Menopause Friendly – information and advice for athletes

Menopause refers to the last menstrual period.

Menopause is a natural event, which typically occurs between the ages of 45 and 55, as levels of oestrogen drop in the body. The average age of menopause in the UK is 51. Some people experience early menopause, which may be spontaneous, or due to a medical condition, or a result of cancer treatment.

The time before menopause is called perimenopause, and is when many people experience the most symptoms. The time after the last period is postmenopause, generally recognised from 12 months after the last period. For many, symptoms will abate with postmenopause, but for some they will continue for longer.

For simplicity, in general on these pages, we will use the term ‘menopause’ to refer to the time from peri- to post-menopause, except where there is a specific need to differentiate between the different stages.

A wide variety of physical and mental symptoms can result from menopause, and they can appear (and disappear) throughout perimenopause, menopause and postmenopause. Everyone’s experience is different. Some may have few, or no symptoms at all. For others these symptoms are not just minor irritations – they can be debilitating and make everyday life difficult. Symptoms may also fluctuate from week to week, month to month, and year to year.

Symptoms can include:

anxiety
changes in mood – such as low mood or irritability
changes in skin conditions, including dryness or increase in oiliness and onset of adult acne
difficulty sleeping, which may cause tiredness and irritability during the day
discomfort during sex
fatigue
feelings of loss of self
hair loss or thinning
headaches or migraines
hot flushes – short, sudden feelings of heat, usually in the face, neck and chest, which can make your skin red and sweaty. There can also be a wider with temperature regulation – feeling hot one minute and cold the next.
increase in facial hair
incontinence and pelvic floor issues
joint stiffness, aches and pains
loss of self-confidence
night sweats – hot flushes that occur at night
palpitations – heartbeats that suddenly become more noticeable
problems with memory, concentration and ‘brain fog’
recurrent urinary tract infections (UTIs), such as cystitis
reduced sex drive (libido)
reduced athletic performance
slower recovery time needed
tinnitus
vaginal dryness and pain
weight gain

It’s easy to read all these symptoms and feel that menopause is something to approach with a sense of dread. But this is a comprehensive list, which doesn’t mean that everyone will experience them all. They are also likely to fluctuate, and there are things that can be done to help manage symptoms.

Some of the symptoms above will have obvious effects on someone’s ability to continue enjoying sport – for example fatigue and joint aches. Others may be less obvious but can still have an impact. For example:

• Changes in mood can reduce motivation and confidence.
• Difficulty sleeping can reduce energy during the day.
• Temperature regulation issues like hot flushes can make exercise uncomfortable or awkward, with athletes constantly putting layers on and off.
• Excessive sweating during hot flushes may make athletes self-conscious.
• Physical symptoms such as UTIs, incontinence, irregular/heavy bleeding, breast tenderness or vulval dryness can make sport uncomfortable or worrying.
• Brain fog can make it harder to concentrate or remember instructions and directions.
• Reduced performance and increased recovery can be demoralising and make people want to drop out.

People other than athletes could also be affected – for example officials or coaches who are fatigued, or who need to make more regular toilet trips may find it harder to stay in the field for long periods of time, or may find brain fog makes it harder to carry out their roles.

As they go through menopause, we want our members to continue feeling strong, active, and capable. We are proud of every scottishathletics member, and we want to keep our them active throughout menopause and beyond, even if their sporting life changes over the years.

With a little patience and exploration, it’s possible to use these years to set the groundwork for remaining healthy and energetic for many years to come.

Some of the ways that continuing to train with an athletics club can help athletes through menopause and beyond:

• Even though it can be hard to exercise through fatigue, if you can manage to get active, it’s often one of the quickest ways to boost your energy level.
• Remaining active in your sport will help you maintain muscle mass and bone density, which both decrease through and after menopause.
• Physical activity can help regulate the mood, improving symptoms of anxiety and depression. Being active outdoors, with other people, is particularly beneficial for mental health.
• Athletics clubs can be great places to discuss all the things our body puts us through. If we’re already talking about our blisters, chafing and sweat rash, then why not menopause?! You may find other members of your club have experience of menopause that could be useful, and they’ll be happy to chat or offer moral support. If you feel awkward broaching the subject, moments when you’re running shoulder to shoulder without eye contact, can make it easier.
• Being active can help control weight, and boost your body image and confidence.
• Some studies have suggested that exercise can help reduce the occurrence of hot flushes (example).

