk, hips and spine, plus standing and wall work in many classes; the reformer adds springs. A few classical moves round the spine deeply under the weight of the upper body or legs (the roll-up, the rollover, rolling like a ball, the teaser), which is what the Royal Osteoporosis Society suggests changing if your bones are thin. Most Pilates is low impact and light, so on its own it gives your bones little of the load they respond to.
Most Pilates trials in older adults recruit women (31 of 51 trials in people over 55 recruited only women), but few are squarely in women aged 50 to 65; most are in women in their late 60s and 70s. Some trials are reported in more than one paper: one Spanish trial of 110 women appears in several papers, and a Spanish trial of Pilates against weights in two papers that give different numbers of women. We count each trial once.
Across 39 studies of 1,770 older adults (only 14 of good quality), Pilates improved balance tests against doing nothing, and about as much as other exercise. Against no exercise it also improved strength, flexibility and everyday function in people over 60.
In 57 women aged 50 to 60, Zumba improved balance on harder tasks (on foam, eyes closed) where Pilates didn't. One small trial; it suggests standing, moving balance work adds challenge that mat Pilates may not.
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In older adults, Pilates was no better than other exercise for strength (24 trials), and a review of 12 studies in adult women found no clear change in lean mass or grip. In 25 women aged 59 to 66 with no comparison group, 12 weeks of mat Pilates raised grip by 8% and chair stands by 23%: a start, not proof.
In 11 trials in women after the menopause, Pilates improved 5 of 9 areas of a quality of life questionnaire, including pain and physical function, at very low to moderate certainty.
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Symptom scores fell in small trials: by about 6 points on the Menopause Rating Scale after 6 weeks of online classes in 40 women, with no change in bladder and vaginal symptoms. Against aerobic exercise, in 30 women, Pilates did no better. The trials were small, unblinded and mostly compared Pilates with doing nothing.
Pooled Pilates trials found no clear change in sleep quality in women after the menopause. Exercise in general eased depressive and anxiety symptoms around the menopause across 21 trials, and mind-body exercise (Pilates among it) helped sleep and mood a little.
Pilates trials in older adults report no adverse events, but few measure them, and no study has counted fractures with Pilates in people with thin bones. Structured exercise is safe for people with osteoporosis or osteopenia, a review of harms concluded.
In 3 trials of 6 months or more in women after the menopause, Pilates made no significant difference to bone density at the spine or hip, and only one trial was of good quality. Across 11 studies of Pilates or yoga in 591 women aged 45 to 78, the pooled effect was close to zero. A 2026 review of leisure activity agreed: no clear gain, though it may help hold bone steady.
In 41 Turkish women with osteoporosis, spine bone density rose with 24 weeks of clinical Pilates and fell without it; in 51 Brazilian women, Pilates beat no exercise for spine density by an effect far larger than exercise usually has on bone. A third study, of once-weekly Pilates in 40 women over 60, found no change in bone markers. Treat the gains as unconfirmed.
Across 100 trials, low-intensity exercise didn't increase bone mass; across 53, resistance training, with or without impact, did most at the spine and hip. The Cochrane review found combined programmes did most for the spine, though not enough trials counted fractures to show fewer. A 2026 review of newer trials agreed, with small effects.
In the LIFTMOR trial, 101 women about 65 with low bone mass did 8 months of twice-weekly, 30-minute supervised heavy lifting (5 sets of 5) with impact work, or a gentle home programme. Spine bone density rose 2.9% with lifting and fell 1.2% with the home programme, with one minor back spasm and no new spinal fractures on scans. Limits: one centre, close supervision, no women with recent fractures, and the figures come from the abstract, as the trial's 2019 correction couldn't be read.
In MEDEX-OP, 115 women about 64 with low bone mass did the same lifting programme or a deliberately low-intensity Pilates-based class for 8 months. Spine density rose 1.9% with lifting and 0.1% with the gentle class, and only lifting helped the structure of the hip. Both were well tolerated. This compares lifting with one gentle class, not with every Pilates class.
In 80 trials, exercise helped bone about as much in early as in later postmenopause, and with normal or low bone density.
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The UK osteoporosis guideline strongly recommends combined weight-bearing and muscle strengthening exercise. The UK consensus gives the dose: strength work 2 to 3 days a week with a weight you can lift 8 to 12 times, building to 3 sets, and about 50 moderate impacts on most days if you have no spinal fractures. The NHS advises regular exercise that includes weight-bearing, strengthening and balance exercises.
