The 3 Things I’d Get Almost Every Woman Over 45 Doing for Better Health, Fitness and a Body That Still Feels Like It Works

Written By Richard Grieh

There is a weird point for a lot of women over 45 where fitness starts getting marketed to them like they are either made of glass or should be punished for eating a biscuit in 2007.

Neither is useful.

Most women in this age bracket do not need another extreme plan, another detox, or another class that leaves them crawling to the car but no better at lifting shopping, getting off the floor, climbing stairs or feeling strong in their own skin.

They need training that actually does something.

And no, before anyone says it, I know I’m not a woman. I’ve not lived through perimenopause or menopause myself, and I’m not going to pretend I have. But I have coached women through their 40s, 50s and 60s for years. I’ve seen what helps, what gets ignored, what people are scared of, and what actually changes how they feel day to day. I’ve also learned a lot from the women I’ve coached, because it is also about listening to them, adjusting and using what works.

The good news is the evidence is actually pretty consistent.

If I had to strip it right back, there are three things I’d want most women over 45 doing regularly for health and fitness.

1. Strength Training Properly

Not endless tiny pink dumbbells. Not twenty minutes of waving your arms about to music and calling it toning.

Proper strength training.

That does not mean powerlifting. It means resistance training that challenges the body enough to build or keep muscle, improve strength, support bone health and make everyday life easier. NHS guidance says adults should do strengthening activity for all the major muscle groups at least twice a week, not as an optional extra, but as part of basic health.

That matters even more for women over 45.

Around and after menopause, muscle mass, strength and bone health matter more, not less. A 2024 systematic review and meta-analysis found resistance training improved physical fitness, physiological variables and body composition in postmenopausal women. A 2025 meta-analysis also found resistance training improved bone mineral density in postmenopausal women, which is a big deal when bone health becomes more of a conversation in midlife and beyond.

This is why I will keep banging on about squats, hinges, rows, presses, step-ups, carries and controlled lower-body work.

Because women over 45 do not need less strength work. They usually need more of it, done properly, with progression, not just random HIIT and Pump classes.

And let’s be honest, “I go for a walk” is great, but it is not the same as giving your muscles a reason to stay.

2. Some Form of Proper Cardio That Gets You Breathing

Walking counts. Cycling counts. Swimming counts. Cross trainer counts. A brisk uphill walk round Pershore counts. Wandering slowly round the shops while holding a latte does not.

For general health, your heart and lungs still need some work.

The NHS recommendation for adults is at least 150 minutes of moderate-intensity activity a week, or 75 minutes vigorous, alongside strength work. Nationally, Sport England reported that 63.7% of adults in England were meeting that 150-minute guideline in the latest Active Lives results, which is the highest level on record, good news, but it still means a big chunk of people are not there yet.

There is also good evidence for this specifically in postmenopausal women. A 2024 systematic review and meta-analysis found aerobic training may improve cardiometabolic health outcomes in postmenopausal females, and a 2025 systematic review and meta-analysis reported benefits for cardiovascular and mental health.

You do not need to throw yourself into bootcamps five days a week. You need enough movement to improve fitness, manage health risk, and remind your body it is supposed to do more than sit, drive and scroll.

A brisk walk. A bike. The rower. A solid conditioning block. Anything that gets the breathing rate up and is actually sustainable.

3. Strength and Balance Work That Carries Over Into Real Life

This is the bit that gets ignored until someone feels wobbly, stiff, or starts saying things like, “I just don’t feel as stable as I used to.”

Balance is not just standing on one leg in the kitchen while waiting for the kettle to boil. It is being able to control your body. It is being able to step up, get down to the floor, get back up, catch yourself, move well, and trust your legs.

For older adults, exercise programmes that focus on balance and functional training reduce falls, and Cochrane’s review found balance and functional exercises reduced the rate of falls by 24%. World guidelines on falls prevention recommend exercise that includes balance-challenging and functional work such as sit-to-stand and stepping, done regularly and progressed over time. NHS guidance for older adults also recommends activities that improve strength and balance at least twice a week.

That is why I like movements such as sit-to-stands, step-ups, split squats, carries, controlled lunges, and anything that teaches people how to use their body in a way that transfers into actual life.

Because feeling “old” is often less about age and more about losing confidence in movement. And that can be trained.

Why this matters here, not just in some research paper

This is not just theory.

Around 19.7% of adults in Wychavon were physically inactive in 2023/24, and across Worcestershire the proportion of adults classed as overweight or obese was reported at 66.5% in the county JSNA summary. That does not mean everyone needs to panic. It does mean this conversation is relevant right here, right now, not just in some London studio or on a podcast from someone in LA telling you to “honour your feminine energy” while selling protein powder.

Around here, most women are busy. They are juggling work, kids, grandkids, ageing parents, stress, poor sleep, hormonal changes, and about twelve other things before they have even thought about themselves.

So fitness needs to stop pretending people have unlimited time and energy. That is exactly why the basics matter. Strength work. Cardio. Balance and functional movement. Done consistently, with proper coaching, they cover a lot of ground.

This is also why small group PT makes sense

Because most people do better when they are coached.

They do better when the session is planned. When someone shows them how to lift well. When the intensity is right. When the exercises make sense. When there is progression. When there is a bit of accountability. And when they are around other people who are trying to do the same thing.

That is a big part of why small group PT works so well.

It is not just exercise for the sake of exercise. It is structure. It is support. It is knowing what to do when you walk in. It is getting stronger without feeling like you have to figure it all out on your own.

And for a lot of women over 45, that is the difference between another stop-start attempt and actually building something that lasts.

So if you are a woman over 45 and you want to improve your health and fitness, I would not overcomplicate it.

I would ask:

Are you strength training properly?
Are you doing enough cardio to actually challenge your fitness?
Are you working on balance and functional movement, or just hoping that side of things looks after itself?

Those three things will take you a long way.

Not because I said so.

Because the evidence backs them, and because I have seen them work with real women, in real life, over and over again.

And if you want help doing that in a way that feels realistic, coached and actually enjoyable, that is exactly what we do at RSG Fitness Club in Pershore.

Build Strength. Create Habits. Sustain Results.

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Richard Grieh