The Athlete’s Guide to Menopause
Much more than fertility changes when menopause hits. Here's how to train through it.
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Menopause, like menstruation, is often talked about in whispers. We don’t shout about reaching the period of life when we’re no longer fertile, perhaps because many of the symptoms of menopause are intensely personal: Hot flashes. Night sweats. Weight gain. Mood swings. Painful sex. Insomnia.
It can also wreak havoc on physiological assets we’ve spent a lifetime cultivating, like lean muscle, strong bones, and the ability to bounce back from a challenging workout with eight hours of restorative, protein-synthesizing sleep. Until recently, many of these symptoms were written off as a natural part of aging, as inescapable as graying hair and wrinkles. But recently, researchers discovered something interesting: it’s a lack of estrogen—not advancing age—that’s behind much of the bone deterioration, fat gain, and lean-muscle loss associated with menopause. And that’s good news for aging athletes, since hormonal changes are easier to fight than the inexorable march of time.
Why It Matters
Officially, menopause is caused by the natural decline of estrogen, and it’s diagnosed after 12 consecutive months without a menstrual cycle. For Americans, this usually occurs around age 51, but perimenopause—the preceding transitional phase—can last anywhere from several months to ten years and can begin as early as your thirties.
The detrimental effects of changing hormones typically begin with perimenopause, soon after estrogen levels begin to fall. Physiological changes include a loss in bone density and lean muscle mass and an increase in body fat—particularly belly fat. Estrogen loss also slows your metabolism and messes with your hunger and satiety signals. In part due to these changes, many people see a significant drop in physical activity (and corresponding weight gain) by the time they reach menopause.
You don’t have to be an expert to realize that this all translates to feeling heavier and slower and becoming more prone to broken bones. But while this may sound like a major bummer, don’t stress: there are steps you can take to stave off the effects of estrogen decline.
Mitigating Menopause-Related Changes
“Menopause doesn’t mean the end of being a competitive athlete,” says exercise physiologist and nutrition scientist Stacy Sims, who researches training and recovery specifically in relation to female physiology. Sims’s prescription to outsmart estrogen depletion looks like this: “Lift heavy shit—carefully. Do high-intensity interval training and plyometrics. Up your protein. Do less volume and more intensity. Recover longer.” Here’s how all that breaks down.
“You have to try to prevent the loss of muscle and bone, and while cardio will make your heart and lungs fitter, it won’t increase—and might not even prevent—loss of muscle mass,” says Wendy Kohrt, an exercise physiologist and a professor of geriatric medicine at the University of Colorado Health Sciences Center. “The research is preliminary, but it suggests that those who do resistance training seem to preserve the level of lean mass they had before menopause.” That’s enough reason to hit the gym, get a set of resistance bands, or find a buddy with a weight bench.
Sims is a huge fan of CrossFit, because it combines range-of-motion exercise and heavy resistance, but if you’re not into the competitive culture of CrossFit or don’t feel comfortable returning to the gym until there’s a coronavirus vaccine, there are plenty of other ways to add resistance to your routine. Dumbbells, resistance bands, and body-weight exercises work just as well.
Ditch Endurance Workouts for HIIT
Resistance training may be the most effective way to build lean muscle mass, but cardio still plays a critical role in keeping you strong and healthy during the menopausal transition and beyond. It’s linked to a healthy heart and lungs, helps burn fat, and builds bone mass. But if you want to reap the most benefits from your cardio, choose high-intensity, calorie-torching interval sessions over long, slow-distance workouts.
“Estrogen naturally prompts your body to synthesize protein into lean muscle. When that’s taken away, you need a new stimulus,” Sims says. High-intensity interval training (HIIT) can be that stimulus. It prompts your body to build lean muscle and shrink visceral fat more effectively than a slow-burn endurance workout. It also helps your body continue to process insulin efficiently, making you less prone to insulin resistance, which increases the risk of being overweight, having high blood pressure, and developing heart disease or Type 2 diabetes.
Train Hard, Recover Harder
Athletes in menopause are prone to overtraining, particularly if they’re trying to regain the leaner, toned body they enjoyed premenopause. “You might try to push harder and longer to get rid of this new belly fat, but ultimately that backfires, because it puts you in a state of low-energy, high-stress cortisol cycling,” Sims says.