Across 20 trials in adults over 45, exercise programmes reduced low-trauma fractures, and supervised programmes did best. A qualified teacher or a supervised class is worth it if your bones are thin.
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In 60 women aged 60 to 80, twice a week for 18 weeks, resistance training built more of the strength measured on machines and Pilates more of the held strength at the hip and trunk; both raised lean mass, and neither caused an adverse event. The trial is reported in two papers that give different numbers of women, so we count it once. In 34 women about 70, device-based balance and core resistance training beat Pilates on balance, trunk strength and leg power.
In 27 trials of women aged 40 to 60, exercise, mostly resistance training, improved lean mass, grip and knee strength; 3 sessions a week did best. No Pilates trial was included. Resistance training after the menopause had no serious adverse events across 12 trials.
In 41 women about 52 lifting free weights twice a week, strength rose in everyone, but muscle grew only in those before the menopause; the authors suggest more than 6 to 8 sets per muscle a week afterwards. One small study.
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The American College of Sports Medicine's 2026 position stand, from 137 reviews and for all ages: heavier loads, 2 to 3 sets and at least 2 sessions a week build strength; 10 or more sets a week build muscle. For bones, the UK consensus asks for a weight you can lift 8 to 12 times, building to 3 sets, 2 to 3 days a week.
Strength training on 2 or 3 days and Pilates on 1 or 2 is our editorial starting point; our Pilates for women over 40 class puts weights, impact, pelvic floor work and head-down Pilates in one 40-minute session and suits your 50s too.
No Pilates trial big enough to count falls has been done: a pilot estimated a trial would need 804 people. A 2016 menopause journal review said Pilates prevents falls after the menopause, which goes beyond the trials.
Exercise cut the rate of falls by 23% across 59 trials (high certainty), though most volunteers were about 76; programmes with 3 or more hours a week of balance and functional exercise did best. The World Falls Guidelines ask for balance-challenging exercise 3 or more times a week, made harder over at least 12 weeks, and say supervised classes such as Pilates or yoga eased worries about falling most.
The Cochrane review found too little evidence that exercise treats hot flushes. A review of 21 trials found no change in how often they come (high certainty), and a UK trial of 261 women concluded that women shouldn't be told exercise will relieve them.
In 58 Swedish women about 55, 15 weeks of resistance training 3 times a week cut moderate to severe hot flushes by about 44%, against 2% in the comparison group. The effect lasted 6 months but had gone by 2 years. One small trial.
Hormone therapy is the most effective treatment for hot flushes, the North American Menopause Society says, and it lists exercise and yoga among options it doesn't recommend for them. Talk to your GP about treatments; our Pilates for menopause guide covers the rest.
Exercise eased depressive and anxiety symptoms around the menopause, with low and moderate intensity both helping. In women with hot flushes, exercise trials found little effect on sleep. The NHS suggests regular exercise, rest and relaxing activities such as yoga or tai chi.
Women with stress leaking (leaking when you cough, laugh or lift) who did pelvic floor training were 8 times more likely to be cured: 56% against 6%. NICE recommends supervised pelvic floor training for at least 3 months as the first treatment. In women about 68, group classes did as well as one-to-one sessions, and biofeedback gadgets add little.
In 40 women after the menopause, Pilates with deliberate squeezes did as well as pelvic floor training for leaking. In the newest trial (2026), pelvic floor training did better than Pilates, with or without squeezes. A 2026 review of small trials found alternatives similar on average, while a 2013 review said they shouldn't yet be recommended. Training without a squeeze works less well than direct training. Our suggestion: learn the squeeze directly first, then build it into Pilates.
Heavy lifting and impact for bone didn't worsen pelvic floor quality of life in women after the menopause. With a prolapse, strenuous exercise worsened symptoms in a few small studies. In 20 women, Pilates raised the pressure in the tummy no more than standing up from a chair, except roll-ups, which makes the roll-up the move to ease off first if you feel heaviness.
In 447 women with a prolapse, 16 weeks of one-to-one pelvic floor training eased symptoms more than a leaflet, and in a trial of women 55 and over with a mild prolapse, 57% felt better against 13% with watchful waiting. The NHS also advises avoiding activities that put a lot of strain on the pelvic floor if you have a prolapse. Our Pilates for prolapse guide has more.
From the pelvic floor exercise move page's dose and NICE's advice of at least 3 months of supervised training; see a GP or pelvic health physiotherapist if you can't feel the squeeze or leaking isn't improving.
