In 187 female endurance athletes aged 40-60, the menopausal symptoms perceived to hurt training most were not hot flushes but joint and muscular discomfort, weight gain, sleep problems and exhaustion
And more severe symptoms went with a greater perceived impact
Protocol
n = 187 female endurance athletes — runners, cyclists, swimmers and triathletes — aged 40-60, surveyed anonymously online with self-reported menopausal status and the Menopause Rating Scale (MRS), plus perceived influence of each symptom on training and performance.
Key Findings
Symptom frequency:
| Symptom | Reported by |
|---|---|
| Sleep problems | 88% |
| Physical and mental exhaustion | 83% |
| Sexual problems | 74% |
| Anxiety | 72% |
| Irritability | 68% |
| Depressive mood | 67% |
| Weight gain | 67% |
| Hot flushes | 65% |
| Joint and muscular discomfort | 63% |
Athletes rated joint and muscular discomfort, weight gain, trouble sleeping, and physical and mental exhaustion as the symptoms that hurt training and performance most — not the vasomotor symptoms that define menopause in the public mind.
Severity tracks perceived impact: participants who perceived a strong negative effect on training and performance had higher total MRS scores than those reporting no or a slight negative effect (p ≤ 0.001).
Symptom severity was similar to that reported in the general population — high activity levels did not make these athletes' menopause milder.
Authors' conclusion: even though these women are highly active, clinicians should deal with their symptoms so that they keep taking part in physical activity.
Practical Application
In 187 female runners, cyclists, swimmers and triathletes aged 40-60, sleep problems (88%) and exhaustion (83%) were the most common menopausal symptoms, and joint and muscular discomfort, weight gain, sleep problems and exhaustion were the ones perceived to hurt training most — hot flushes (65%) were not among them. Ask about sleep and joints, not only about hot flushes.
Reinterpret the pattern rather than the athlete. Inference, not tested: a masters woman who reports exhaustion, poor sleep, joint discomfort and weight gain is describing the commonest symptom set in this survey, not a motivation problem.
Sleep is the most common symptom here (88%). Inference, not tested: it is a practical first thing to ask about and protect; this survey did not test any sleep intervention.
Inference, not tested: joint and muscular discomfort argues for keeping strength work, not dropping it. Not from this paper: REF-523 found 1-RM strength rose after menopause as before it, while muscle mass did not grow at 6-8 sets per muscle per week (the authors infer more volume is needed; REF-513 for the volume dose-response).
Not from this paper; the base's own practice: protein toward the top of the general athlete range and energy availability protected (REF-582 states no sex-specific protein guideline exists yet; REF-725, REF-341) — weight gain here is a symptom to investigate, not a discipline failure to correct with a deficit.
⚠️ Refer out. Symptom management, and any conversation about menopausal hormone therapy, belongs with a physician. A coach's contribution is to name the pattern, adjust the plan, and stop the athlete concluding she has simply got old.
Limitations
Self-reported cross-sectional survey with self-reported menopausal status — no hormonal confirmation of stage, and perceived influence on training is not measured performance.
n = 187, self-selected online sample of women engaged enough with endurance sport to answer a survey about it; prevalence figures should not be read as population estimates for masters women generally.
Perceived impact cannot separate menopause from ageing. Inference, not tested: joint discomfort, exhaustion and weight gain also rise with age, and this design cannot apportion them.
No control group of premenopausal athletes of similar training load, and no longitudinal follow-up through the transition.
Nothing here evaluates any treatment — not hormone therapy, not training modification, not supplementation. It describes a burden; it does not test a response to it.
How this entry was checked and changed
Content correction 2026-09-27
Title "what most damages training ... severity tracks the damage" -> impact on training was perceived, not measured; weight change -> weight gain as in the abstract.
Severity result restated as in the abstract (strong-impact group had higher MRS than no/slight-impact groups); added the abstract's finding that severity matched the general population.
Unsourced claims (symptoms "rarely attributed to menopause", "slowed recovery", sleep "more tractable") removed or labelled as inference; lead now carries the study's numbers.
Protein "top of the band" labelled house practice (REF-582 itself says no sex-specific guideline yet); REF-523 claim corrected (no hypertrophy at 6-8 sets/week; "more volume" is the authors' inference).