A Just Ask Tante Pia column

By Pia Johansson

Are we heading for disaster as menopause hits? Are we to expect, in addition to hot flashes, mood swings, and the end of fertility, a sudden drop in athletic performance? Or is it contraindicated? Thankfully, no and no.

I wanted to investigate what lies ahead. Menopause. It happens to all of us as a natural part of our fertility journey, but just as the onset of our menstrual cycle was shrouded in hormone fluctuations, so too is the end of them. Hormone fluctuations, my lord, are the cause of a lot of both physical and mental craziness, and menopause can indeed be extremely difficult. Here, I focus on what the transition from being pre- to post-menopausal will bring in terms of performance and health, and how to navigate the transition in terms of training.

I did a quick search and found that, surprisingly (insert sarcastic eye-rolling emoji here), not that research had been done on the effect of menopause on female athletes. But recent years have seen an enormous increase in women over 40 taking part in endurance and fitness races, so, hopefully, the research will catch up. What is good, though, is that high-profile sportswomen, like Stacy Sims and Jillian Michaels, are also getting older, and have started researching and offer help with how to stay fit and healthy as we age (and go through menopause).

What happens?

First, a quick look at what happens during the menopause period (this includes the pre-, peri-, and post-menopausal stages, as they all involve the reduction of hormone levels, but to differing extents). At the end of our fertile phase, our ovaries will start to decrease the amount of sex hormones they produce. This is a pretty long process, and for the first six to ten years you might still have your period, and you can still conceive, but your hormone levels are continuously dropping. At some point, they will become low enough for your period to stop (this would be perimenopause). This final drop can be quite rapid and can cause the strong symptoms most associated with menopause (hot flushes, anxiety, etc). Once you have not had your period for twelve months, you have officially gone through menopause and are in the post-menopausal period. This is also a transition and some of the menopause symptoms might persist for a while into the post-menopausal stage.

To be noted is that it is hard to separate the effects of age and menopausal status but I will try to focus on things that seem to be directly related to a decrease in sex-hormone levels.

First, low levels of sex hormones are not per se related to poor performance, as hypogonadism is quite common in elite athletes, but this doesn’t show how the effect is on an individual basis. One study, where age and training were also accounted for, showed that menopausal status did not affect cardiorespiratory fitness. But, in general, the research shows that as menopause progresses, it will be easier to gain weight, harder to build muscle (often resulting in muscle loss and lack of power), harder to recover, harder to regulate heat, and sleep will be poorer.

Oh, joy!

The good news is that exercise will not make any of this worse, quite the contrary. For example, one study shows that a high level of physical activity provided more capacity to counteract the negative influence of menopause on muscle function. Indeed, exercise is thought to be beneficial for coping with menopause and aging on both a physical and psychological level. So, menopause might not automatically take five minutes off our PBs or prevent us from doing marathons, but it might mean we have to gradually start to train a little bit differently.

What to do?

First, heat is harder to tolerate and to regulate (due to hormone-related changes in blood vessel properties), so pay more attention to hydration and cool yourself during and after races or hard training sessions.

The decrease in sex hormones makes it harder to build muscle and to recover from workouts. Therefore, it is more important than ever to help your body by supplying lots of high-quality protein, in particular just after a hard work-out.

Fluctuations in hormone levels will also lead to increased cortisol levels, which can lead to a bit of weight gain. Try not to be too worried about this, and especially don’t start a diet as that will stress your body more and make everything worse.

It might be easy to think that as we grow older and hormone-deficient, we should focus more on low intensity, endurance-type workouts, but, surprisingly, the research (and Stacy Sims) says to include more, but short, high intensity, and high resistance workouts (e.g. HIIT and heavy weights). Basically, as our bodies don’t respond as well to muscle making and fitness building stimuli as they used to, we have to dial it up a bit. Weight training is also extra important as that helps thwart the bone density decrease strongly associated with menopause.

In terms of general symptoms, don’t be afraid of talking about it with your doctor and friends. Don’t be too afraid of treatment for your symptoms; there is more than one option out there and women suffer very differently through this phase. Some need or want medication, some don’t. It is your choice!

So, best wishes for a smooth transition into the next stage of womanhood!