Why Premenopausal Women Are Turning to Pilates — And the Research Says They’re Onto Something

If you’ve been feeling more tired than usual, noticing mood swings that seem to come out of nowhere, or dealing with joint stiffness that wasn’t there a few years ago — you’re not imagining it. The premenopausal years (typically the late 30s through mid-40s) bring real, measurable hormonal shifts that can affect your energy, your body, and your mind. The good news? One of the most effective tools for managing these changes might already be on your radar: Pilates.

Let’s dig into what the research actually says — and how you can put it to work for you.

What’s Happening in Your Body During the Premenopausal Years?

Perimenopause and the premenopausal phase involve a gradual decline in estrogen and progesterone — the hormones that do a lot more than regulate your cycle. They also play a key role in joint health, bone density, mood regulation, and sleep quality. As levels begin to fluctuate, many women experience fatigue, increased cortisol (the body’s primary stress hormone), disrupted sleep, and musculoskeletal discomfort.

In fact, research shows that as many as 71% of perimenopausal women experience musculoskeletal pain, which can lead to decreased activity and compounding weight gain driven by hormonal changes. It’s a cycle that’s hard to break — unless you find the right kind of movement.

Why Pilates Is Uniquely Suited for This Life Stage

Not all exercise is created equal during the premenopausal years. High-intensity workouts can actually spike cortisol further, leaving you feeling drained rather than energized. Pilates, by contrast, is low-impact, deeply intentional, and designed to build from the inside out.

Here’s what the science tells us:

1. It Helps Balance Your Hormones

One of Pilates’ most compelling benefits for premenopausal women is its effect on hormonal regulation. Research published on PubMed found that Pilates training significantly improved mental and physical function, accompanied by meaningful changes in cortisol and DHEA levels — two key markers of stress and vitality in women.

Because Pilates integrates mindful breathwork with controlled movement, it actively works to lower cortisol while encouraging the release of serotonin and endorphins. Studies show that mind-body exercise like Pilates supports the production of serotonin (the “happy hormone”) while reducing cortisol (the “stress hormone”) — giving you a natural, drug-free tool for emotional balance.

2. It Supports Bone Density

As estrogen begins to decline, bones become more vulnerable. The gentle, weight-bearing nature of Pilates movements builds muscle and places healthy stress on the skeletal system, which supports bone mineral density — an important buffer against osteoporosis down the road.

3. It Strengthens the Pelvic Floor and Core

The premenopausal drop in estrogen and progesterone affects pelvic floor muscles, which can lead to changes in bladder control and core stability. Pilates places a strong emphasis on core engagement and pelvic floor activation, helping to fortify these muscles before symptoms become significant.

4. It Eases Joint Pain and Improves Mobility

Pilates exercises ease joint pain and stiffness while improving overall mobility — something that becomes increasingly important as estrogen levels shift and joints lose some of their natural lubrication.

5. It Reduces Fatigue and Improves Quality of Life

A 2024 study published in the International Journal of Science and Research Archive found that an 8-week Pilates program significantly reduced fatigue scores in women navigating menopausal transition — cutting general, physical, and mental fatigue. A separate 12-week controlled study of premenopausal women showed statistically significant improvements across all measures of well-being following a structured Pilates program.

How Many Days a Week Should You Practice?

This is one of the most common questions — and the research gives us a clear, encouraging answer.

- Beginners: Aim for 2–3 sessions per week. This frequency is enough to build strength, improve flexibility, and begin noticing relief from hormonal symptoms.

- Intermediate / Optimal results: 3–4 sessions per week is the sweet spot recommended by most experts for improving flexibility, reducing stress, and increasing muscle tone.

- Session length: Aim for 30–60 minutes per session. Even a focused 30-minute practice delivers meaningful benefits.

- Daily movement: Simple breathwork and core exercises can be done daily to accelerate progress, even on rest days.

The most important thing? Consistency over intensity. A regular, moderate Pilates practice will serve you far better than sporadic intense sessions.

Tips for Beginners:

- Start with mat Pilates before progressing to reformer — it’s accessible, effective, and can be done at home.

- Focus on your breath. The breathing technique in Pilates is not decorative — it’s what activates your nervous system response and drives the hormonal benefits.

- Don’t rush the reps. Slower, more controlled movements are more effective than rushing through exercises.

- Listen to your body. The premenopausal phase means your energy levels may fluctuate with your cycle. On lower-energy days, a shorter, gentler session is always better than skipping entirely.

- Work with a certified instructor to start, even for a few sessions, to establish correct form — especially for pelvic floor and core activation.

The Bottom Line

Pilates isn’t just a workout — for premenopausal women, it’s a research-backed form of self-care that works with your body’s changing chemistry, not against it. From hormonal balance and bone density to pelvic floor strength and emotional wellbeing, the evidence is clear: a consistent Pilates practice during these years is one of the best investments you can make in your long-term health.

So roll out your mat. Your future self will thank you.

As always, consult your healthcare provider before beginning a new exercise program, especially if you are managing specific health conditions.

References

Farzane, A., & Koushkie Jahromi, M. The effect of Pilates training on hormonal and psychophysical function in older women. PubMed (PMID: 33555671). https://pubmed.ncbi.nlm.nih.gov/33555671/

Yiğit Kocamer, M., & Atilgan, E. Investigating the effects of Pilates exercises on menopausal symptoms and sexual dysfunction in postmenopausal women: A randomized controlled trial. Medicine (Baltimore). 2025;104(23):e42689. https://pmc.ncbi.nlm.nih.gov/articles/PMC12150949/

Effects of pilates exercise on quality of life and menopausal symptoms in menopausal women: A quasi experimental study. International Journal of Science and Research Archive. 2024;12(01):648–656. https://doi.org/10.30574/ijsra.2024.12.1.0851

Sheppard Method Pilates. Pilates and Hormones: Changes in Energy and How Pilates Can Help. (2022). https://sheppardmethodpilates.com/pilates-and-hormones-changes-in-energy-and-how-pilates-can-help/

Lindywell. 4 Powerful Ways Pilates Supports Women’s Hormone Health. (2023). https://lindywell.com/womens-hormone-health/

Core LDN. Why Pilates Is the Best for Menopause: From Pelvic Floor to Prolapse. (2025). https://www.coreldn.com/post/pilates-menopause-prolapse

Lemon Tree Wellness. 6 Important Ways Pilates Can Nurture Your Body and Mind After and Before Menopause. (2024). https://lemontreewellness.co/6-important-ways-pilates-can-nurture-your-body-and-mind-after-and-before-menopause/

Woman & Home. I swapped HIIT for Pilates in perimenopause and felt better ‘almost overnight’. (May 2025). https://www.womanandhome.com/health-wellbeing/fitness/pilates-in-perimenopause/