See the movement on the 3D figure: Pelvic floor exercise (Kegel)
"Most people with osteoporosis can exercise safely", the Royal Osteoporosis Society says. Its Pilates fact sheet suggests a wall-supported roll-down, the hip roll with your feet down, a wedge or the knee fold instead of curl-ups, the cat instead of rolling like a ball, the spine curl instead of the rollover, and a hip hinge for the spine stretch and the saw. The UK consensus suggests alternatives to the roll-down and curl-up as a precaution.
The caution rests mainly on one 1984 study of 59 women aged 49 to 60 with spinal osteoporosis, who weren't randomly assigned; 9 did bending exercises, and the group that did no exercise also had many new fractures. The UK consensus says its bending advice is consensus rather than evidence, and the UK guideline says repeated forced forward bending should be done with care. Fractures linked with bending exercise are rare. A sensible precaution, then, not a ban.
Eight years after a 2-year back-strengthening trial, fewer spinal fractures were found in the women who had trained (1.6% of vertebrae against 4.3%). An international panel strongly recommends exercise that includes strength and balance training for people with osteoporosis, with daily balance work and endurance training for the back muscles. The swan, swimming and the seated upper-back lift fit.
In 70 women aged 45 to 65 with osteoporosis, a year of supervised Pilates twice a week eased pain and improved walking, chair stands and quality of life more than home exercise. Across 23 exercise trials in people with osteoporosis, two small clinical Pilates trials ranked best for mood, quality of life and pain.
One case report describes a 69-year-old woman who dislocated and broke both shoulders during arm work on a Pilates machine. It's rare, but a reason to start with light springs and a teacher.
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Pelvic floor exercise: 8 slow holds of up to 10 seconds and 8 quick squeezes, three times a day, building towards 10 of each (from the move page's dose); pelvic floor relaxation: 5 to 10 slow breaths, 1 to 3 times a day, plus a full release after every squeeze (from the move page's dose); lateral breathing: 5 to 8 breaths at the start of every session (from the move page's dose).
Sit to stand: 2 sets of 5 slow, and step-up: 2 sets of 8 each side (our Pilates for older women class); goblet squat, dumbbell Romanian deadlift: 3 sets of 8 to 12 each, and incline push-up: 3 sets of 6 to 12 (our Pilates for women over 40 class); band row: 3 sets of 10 to 15, stopping 2 to 3 reps short of failure (from the move page's dose); farmer's carry: 2 walks of 30 m (our Pilates for longevity class). Stop each set with 2 or 3 good reps left, and add weight as it gets easier.
3D demoSit to stand from a chairBeginner · A bench or box
3D demoDumbbell goblet squatIntermediate · A dumbbell
3D demoDumbbell Romanian deadliftIntermediate · A dumbbell
3D demoStep-upBeginner · A step
3D demoBand rowBeginner · A band + An anchor point
3D demoIncline push-upBeginner · A bench or box
3D demoFarmer's carryIntermediate · A dumbbell + A kettlebellHeel drops: 20 to 30 at first, building toward about 50 on most days, for example 5 sets of 10 (from the move page's dose), only if your spine is healthy and you don't leak on impact; single-leg stand: 2 holds of 20 s each leg (our Pilates for women over 40 class); tandem stance and heel-to-toe walk (our Pilates for older women class) and side-stepping: 10 steps each way, next to a counter (from the move page's dose).
Dead bug heel taps: 6 each side (our Pilates for women over 40 class); knee fold: 5 to 10 each side (our Pilates for osteoporosis class); the hundred: 50 beats to start, building to 100 (from the move page's dose), head down; swan: 3 to 5 small lifts, each held 3 to 5 s, and glute bridge: 2 sets of 12 (our Pilates for older women class); swimming: 2 to 3 sets of 20 to 30 seconds (from the move page's dose); side kick: 8 to 10 each side, and knee hover: 3 holds of 15 to 30 seconds (from the move pages' doses); seated upper-back lift: 3 to 5 repetitions, each held 3 to 5 seconds, at least twice a week (from the move page's dose).
