Podcast episode 103 (in German)
Cardio after menopause – why Zone 2 was never tested
October 11, 2026
LDL rises more than three times as fast in the year around the final menstrual period as before — and the scale shows none of it. This episode puts into context what really changes in the cardiovascular system and what follows from it for training.
What it is about
Around the final menstrual period, several things shift at once: total cholesterol, LDL and apolipoprotein B each show their own kink, arterial stiffness jumps, and abdominal fat starts increasing as early as two years before. Blood glucose, insulin and inflammatory markers, by contrast, simply follow age. Weight keeps rising steadily, while the composition underneath shifts. Then it turns to training: the recommendation most often given in this group is Zone 2 cardio — and for exactly that, the trial registry contains not a single trial. What has been tested is something else, a dose–response study over half a year, and the episode calculates how small the gains turn out to be there.
Key points
- Before the transition, LDL rises by 1.6 milligrams per deciliter per year, in the year around the final period by 5.2 — after that it stands still again.
- Arterial stiffness increases by 7.5 percent in the year around the final period, previously by less than 1 percent; abdominal fat increases by 8.2 percent, starting 2 years before.
- Annual fat gain doubles from 0.25 to almost 0.5 kilos and lean mass tips into the negative, while weight continues to rise steadily, unchanged.
- A query of the trial registry for Zone 2 and menopause returns 0 hits; for Zone 2 training alone there are 2 studies, both in other groups.
- What has been tested instead is a study of 464 women after menopause: 72 minutes per week bring 4.2 percent more oxygen uptake, 192 minutes 8.2 percent.
- Strength and cardio interfere with each other only for explosive strength, an analysis of 43 studies shows — with 3 hours between them, this effect also disappears.
- In an analysis of more than 1 million heart attacks, 42 percent of women had no chest pain, versus 30.7 percent of men.
Where the data stop
The recommendation to run in Zone 2 is not disproven for women after menopause — it is untested. It rests on observations in elite endurance athletes, on meta-analyses of polarized training whose advantage appears only in highly trained athletes and only under 12 weeks, and on mechanistic arguments. The strictest of these analyses requires an oxygen uptake above 50 milliliters, a value most 50-year-old women do not reach. A definition of the term has only existed at all since 14 sports scientists and coaches wrote one down last year.
The opposite direction also remains open. That higher oxygen uptake goes along with lower mortality is well supported as an association: 17 percent lower mortality risk per fitness level in 5,721 asymptomatic women. The trial meant to test whether training delivers on this association missed its primary endpoint in 790 women, and in women between 70 and 77 one observation points to a threshold at 22 milliliters. On blood pressure across the transition, two analyses of the same study contradict each other.
Listen (in German)
Listen on Spotify Listen on Apple Podcasts Listen on Amazon Music
Published on October 11, 2026.
The topic in the database
- Easy endurance training builds mitochondria. That Zone 2 of all things is optimal for this is a popular oversimplification.Zone 2 cardio 2–4× per week
All episodes in the app (German)
Information only, not medical advice and not a usage or dosage recommendation. Prescription-only and unapproved substances belong in the hands of a physician. Last updated: 2026-09-19.