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As a female athlete my entire life, and now fifty-one years old, I am smack dab in the middle of a significant change. While women frequently discuss menopause, the conversations about how these changes affect endurance athletes are not ordinary. In fact, I have found in my community that women are almost ashamed by the changes they are going through, and they try to ignore them and push through with sayings like “I just have to do more training and I’ll be fine”. As a personal trainer working with many women undergoing these changes, and as someone who collaborates closely with physical therapists and physicians, I thought I would shed some light on the topic.

Let the Rollercoaster Ride Begin

What many women experience between the ages of 40 and 55 can often be described as a very unwelcome journey. I hear women mention they feel like an alien has taken over their bodies. I was one of the naïve women who thought that, due to my high level of health and fitness, I’d sail right through these changes. It was all fine until one day I woke up and realized I not only lost a good chunk of my endurance, but I also wanted a nap every day, couldn’t sleep at night, and needed two days of recovery between strenuous efforts, rather than one. I also felt as though I had lost a step, as I could no longer keep up on long rides with friends.

As women’s estrogen levels drop, it not only affects our mood, but also affects other elements of our lives. Reductions in muscle mass (often leading to a loss in power and strength), an increase in metabolic disorders, lower bone density, higher rates of connective tissue tears, increased anxiety and loss of self-confidence, heart palpitations, joint stiffness and inflammation, and brain fog or a lack of concentration all can rear their ugly heads during the entire menopausal change. So you can see how women may feel betrayed by their well-tuned and trained bodies and minds if so much time and energy has been spent getting them to that point.

You are not alone— what other female athletes have experienced and what you can do

Stacey Brickson, a physical therapist in Middleton, WI, and a coach through Source Endurance, shared, “Everyone is affected differently, but everyone is affected. On the bike, things were off for me. Training wasn’t giving me the same gains. To be clear, at age 56, gains are simply keeping the same threshold power as the previous year. Getting better looks a lot like staying the same. But I wasn’t staying the same. Power was dropping, and I was more fatigued after each ride, a fatigue that lasted much longer than I was accustomed to. My cycling kit was a bit snug around my mid-section. I was an endurance cyclist not accustomed to enduring this cluster of symptoms.

When the balance of training load and recovery is thrown into a tailspin, seemingly overnight (compared to other age-related changes), it becomes extremely challenging, both mentally and physically, to know how to respond. Naturally, I pulled on the same levers I always had to induce a training stimulus: I rode harder and longer. For good measure, I cut calories in the hope that I could fit into my kit with less stretch over my midsection. The one variable I had not been willing to negotiate was increasing recovery time. I did not choose wisely.

Off the bike, other menopausal perks were beginning to reveal themselves. Poor sleep, irritability, and brain fog made me question my abilities to socialize the way I used to. I feared these characteristics were becoming my new identity, which was more terrifying than diminished cycling capacity. In all seriousness, I started looking into early-onset dementia literature (my beloved Grandmother had Alzheimer’s, and it is my greatest fear) and was tested for the APOE gene variants because I felt so off and I didn’t know what was going on with me.

I’m a physical therapist and have a PhD in Exercise Physiology, so you’d think I would have seen this coming. But honestly, I don’t recall discussing menopause during all of my training, except as a side note that, at some point, childbearing capabilities would become impossible due to estrogen and progesterone decline. These two hormones signal muscle growth and repair, collagen synthesis, inflammation, and insulin resistance. How could I overlook the thought that pulling the same training levers (intensity and duration) would not elicit the same response as when these hormones were full strength?

Recognizing and distinguishing menopause from other age-related changes was paramount for recovering from the tailspin. For Brickson, the game changers have been:

More recovery
Adding heavy weight training

Dietary changes:  adding more protein (and timely protein) and understanding that energy balance is more complicated than calories in=calories out.

Lora Glasel, a long-time competitive cyclist and owner of Recyclist Bike Company in Kaukauna, WI, said, “As someone who’s been an athlete a good part of my adult life, menopause has been hard. My identity is tied to movement, discipline, and how my body performs, but sadly also how my body looks. You can be doing everything “right”, eating well, riding regularly, lifting, sleeping (or trying to), and still feel like a stranger in your own skin. That’s where the dysmorphia creeps in. You start comparing yourself to who you used to be instead of appreciating who you are right now. What I’m trying to embrace is this: our bodies are not betraying us, they’re adapting. They’re shifting into a new phase that deserves the same respect and attention we gave our training schedules. It’s not easy. It’s not linear. But it’s real.”

With that, the three things Glasel wants other women to go away with are:

It’s not a weakness, it’s physiology. It’s not that women “lose fitness”,  it’s that our bodies are running a different operating system. Training and fueling have to shift, not stop.

Recovery becomes non-negotiable. What used to be an easy bounce-back day now takes longer. Sleep, nutrition, hydration, and stress management become integral to your training plan, not afterthoughts. If we don’t respect recovery, performance suffers fast.

The mental side can be tougher than the physical. The mood swings, anxiety, and body image changes can shake even the most confident athletes. We’re used to controlling outcomes, and menopause doesn’t play by those rules. Community and honest conversation make a massive difference for me

There are a few other items I’d like to add on to what Glasel and Brickson have mentioned to be aware of and what can help:

Prevent connective tissue tears that are common with hormonal influxes by doing more stability and proprioception training.

Try lowering increased anxiety and lower self-confidence through mind/body exercises and meditation.

Joint stiffness and inflammation can be mitigated through mobility work, anti-inflammatory diets, plenty of water, and a decrease in alcohol. These also help with brain fog!

Depression: Seeking out other female athletes who are going through similar things can help immensely, as can speaking with a sports psychologist.

Have your vitamin D levels checked. Just because you spend time in the sun doesn’t mean your body assimilates it. I spend hours outside daily and was shocked to find my levels dangerously low. This affected both my bone density and my energy levels.

Discuss HRT (hormone replacement therapy) with your physician. This has been a hot topic for many years. Although it is not right for some (I have the blood clotting gene and can never use it), the fears of increased cancer risks have significantly been quieted by many scientific studies. HRT, if properly used, can often alleviate many of the symptoms and decrease the risk of low bone density.

When seeing your primary care provider, come in prepared with specific concerns and symptoms. Have them written out clearly, including frequency, intensity, and major changes. Ask about the options you may have and their associated risk factors. Finally, ask if a specialist would be a good option to help.

Every woman has a different experience. If there’s one message I can get across, it is that you are not alone! Hopefully, reading some of these experiences and tips will help guide you through what can be a challenging time.