How Menopause Affects Exercise Performance — and How to Adapt Your Training

Menopause and exercise performance are closely linked, yet many women are surprised by how dramatically their training begins to feel harder during perimenopause and menopause. Women who once led group rides, sprinted with ease, or powered up climbs may suddenly find themselves struggling — despite consistent training. The instinct to push harder is understandable, but it’s rarely the right solution.

How menopause affects exercise performance

The physiological changes of menopause affect nearly every system involved in athletic performance, including muscle function, circulation, temperature regulation, recovery, sleep, and stress response. These shifts don’t mean you can’t remain strong or competitive, but they do mean your training approach needs to evolve.

In addition to GSM, menopausal women experience loss of muscle mass and strength, reduction in height and increased risk of fracture due to osteoporosis, poorer temperature regulation, higher levels of inflammation leading to joint pain and anemia, impaired gut performance, decreased ability to utilize proteins, loss of some ability to manage cortisol, sluggish blood vessel dilation/constriction, looser tendons and ligaments, decreased pain tolerance, disrupted sleep, increased anxiety and depression, and a weakened pelvic floor. All of those issues have a negative impact on athletic performance and increase injury risk. In good news, we know some ways to compensate for the changes we see in menopause. Sure...we may have to accept that we aren't the same athlete as we were 20 years ago, but for most of us, we learned that well before menopause when we saw slower race times between age 20 and age 40 that couldn't be blamed on menopause.

The role of estrogen and progesterone in exercise adaptation

The role of estrogen and progesterone in the body is complicated and not yet completely understood. We know that there are receptors for both hormones found throughout the body, not only in reproductive organs and tissues. Estrogen and/or progesterone receptors can be found in the cardiovascular, nervous, immune, and musculoskeletal systems. The interplay of the sex hormones with other hormones, neuropeptides, and neurotransmitters throughout the body impacts physiological functions as varied as appetite, temperature regulation, bone and muscle growth, mood control, and blood pressure, among many others. The inability of menopause hormone therapy (MHT) to reverse all of the effects of menopause suggests that the effects of menopause are multi-factorial and not solely caused by decreased estrogen and progesterone. There are hormonal and non-hormonal treatments and therapies that may alleviate some of the most significant menopausal changes that impact our ability to exercise and perform at the level we would like.

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