Menopause symptoms are common even in elite endurance athletes

Regular physical activity is often linked to reduced menopause-related difficulties, especially those involving muscles, joints, and overall quality of life. At the same time, symptoms associated with menopause can create barriers to staying active, making participation in sports and structured training more difficult for some women.

The research team surveyed 187 female runners, cyclists, swimmers, and triathletes between the ages of 40-60 years. All participants were highly active, training at least three days per week for a minimum of three total hours each week. The women completed the Menopausal Rating Scale (MRS), a validated tool used to assess menopause symptoms, and also described how those symptoms influenced their training routines and athletic performance.

The survey results showed that menopause symptoms were common across this athletic group. Sleep problems were reported by 88% of participants, followed by physical and mental exhaustion at 83%. Other frequently reported symptoms included sexual problems at 74%, anxiety at 72%, irritability at 68%, depressive mood at 67%, weight gain at 67%, hot flushes at 65%, and joint and muscular discomfort at 63%.

Certain symptoms were more likely than others to interfere with training and competition. Joint and muscular discomfort, weight gain, sleep disturbances, and physical and mental exhaustion were most often linked to negative effects on performance. Among women who experienced joint or musculoskeletal discomfort, 97% said it negatively affected their training and 91% reported a negative impact on performance. Overall, athletes with more severe symptoms were more likely to report greater challenges, with about one third saying menopause had a moderate or strong negative effect on training and roughly one quarter reporting a negative effect on performance.

The authors note that the study's cross-sectional design and the absence of detailed demographic information limit how broadly the findings can be applied to other populations. Even so, they conclude that menopause symptoms are highly prevalent among female endurance athletes, and that symptom severity appears comparable to what is seen in the general population. Despite high levels of physical activity, the researchers emphasize that healthcare providers should address menopause-related symptoms to help women continue participating in physical activity.

The authors add: "We hope this work brings attention to a growing, yet understudied population that is eager for guidance in how to navigate the menopausal transition while continuing to participate in sport and exercise."

This study was supported by the National Heart, Blood, Lung Institute in the form of a grant awarded to N.M.Y. (K01 HL159348-01) and Old Dominion University in the form of a salary for N.M.Y. The specific roles of this author are articulated in the "author contributions" section. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.