• It’s fine to train less intensely if your body’s telling you to, whether occasionally or permanently – that’s common and doesn’t mean you have to feel bad about yourself, or give up your sport completely. Chat to your coach about adapting training from week to week if you need to, or ask how they can help you adapt sessions to various levels of difficulty. You can find out more about the advice we’re giving clubs and coaches on how to support you on our page of Menopause advice and information for clubs and coaches.
• Your life as an athlete might change during/after menopause, and that’s OK. You might find you’re slower, or more tired, or need more recovery time and fewer training sessions per week. You are still an athlete.
• The journey of being active throughout life is about listening to your body and what it needs, day to day and month to month, not about always pushing yourself to run harder, faster, year in, year out. Responding to what your body needs is the true mark of a lifelong athlete, not pushing yourself to breaking point.
• Remember the changes that might make training and competing more achievable as you progress through age groups. For example, for throws athletes, the age group change at 50 brings lighter implements, which might make continuing to compete more achievable; for hurdlers, hurdle heights will drop; endurance runners who might feel frustrated by changes in their performance in their late 40s might find it motivating to remember that they’ll change age groups at 50 and become the youngest in their new age groups, with the relative performance boost that brings – and so on.
• If you feel you can’t continue training right now, that’s OK. Some people find walking, yoga, or other forms of activity suit them best, and some people really do just need to rest for a while. You’re still an important member of the club community – perhaps you can stay involved as an official, a club leader, coach, or volunteer. Even if you pause your activity with the club, keep in touch and/or stay on the their social media and if you feel like returning at a later date, they’ll welcome you back.
• “Brain fog” is a common symptom of menopause and might include poor memory or concentration. It’s fine to ask your coach to repeat instructions for the session that you might have forgotten.
• If you’re experiencing hot flushes or temperature fluctuation, wear several thin layers rather than one thick one, so you can vary what you wear. If you’re on a long run, think in advance about how you can carry layers as you shed them – perhaps a pal or your coach would be happy to take some; perhaps there’s a safe spot you can stash it and return for it; a well-fitting backpack can be surprisingly easy to run with if it’s not too heavy, though carrying it may in turn make you hotter – experiment and see what works best for you.
• If you take a break from training during menopause and then return, be gentle with yourself both physically and emotionally when you start to train again. Build up gradually. Don’t try to compare your achievements now with previous years – celebrate that you’re back training once more.
• Many people find that staying active can help with menopause symptoms such as fatigue, depression and anxiety. It’s also beneficial for other changes that occur in our body as we grow older, such as loss of muscle mass and bone density.
• Menopause is a normal part of life – it can be tough, but you’re probably surrounded by many others who’ve been through it, and chatting about it can be a huge help.
• Information is power! Finding out more about menopause can give you more confidence to advocate for yourself with doctors and to talk with friends and family about what’s happening to you. Chatting with others can be a great source of knowledge, but if you don’t feel comfortable discussing it, there are a lot of useful online resources – some of them are linked below.

Yes! If they want your support, there’s plenty you can do, whether or not you have – or will ever have – personal experience of menopause. Whether you will never experience menopause, are young and menopause seems a long way off, or your own menopause was trouble-free, you can still be supportive. Things you can do include:

• Listen, non-judgementally, if someone talks to you about their menopause experiences. By all means offer suggestions if they ask for them, but also bear in mind that they might not be looking for a solution – sometimes just being able to say out loud what’s happening to you is valuable.
• Bear in mind that menopause symptoms can fluctuate, and might result in other athletes in your training group changing the intensity of their training between sessions, for reasons they might not want to discuss with you. Respect their decision to tackle an appropriate challenge for themselves each week.
• Humour can often help people dealing with difficult experiences, but should only be used if you’re sure it will be well-received. Frequent cracks about hot flushes might make someone feel they can’t talk about the more complex realities of menopause without it being treated as a joke. If in doubt, leave it to the people who are experiencing it to crack the jokes if they feel like it. For some people, knowing the people around them take menopause seriously can create a safe haven to discuss it honestly.
• If you’re an endurance runner and you have a running buddy who is open about experiencing hot flushes and temperature variations while they train, perhaps you can offer to carry a layer of clothing as and when they need to remove it. It might mean staying close at hand throughout the session as they might feel very hot one minute and cold the next.

• If your symptoms are affecting your everyday life, speak to your doctor to find out what could be done to help. HRT can alleviate symptoms for many, and your GP should support you to decide what’s best for you. Reading up on the resources below and chatting to others with experience of menopause before you visit the doctor, can give you the confidence and knowledge to advocate for yourself.
• Talk to others – realising you are not alone and hearing how others have handled symptoms can be powerful.
• As well as staying active, eating a balanced diet, cutting down on alcohol, and stopping smoking can all contribute to improving menopausal symptoms.

• The NHS Inform website has an excellent section on menopause, including pages on signs and symptoms, treatments, and supporting someone else through menopause.
• Menopause café – organises get togethers where people can chat about menopause, and a festival called Flush Fest.
• Dr Juliet McGrattan writes on women’s health and running, – dip into her site, or view her articles tagged ‘menopause’.
• HRT for runners – an article by Juliet for Women’s Running magazine.
• Menopause and diet – article by Gemma Holloway, registered dietician and jogscotland jog leader.
• Balance menopause – website run by Dr Louise Newson with a huge library of articles on menopause-related topics, and an associated app to help you track symptoms.
• Menopause and pelvic health – article by pelvic health physio Jo Dafforn for Nuffield Health, discussing 5 common symptoms and treatments.
• Menopause and diet – information and advice from the Association of UK Dietitians.
• Menopausal symptoms and cancer treatment – article by Macmillan Cancer Support. As well as discussing cancer-related menopause, has a good overview of menopause, symptoms and treatments.
• Menopause and running – what do clinicians and women need to know? By physiotherapist Claire Callaghan. A technical, but interesting, article focusing on the physical effects of menopause on our joints, bones and muscles.
• Black Women in Menopause was founded by Nina Kuypers in 2020 to create a safe space for Black women to share their experiences of menopause and receive support. She has featured in a campaign for Women in Sport campaign – Inspiring Women to be Active during Midlife and Menopause. She podiumed in the SPINE Challenger South 108-mile ultra-marathon, helping to shatter stereotypes in sport and menopause and redefine what’s possible.
  More research is needed into the ways that menopause can vary for people of different ethnicities, but the American Study of Women’s Health Across the Nation (SWAN), reported that Black women reach menopause 8.5 months earlier compared to white women. They may also have a longer transition and experience more severe symptoms. Read more from Nina:

  The Colourless Menopause, The Voice magazine

  Nina Kuypers on why she ran an ultramarathon for Wellbeing of Women

  Meet the women redefining what menopause looks like.