Navigating Perimenopause & Menopause: Thriving not just Surviving - Heidi Storer

It is best to pre-frame this article by first explaining exactly what Perimenopause and Menopause are.

Perimenopause is the transitional phase leading up to menopause, when a woman's body gradually produces less estrogen and begins the natural end of her reproductive years. It typically starts in a woman's 40s but can begin earlier or later.

Menopause is the point in a woman’s life when she has not had a menstrual period for 12 consecutive months and is no longer able to become pregnant naturally. It marks the end of reproductive years and is a normal biological process.

Athletes entering perimenopause and menopause face a unique set of challenges that may impact their performance, recovery, health, and mental well-being. Unlike the general population, athletic women are navigating hormonal changes while also trying to maintain a high level of physical performance. It is a difficult transition but armed with the right information and surrounded by the right people, athletes can continue to grow and even thrive through what is an inevitable stage of life. The key challenges include:

Physical Challenges

1. Hormonal Fluctuations

• Oestrogen and progesterone levels decline irregularly in perimenopause and more steadily in menopause, affecting energy, strength, and coordination.

• Lower oestrogen impacts muscle recovery, joint health, and bone density, increasing the risk of injuries (e.g. stress fractures, tendonitis).

2. Changes in Body Composition

• Many athletes experience increased fat mass, especially around the abdomen, and reduced lean muscle mass.

• This can impact speed, power, and endurance, even when training volume remains high.

3. Thermoregulation and Hot Flashes

• Hot flashes and night sweats can disrupt sleep and impair temperature regulation during exercise.

• These issues can particularly affect athletes in endurance sports or those competing in hot/humid environments.

4. Sleep Disruption

• Night sweats, anxiety, and hormonal imbalances often lead to poor sleep, which compromises recovery, cognitive performance, and training adaptation.

Mental and Emotional Challenges

5. Mood Swings and Depression

• Hormonal changes can lead to mood instability, anxiety, irritability, and depression, which can undermine motivation and focus.

6. Loss of Confidence and Identity

• As performance shifts and body changes occur, some athletes may struggle with self-image and athletic identity, especially if they’ve tied their self-worth to physical capabilities.

Training and Performance Challenges

7. Decreased Recovery Capacity

• Recovery takes longer due to increased inflammation, reduced oestrogen, and disrupted sleep. This can require changes in training volume, intensity, and recovery protocols.

8. Reduced VO2 Max and Power Output

• Studies show VO2 max (a measure of cardiovascular fitness) and maximal power output often decline, affecting endurance and sprint capacity.

9. Injury Susceptibility

• Increased risk of tendon and ligament injuries, particularly in load-bearing and high-impact sports.

• Bone density loss (osteopenia or osteoporosis) increases risk of fractures.

Medical and Nutritional Challenges

10. Nutritional Needs Change

• Greater need for calcium, vitamin D, protein, and antioxidants.

• Athletes may need to adjust macronutrients to maintain energy levels and manage weight.

11. Impact of Hormone Replacement Therapy (HRT)

• Deciding whether to use HRT is complex for athletes. It can help mitigate symptoms and preserve bone and muscle but requires careful medical guidance due to individual risks and sport-specific regulations.

So, what can we do….

It is hard not to look at this list and takeaway anything positive which is why many athletes resign themselves to declining performance and eventually fade away from their sport altogether. However, acceptance that athletes will likely be faced with any or all these challenges arms them with the knowledge to build in strategies to positively manage the impact.

There is increased conversation in the fitness industry about athletes in menopause. Part of the battle is won when we start talking openly about it and sharing our strategies for managing the challenges.

Navigating perimenopause and menopause as an athlete involves adapting training strategies to align with hormonal changes. Dr. Stacy Sims, a renowned exercise physiologist, emphasizes the importance of tailored approaches for women during this life stage.

Navigating perimenopause and menopause as an athlete involves adapting training strategies to align with hormonal changes. Dr. Stacey Sims, advocates for specific training modalities to counteract the effects of declining oestrogen levels. These are:

• Heavy Resistance Training: Incorporating heavy strength training helps in building and maintaining muscle mass, which is crucial as oestrogen levels drop.

• Sprint Interval Training (SIT): Short bursts of high-intensity exercise can stimulate muscle growth and improve metabolic health.

• Plyometrics: Engaging in explosive movements supports neuromuscular function and bone density.

Practical Recommendations

For athletes approaching or experiencing perimenopause or menopause:

• Prioritise Strength Training: Engage in heavy lifting sessions 2–3 times per week to combat muscle loss.

• Incorporate High-Intensity Intervals: Add short, intense workouts to stimulate metabolic health.

• Focus on Recovery: Ensure adequate rest and consider incorporating mobility and flexibility exercises.

• Monitor Nutrition: Adjust dietary intake to support training and hormonal balance.

Add to this the significance of community and support systems in maintaining motivation and consistency during this phase.

Bottom-line…

Menopause is not a limitation—it’s a transformation. With proper strength training, smart programming, and recovery, athletes can continue to perform at high levels and maintain overall well-being during and after menopause.