3D demoDead bug heel tapsBeginner · No equipment
3D demoKnee foldBeginner · No equipment
3D demoHundred (Pilates)Intermediate · No equipment
3D demoSwan (Pilates swan dive)Intermediate · No equipment
3D demoSwimming (Pilates)Intermediate · No equipment
3D demoGlute bridgeBeginner · No equipment
3D demoSide kick (Pilates side kick series)Beginner · No equipment
3D demoKnee hover (Pilates tabletop hover)Beginner · No equipment
3D demoSeated upper-back lift (sit tall, shoulders back)Beginner · A bench or boxWall roll-down: 3 to 5 slow reps (from the move page's dose), with your hands on your thighs if your bones are thin; wall sit: 2 holds of 20 to 30 s, wall push-up: 10 reps, and wall angel: 8 reps (our wall Pilates for beginners class). No trial has tested wall Pilates itself; these are ordinary strength and mobility moves with the wall for support.
Each move's page carries its own caution; these are the swaps the Royal Osteoporosis Society's fact sheet and the UK consensus suggest.
The roll-up rounds the spine again and again; its page suggests alternatives with osteoporosis, while people who already move comfortably and smoothly can carry on. Do the hundred, single and double leg stretch and criss-cross with your head down, or use the knee fold and dead bug instead.
Rolling like a ball and the rollover aren't recommended with osteoporosis or a higher risk of fracture; use the cat to move your spine and a low bridge instead of the rollover. Leave out the jack knife, teaser, neck pull and control balance too.
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In the spine stretch forward and the saw, bend your knees and hinge forward from your hips with a long back instead of curling. With a high risk of fracture, avoid or change side bending in the side bend and mermaid, as their pages say.
In 48 women about 65, mat and apparatus Pilates improved everyday function by similar amounts in 8 weeks. In 24 women aged 45 to 65 with no comparison group, the reformer wasn't clearly better than the mat. A review found more quality of life gains with equipment and with 48 or more sessions, but that compared different trials, not like with like.
Our searches found no trial of wall Pilates. The wall moves are ordinary strength and mobility moves with the wall as support, so they count by the same rules: they work when they're hard enough and you keep doing them.
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Any format counts. A supervised class, mat or reformer, is worth it if your bones are thin or you're new to exercise; for bone and strength, add load whichever you choose.
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Our editorial week, built on the UK osteoporosis consensus, the NHS activity guidelines and NICE's pelvic floor advice; our workout plan for women over 50 sets out the strength week.
Our Pilates for women over 40 class suits your 50s too: pelvic floor squeezes and release, heel drops, goblet squats, Romanian deadlifts, rows and push-ups, then head-down Pilates for your trunk and some balance. The older women class is gentler, with no curl-ups or rolling; the osteoporosis class builds in the bone swaps; the beginner over-50s class is for a first start; wall Pilates is for the wall.
A 40-minute class for women over 40: pelvic floor squeezes, heel drops for bone, strength with dumbbells and a band, head-down Pilates and balance.
40 minBeginner19 movesDumbbell, bandA 30-minute class for women over 60: pelvic floor squeezes, gentle heel drops, leg and arm strength at a chair, balance at a counter and head-down Pilates.
30 minBeginner22 movesBench or box, stepA 25-minute Pilates workout for osteoporosis and osteopenia: the Royal Osteoporosis Society's swaps for rounding moves, plus back strength and balance.
25 minBeginner16 movesWall, bench or boxA 20-minute beginner mat Pilates session for over-50s with no deep or repeated rounding of the spine, plus back strengthening and standing balance.
20 minBeginner13 movesWallA 20-minute beginner wall Pilates workout: standing and floor moves that use a wall for support and feedback. No equipment.
20 minBeginner9 movesWallA 20-minute Pilates workout for your pelvic floor, built on UK pelvic health physiotherapists' booklet: squeeze as you breathe out, move, then fully release.
20 minBeginner18 movesWall, bench or boxA 25-minute Pilates class for steadier balance: standing balance and leg strength at a kitchen counter, then mat work for your trunk and hips.
25 minBeginner17 movesWall, bench or boxImpact, strength and balance for stronger bones, following UK osteoporosis consensus advice, with options for every level.
40 minBeginner14 movesKettlebell, other / check instructionsThe women over 50 plan is the strength, bone and walking week to build around; Pilates can take its balance day. The wall Pilates challenge and the beginner Pilates plan are gentle starts.
A weekly plan for women over 50: strength, bone-loading and balance on 3 days plus walking, built on UK osteoporosis consensus advice.
3 training days45 minBeginner3 days a weekA free 30-day wall Pilates challenge for beginners: three 20-minute wall classes a week that get harder step by step, with an honest look at the 28-day trend.
3 training days20 minBeginner3 days a weekA free 4-week, 3-day Pilates plan for complete beginners. Two mat days and one wall day, with clear rules for when to move each exercise to its harder version.
