Perimenopause and the athlete
In earlier articles Coach Denise has looked at the impact of the menstrual cycle on the female athlete, and how to train effectively within the body’s natural rhythm. In this article, Coach Denise looks at the impact that perimenopause can have on the athlete, and how to continue to train effectively through this phase of your life.
In earlier articles Coach Denise has looked at the impact of the menstrual cycle on the female athlete, and how to train effectively within the body’s natural rhythm. In this article, Coach Denise looks at the impact that perimenopause can have on the athlete, and how to continue to train effectively through this phase of your life.
Not many years ago the menopause was a taboo area, something only discussed between women ‘of a certain age’. Now there seems to be a never-ending amount of information, articles and programmes around the whole topic, providing information for anyone with an interest in the area.
While this vastly improved access to information is certainly a good thing, it can also be very confusing. In particular, the information and advice available tends to be provided for the general population. Athletes who are training regularly, exercising on a daily basis and looking at food and nutrition as fuel for their activities may not be considered as the average person. Their specific concerns may go into areas which are not usually included in such articles. Some of these have been addressed in past blogs but this article looks in more detail at the specific areas likely to impact an athlete's ability to train and race.
In looking at the whole area of just what the female athlete can expect during the menopause phase of their life, it is useful to look in more detail at just what is meant by the term menopause.
In fact, there are three distinct phases; perimenopause, menopause and postmenopause. Here we will look at the perimenopause phase in detail.
The NHSinform website has this definition:
Perimenopause is the time from the start of menopausal symptoms until after a woman has experienced her last period. Periods will usually start to become less frequent over a few months or years before they stop altogether. They might be more irregular and become heavier or lighter. For some women, they can stop suddenly.
The perimenopause phase lasts until twelve months after the last period, defined as the menopause (it’s really a point in time rather than a time period), and then the post menopause phase starts.
Perimenopause starts when the levels of oestrogen reduce, leading to changes in the usual hormone levels in the body, which in turn cause the typical symptoms of menopause. There are a wide number of symptoms, and a number of good sources exist to learn more about them in detail. It can take as many as 14 years from the first reduction in oestrogen levels for them to reduce to post-menopausal levels, and so many women enter into the perimenopausal phase without being aware of it.
Perimenopause may be one of the most complex times in a woman’s life, apart from pregnancy, when thinking about the changes happening within the body. Levels of oestrogen are inconsistent, reducing over time and impacting many areas of life. In postmenopausal, the levels are more stable and the body has found its new normal, which is then easier to understand and work with.
Body awareness is important for all athletes. Knowing what is happening within your own body across the usual monthly cycle will always help in terms of training. Knowing when your body is feeling strong and can cope with a high training load and when it needs more rest will help to get the most out of any training program. If you are tracking your regular cycle then any changes in this will be seen more quickly. These can, and should, be discussed with your coach to consider how best to accommodate any significant effects into your planned training.
In general, regular exercise and healthy eating is recommended as a great way to alleviate symptoms, physical, mental and emotional. Specifically there are some considerations around some of the symptoms which will help to minimise disruption to training.
Hot flushes and night sweats will lead to increased sweat rates, making the body more prone to dehydration. Regular hydration throughout the day will help to ensure the impact is minimised. Avoiding excess caffeine and alcohol is also a good idea.
Also, the amount of salt excreted in sweat may change, so for the serious athlete, sweat testing is a good idea, to enable accurate rehydration strategies to be developed both for training and racing.
One of the most common symptoms is an increase in tiredness. While training can help to reduce lethargy, it can be hard to get the motivation to get out the door, and tough sessions may just seem too hard. Taking supplements of high levels of complex vitamin B can help boost energy levels. These may only need to be taken for a short time to give the body time to adjust to the new normal.
Lower levels of oestrogen will impact on bone density, so weight bearing exercise and lifting weights is recommended to reduce the chances of osteoporosis in later life.
One aspect which is not often considered is the psychological aspect during this time. Over many years you have got to know your body, what it can do, how it behaves during the monthly cycle and how it reacts to training. Now that is all changing and as the changes make a difference to how you react to training, it can lead to a loss in confidence. What you thought you knew is no longer true. Embracing the change and listening to your body can help you to feel more in control at this time and so maintain confidence in yourself.
One of the big debates is whether to use HRT or not to alleviate symptoms. This is a very personal choice, and if you have any questions or concerns about this option then make an appointment with your GP for a full discussion about your situation. The use of HRT does raise some issues around increased risk of breast cancer (this is higher with some types of HRT than others) but can also help to increase the uptake of calcium in the bones, so there are pros and cons. There should be no judgement from anyone else about the route you choose to take.
It is also important to remember that at the same time, we are all ageing. Our bodies will find that doing things which used to be easy are now harder, or take longer. Being realistic about this while still embracing challenges will help to set goals which can be met.
As with many things in life, we are all different. Some women will sail through the perimenopause with very few symptoms, others will find the whole experience distressing, confusing and hard to handle. Whatever your experience, take the time to listen to your body and adjust to what will become your new normal. Involving your coach throughout the process will get the most out of the coach athlete relationship and make sure your training accommodates what is happening within your body.
Denise has been coaching triathletes since 2019 as a coach at her local triathlon club in West Lothian. Between 2019 and 2022, Denise was the Head coach in the club, working with a team of coaches to support and develop triathletes with a wide range of capabilities, completing her BTF Triathlon Level 2 coaching qualification in 2021.
Denise joined Tri Training Harder as a coach in 2021, building on the qualifications through the experience and knowledge passed on by the coaching team.
In 2019 Denise set up and continues to run her own Jog Scotland running group, a mixed ability group of runners who meet weekly. This delivers on her passion for helping people to do much more than they think they can.
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