Pilates and Bone Health During Menopause: Benefits and Scientific Evidence

Bone disorders such as osteoporosis and osteopenia are common conditions among women during perimenopause and, especially, after menopause. This occurs because the decline in estrogen levels—a hormone essential for maintaining bone tissue—leads to an imbalance between bone formation and bone resorption processes. As a result, bone mineral density decreases, significantly increasing the risk of osteoporosis-related fractures.

Non-pharmacological strategies have been increasingly studied, and physical activity stands out as a key ally in preserving bone health. Evidence suggests that higher levels of physical activity are associated with the maintenance of bone density and the prevention of structural bone loss typically observed during this stage of life.

Among the modalities studied, Pilates has shown promising results. Scientific studies indicate that regular Pilates practice—performed three times per week for six months—was able to significantly increase lumbar spine bone density in perimenopausal and postmenopausal women, contributing to improved bone health.

These effects appear to be related to the mechanical stress generated by muscle contraction during exercise. Pilates requires strong activation of trunk stabilizing muscles and the lumbopelvic region, generating specific forces on the spine. This mechanical stimulus promotes osteoblast activity, the cells responsible for bone formation, while also inhibiting bone resorption, contributing to a better balance in bone metabolism.

In addition, comparisons with other mind–body practices, such as Yoga, suggest that Pilates may generate greater mechanical loading on bones, which may explain its more pronounced effects on bone mineral density.

Another important point is that mind–body exercises do not impact bone health alone. Studies also report additional benefits, including improvements in sleep quality and reductions in anxiety, depression, and fatigue—symptoms frequently experienced during menopause. Therefore, physicians and healthcare professionals may recommend Pilates as an effective and safe option for the comprehensive management of menopausal symptoms.

Despite these positive findings, it is important to note that current evidence still presents limitations, such as small sample sizes and short intervention durations. As such, further randomized controlled trials are needed to more robustly confirm the effects of Pilates on bone health in women during this period.

Overall, regular Pilates practice emerges as a promising and accessible strategy to promote bone health and quality of life during menopause, reinforcing the role of physical exercise as a fundamental tool for healthy aging.

References

Fernández-Rodríguez, R., Alvarez-Bueno, C., Reina-Gutiérrez, S., Torres-Costoso, A., Núñez de Arenas-Arroyo, S., & Martínez-Vizcaíno, V. (2021). Effectiveness of Pilates and Yoga to improve bone density in adult women: A systematic review and meta-analysis. PLOS ONE, May 2021.

Xu, H., Liu, J., Li, P., & Liang, Y. (2024). Effects of mind–body exercise on perimenopausal and postmenopausal women: A systematic review and meta-analysis. April 2024.

Written by: Physiotherapist Marília Monteiro – CREFITO 129693-F