3 training days25 minBeginnerTwisting should be safe if you do it smoothly and comfortably. Slow down and shorten fast or forceful twists, and leave out the added weight.
With osteoporosis or a past spinal fracture, avoid repeated or loaded deep rounding of the back, and bend from the hips. The osteoporosis guide covers impact and lifting.
With a high fracture risk, avoid or change side bending, as the side bend and mermaid pages advise, and keep twists smooth. Don't lie face down later in pregnancy; use an all-fours version of the face-down moves.
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See a GP if you have a lump in or around your vagina or other signs of prolapse, such as heaviness or pressure. With prolapse, the NHS advises avoiding activities that strain the pelvic floor, like heavy lifting, running and trampolining.
If leaking isn't improving, see a GP or a pelvic health physiotherapist: NICE recommends supervised pelvic floor training for at least 3 months first.
Breathe out as you lift, and don't hold your breath.
If you have a heart condition, follow your cardiac team's advice on how hard to work, and stop for the warning signs above. People with long-term conditions may wish to ask their specialist before starting. With uncontrolled high blood pressure, avoid straining against a held breath; the high blood pressure guide has more.
Same day (urgent GP appointment or NHS 111): throbbing pain in one leg (rarely both), usually the calf or thigh; swelling in one leg (rarely both); red, blue or darkened skin around the painful area, which may be harder to see on brown or black skin; or swollen veins. This can be a deep vein thrombosis (DVT). It is more likely after surgery, a hospital stay, 3 or more days in bed, a journey of over 4 hours, pregnancy or a recent birth, cancer, a previous clot, or contraception or hormone replacement therapy (HRT) that contains oestrogen.
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Light layers, a fan and a cold drink help, and stopping to cool down is fine (our suggestion).
Start where you're comfortable: chair, wall and standing versions all count. Our Pilates for plus-size bodies guide covers getting up and down from the floor and the equipment that helps.
These are the warning signs of our older women, women over 40 and Pilates guides, word for word; the health check line is ours. This is general information, not a diagnosis. A&E means accident and emergency; in the US, call 911 for 999, and use your doctor's urgent line or urgent care for NHS 111.
Call 999 if:
Call 999 or go to A&E (accident and emergency) straight away for severe difficulty breathing (gasping, choking or not able to get words out), a chest that feels tight or heavy, pain that spreads to your arms, back, neck and jaw, lips or skin turning very pale, blue or grey, or sudden confusion. If you're more short of breath than usual, or your heart is racing, fluttering or skipping beats, contact NHS 111.
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The NHS's advice:
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See your doctor about back pain, or a change in body shape such as losing height or a more curved back: these can be signs of a spinal fracture, though not all spinal fractures hurt.
See a GP about any bleeding from the vagina after your menopause, even if it's only a small amount or has only happened once. It's not usually serious, but it needs checking, and you shouldn't have to wait more than 2 weeks to see a specialist.
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The NHS suggests contacting your GP if:
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The Royal Osteoporosis Society suggests a physiotherapist first if you:
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You're frail, have moderate to severe dementia, have had a spinal fracture or fall regularly: the UK guidelines suggest any new exercise is supervised by a trained professional at first.
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If you fall repeatedly, or have started avoiding activity because you're worried about falling, ask your GP about a local falls service.
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Stop if you feel any of these, and call 111, or 999 (911 in the US) in an emergency:
See your GP first if you get chest pain, breathlessness or dizziness when you are active, if you have a heart condition and want to exercise harder, or if you have had a fall.
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You feel any pain or become unwell, as the NHS advises for its Pilates videos, and especially for chest pain or pressure, unusual breathlessness, dizziness or fainting. If you have a health problem, an injury or any symptoms, get advice from a healthcare professional, such as a GP, before you start.
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The NHS advises getting advice from a healthcare professional first if you have a health problem, an injury or symptoms, or have recently had a heart attack or an operation.
If you have a heart, lung or joint condition, are pregnant or have recently been unwell, start gently and read our guide for your condition. Muscle soreness for a day or two after a new exercise is common and fades as you repeat it.
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The NHS Health Check is a free check-up of the health of your heart and blood vessels for people aged 40 to 74 who don't already have a condition such as heart disease, diabetes, high blood pressure or kidney disease; your GP or local council should invite you every 5 years. You don't need one before starting Pilates, but it's a good prompt at this age (our suggestion).
