Endurance athletes face major training challenges during menopause

Endurance athletes face major training challenges during menopause

A new study shows that endurance athletes report menopausal symptoms very frequently, with many perceiving them as having a negative effect on their training and performance. The results will be published in the open access journal on December 17, 2025PLUS oneby Heather Hamilton from Old Dominion University, USA, and colleagues.

Physical activity has been reported to mitigate the negative effects of menopause, particularly when it comes to musculoskeletal and quality of life changes. However, menopausal symptoms can also affect participation in physical activity and sports.

In the new study, researchers surveyed 187 female runners, cyclists, swimmers and triathletes aged 40-60 who exercised for a total of at least three hours per week on at least three days per week. Participants completed the Menopausal Rating Scale (MRS), a validated measure for assessing menopausal symptoms, and reported how symptoms affected their training and performance.

Researchers found that the most common menopausal symptoms among athletes were sleep problems (reported by 88% of women), physical and mental fatigue (83%), sexual problems (74%), anxiety (72%), irritability (68%), depressed mood (67%), weight gain (67%), hot flashes (65%), and joint and muscle problems (63%).

The symptoms that most negatively impacted training and performance were joint and muscle discomfort, weight gain, sleep problems, and physical and mental fatigue. For example, 97% of women with joint and musculoskeletal problems reported a negative impact on training and 91% reported a negative impact on performance. Participants with more severe menopausal symptoms reported greater perceived negative impacts on training and performance, with approximately a third of all respondents reporting that menopausal symptoms had a moderate or strong negative impact on training and approximately a quarter reporting a negative impact on performance.

The study is limited due to its cross-sectional design and lack of demographic information, making generalization to other populations difficult. However, the authors conclude that the frequency of menopausal symptoms in female endurance athletes is high and the severity of menopausal symptoms is comparable to that reported in the general population. Despite high levels of physical activity in this population, healthcare providers should address these symptoms to encourage continued participation in physical activity, they say.

The authors add: "We hope this work draws attention to a growing but under-researched population that is eager to seek advice on how to navigate the menopausal transition while continuing to engage in sport and exercise."

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