To be clear, cortisol on its own isn’t a bad thing. Yes, it’s known as the stress hormone, released in traditional fight-or-flight scenarios, but cortisol is also responsible for that extra surge of adrenaline on the starting line of a race, and it can provide a little immunity to the pain and suffering that’s to come. Cortisol cycling occurs when you’re under constant stress, which can force your cortisol levels to stay elevated for far longer than is needed to outrun your rivals in a competition. Eventually, cortisol imbalance can lead to weight gain, exhaustion, and a loss in muscle mass—just what you don’t want. The secret? More rest.
“You need to work out with intensity, but you also have to recover harder,” Sims says. “Everything just takes a little longer.” And remember that the ways you might have measured your fitness in the past—short recovery times, a toned stomach—aren’t good gauges of your hard work as you age.
Sims recommends shorter training blocks for aging athletes. Think along the lines of a two-week build-up of exercise, followed by one week of less intense movement, as opposed to three weeks on, one week off. She also recommends mobility work like foam rolling, dynamic stretching, and body-weight movements to offset stiffening tendons and ligaments. A heart-rate monitor or other fitness wearable, such as the Whoop strap, which calculates recovery based on perceived strain and sleep quality, may also help you avoid overtraining.
Hormone-related sleep issues present another challenge. Both estrogen and progesterone affect sleep quality and quantity; as your hormones drop, sleep disturbances rise, resulting in poor recovery. (Recurring bouts of hot flashes and night sweats don’t help, either. And yes—you can blame estrogen loss for that, too.) But before you reach for the melatonin, Sims recommends downing a glass of tart cherry juice 30 minutes before bed instead. Not only has tart cherry juice been shown to improve endurance and reduce inflammation (prompting faster recovery), it’s also one of the few food sources of sleep-promoting melatonin.
Change Your Workout Fuel
Declining estrogen causes your body to become more sensitive to carbohydrates and insulin, which wreak havoc on your metabolism. You may also struggle to digest fructose, which is a common ingredient in sports-nutrition products. “Change your diet to emphasize high-quality protein, fat, and carbohydrates from fruit, vegetables, and whole grains,” Sims says. She also recommends replacing fructose-containing sports-fuel products with those containing simple sugars such as glucose, dextrose, and sucrose, which fuel menopausal bodies with fewer associated gastrointestinal issues.
You also need to eat protein. A lot of it. Your daily protein needs vary based on activity levels. But for anyone in menopause, Sims recommends about 1.1 grams of protein per pound of body weight. For a 150-pound person, that’s more than 160 grams of protein per day.
While that protein should be spread throughout the day, Sims is adamant about one point: menopausal people need to consume a whopping 40 grams of high-quality protein with about four grams of leucine (one of nine essential amino acids) within 30 minutes of a hard workout to help build lean muscle and recover. Two scoops of most whey protein powders (or a leucine supplement) will get you there, but you can also get leucine from food sources, including eggs, soybeans, chicken, almonds, beef, salmon, and peanuts. There’s also new research suggesting that getting enough high-quality leucine may reduce cognitive impairment—sometimes called brain fog—that many people cite as a menopausal symptom. That’s because it helps decrease levels of tryptophan in the brain. While tryptophan is a generally beneficial amino acid that can be converted into serotonin and melatonin (which help sleep and mood), too much of it can make you feel fuzzy and fatigued.
Make sure you get enough calcium and vitamin D. The National Osteoporosis Foundation recommends a total daily intake of 1,200 milligrams calcium and between 800 to 1,000 international units (IUs) of vitamin D for good bone health. For reference, a glass of milk contains about 300 milligrams of calcium, and one serving of salmon nets you between 250 and 1,000 IUs of vitamin D (wild-caught salmon boasts higher levels of vitamin D). If you aren’t sure you’re getting enough from your diet, don’t hesitate to take a supplement.
Don’t Give Up
If you’re months or years past the menopausal transition, don’t despair. There’s still time to mitigate its effects on your body.
“Exercise can’t entirely reverse the effects of declining estrogen on the body,” the University of Colorado’s Kohrt says. “But there are so many potential health benefits, regardless of what you do. Anything is better than nothing—and it’s never too late to start.”