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It counts as balance and strength work, but it hasn't been shown to build bone, it's no better than other exercise for strength, and you still need 150 minutes of activity that makes you breathe faster. Canada's guideline says Pilates belongs in addition to, not instead of, strength and balance training.
Pooled trials show no clear change in bone density, and a gentle Pilates-based class did far less for the spine than heavy lifting. Lifting and impact are what build bone.
In women about 65 with thin bones, supervised heavy lifting and impact raised bone density, with one minor back spasm and no new spinal fractures, and resistance training after the menopause had no serious adverse events across 12 trials. Build up gradually, with supervision if your bones are thin.
After the menopause, muscle grew little even with twice-weekly free weights; it takes more sets to grow. Strength rises well before size does.
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Most people with osteoporosis can exercise safely, and a year of Pilates eased pain and improved function in women with osteoporosis. Change the deep or loaded rounding moves instead.
They're the moves the Royal Osteoporosis Society suggests changing if your bones are thin, and the UK consensus suggests alternatives as a precaution. The evidence is weak, but back-strengthening is the safer bet until you know your bones are healthy.
It improves balance tests, but no trial has shown fewer falls. Balance-challenging exercise 3 or more times a week does cut falls.
Exercise hasn't been shown to reduce how often hot flushes come, and hormone therapy remains the most effective treatment for them. Pilates may help mood and how you feel day to day.
Direct pelvic floor training did better than Pilates in the newest trial, even with squeezes added, and NICE recommends supervised pelvic floor training first. Squeeze on purpose.
Bone-building lifting and impact didn't worsen pelvic floor quality of life after the menopause. With a prolapse, strenuous exercise can worsen symptoms, so build up gradually and get checked if you feel a bulge or heaviness.
Mat and apparatus classes improved function by similar amounts in women about 65. Use what you enjoy and can keep doing.
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No trial shows that. Pilates can help balance, quality of life and how you move; on its own it hasn't been shown to rebuild bone or muscle.
Yes, as one part of the week. It helps balance, posture, back strength and quality of life, and the UK osteoporosis consensus counts it as balance and strength work. Add strength training and impact for your bones, and walking for your heart.
Small trials found better balance, everyday function and quality of life, and lower menopause symptom scores, though Pilates did no better than aerobic exercise for symptoms. It hasn't been shown to build bone or cut hot flushes.
They do different jobs, so do both. Heavier lifting and impact raised bone density in women with thin bones, and Pilates hasn't been shown to; Pilates was no better than other exercise for strength. Weights twice or three times a week and Pilates once or twice is a good balance.
It can help pain, function and quality of life, but it hasn't been shown to raise bone density. Keep doing it, swap the deep rounding moves as the Royal Osteoporosis Society suggests, and add strength training and impact if your doctor or physiotherapist agrees.
Until you know your bones are healthy, change moves that round your back deeply or under load: the roll-up, rollover, rolling like a ball, the teaser and long curl-ups. Use head-down versions, the knee fold and the hip hinge instead. The evidence behind this is weak, so it's a precaution, not a ban.
A little, in small trials: symptom scores fell, but no more than with aerobic exercise. Exercise hasn't been shown to reduce how often hot flushes come, and hormone therapy is the most effective treatment, so talk to your GP if symptoms are bothering you.
Only if you squeeze on purpose. Pelvic floor training cures or improves leaking for many women, and NICE recommends it first. Pilates did as well in one small trial only when squeezes were built in, and less well in the newest one.
It's a fine way to start: wall moves are strength and mobility moves with support, though no trial has tested wall Pilates itself. If your bones are thin, keep your hands on your thighs in the wall roll-down.
It can be, but it isn't proven better than the mat: both improved function equally in women about 65. Learn the arm work with a teacher and keep the springs light at first.
Twice a week is a good amount, with strength training on 2 or 3 days, about 50 small impacts on most days if your spine is healthy, and walking towards 150 minutes a week. You can do Pilates and strength work in the same session.
Yes. Start with a beginner or chair class twice a week and build up slowly. Exercise helps bone and muscle whether you start soon after the menopause or years later.
See a GP about any bleeding after your menopause, a lump or heaviness in your vagina, leaking that isn't improving, back pain with losing height or a more curved back, or if you've had a fall. Call 999 for chest pain or fainting while exercising.
Exercise education, not a personal prescription, and clinical review of these guides is pending. If you are pregnant, have a health condition or have had recent surgery, check with a doctor, midwife or physiotherapist before starting, and stop for sharp or increasing pain. Health disclaimer.
