Running & Menopause

Running shouldn’t be hard work as you get older, it should be a time when you feel excited about what you could potential achieve as you gain more knowledge and experience; it certainly isn’t a time to hang up your trainers. I want you to be prepared for what’s going to or what might be happening right now to your body so you can work with it and not against it. Transitioning from perimenopause to post menopause can be tricky when you are a runner as some of the symptoms can be indistinguishable from the “normal” aches and pains runners experience and live with daily.

There is a wealth of information out there about the menopause, but the research is extremely limited when it comes to female athletes who are in the menopause transition. I’m sorry but menopause is not a choice, all women will go through it, however there is a distinct lack of understanding, a huge number of myths, a lot of jargon and far too many pieces of the puzzle to sometimes make any sense of it. But one thing I do know is that you don’t have to suffer and put up with it.

Add this to the destructive and often comical view of women in midlife and it’s no surprise that women are just ignoring the signs and symptoms of menopause in the vain hope that it will just go away, with what I think are catastrophic consequences. Women are believing that they won’t ever be able to improve their performance as they get older and can sadly just give up.

There is a lot of information about women's training, health and physiology that is not backed by scientific evidence, in comparison to men’s data this seems insane, women are not small versions of men and research findings should not be transferred or generalised to female athletes who are transitioning through the menopause just because it seems like a “fit”.

A perfect example of this was a recent webinar from England Athletics which promised strategies for female endurance runners to deal with hot flushes, a common symptom of menopause. Disappointingly but not unsurprisingly, the strategy given was for women to acclimatise to the hot flushes by having hot baths! This is a strategy used for male and female endurance runners so they can train in hotter climates but there are literally no words to describe how inappropriate this strategy is for peri-menopausal athletes experiencing hot flushes.

What Happens to A Runners Body during menopause transition?

Perimenopause - This is the transitional period before menopause (menopause is the day a year after your last period, after this you are post menopause). Perimenopause can last anywhere from 4 to 10 years and can begin sooner than you think. This is the time when your oestrogen, progesterone and testosterone levels start to drop, not in a straight line, they fluctuate over the years which is why it can seem impossible for us to recognise and navigate the ever changing, one size does not fit all symptoms!

Here are some of the things that might affect your running as you approach your 40s, there are over 34 symptoms of menopause, there isn’t an area of the body that is not affected by the decreasing levels of hormones. I’ve just chosen a few to focus on for today’s blog.

Weight Gain

• Incontinence - Urine and Faecal

• Heavy, Irregular Periods

• Hot Flushes

• Night Sweats

• Insomnia

• Emotional Changes

Weight Gain

Women tend to gain weight as oestrogen levels drop for several reasons, it’s time to ditch the diet, eat the right carbs and start weight training. By adding 2 strength & conditioning sessions into your week you can kick start your metabolism and build much needed muscle mass. It’s not as simple as that, but it’s a start.

Incontinence - Urine and Faecal

Why don’t we talk about this? The sudden need to pee or poo when you are on a run. How many times have you dashed off to go behind a bush, how do you clean yourself afterwards? A leaf, a tissue that you must leave there. It’s embarrassing and can be upsetting, especially if you’ve someone waiting to continue the run with you. But I want to reassure you that it’s normal again due to the drop in oestrogen, but you don’t have to put up with it. There are specialised Pelvic Physiotherapists who can help you with any incontinence, pee, or poo!

Heavy, Irregular Periods

You may have gone from the perfect menstrual cycle, every 28 days that lasts for a few days, you know what to do and how to fit it in with your training runs and races. Then BOOM heavy, gushing, big blobs of blood clots periods that appear out of nowhere! How do you deal with this when you are training or racing, where do you put your tampons (you need quite a few), how do you dispose of them, where are the toilets? Are they on the race route, what if I’m caught short, this will affect my time? All these questions put real barriers up for women so much so that they don’t run or even think about racing again. Again, you don’t have to put up with it, getting help and treatment doesn’t start only when you haven’t had a period for a year, if you are showing symptoms, ask for help.

Hot Flushes & Night Sweats

I don’t recommend that you sit in a hot bath to acclimatise yourself to these, however you can prepare yourself by wearing breathable layers, run with water and water sources and watch for any triggers that set a hot flush off. Night sweats can play havoc with your sleep so again breathable clothing, cool bedroom. CBT, Yoga and topping up your hormones with HRT have all shown to help with these symptoms.

Insomnia

Not enough sleep can play havoc with your training, if you don’t rest and recover properly you can lose all sense of attention, purpose, and focus. It can then feel as though every training run/session is like running through treacle if you have not recovered enough. The decline in hormones is also responsible for broken sleep and sleep is a gift, getting enough sleep is like having a mini-MOT of our body every night, I cannot recommend if you want to fix just one thing then fix the sleep above everything else (to be honest if you fix the sleep other things tend to fall into place).

Emotional Changes

Please do not underestimate the emotional changes that go hand in hand with perimenopause, we tend to ignore these and shove them under the carpet as “my life is just busy” “feeling down is normal” and yes, it is entirely normal to feel irritable, angry, sad but for some women these feelings can be significant and can last for a long time.

Depression, anxiety, intrusive and suicidal thoughts, lack of motivation and loss of identity can have a huge impact on a women’s life during this time and can seem even more overwhelming if you stop doing the things that you enjoy doing, i.e., running, because you don’t feel any good at them anymore. You might be comparing yourself to the younger, faster runner that you used to be, you could be looking at your Strava runs from 6 months ago and now you feel fatter and slower than you ever were. These changes can affect your identity, sense of worth and value which can ultimately lead to a lowering of self-esteem, sadly the highest rate of female suicide is found between the ages of 45-54 years and whilst we can’t be too simplistic about a complex issue there needs to be an acceptance that psychological changes can make us feel isolated and alone.  

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A beginner’s guide to running - based on my own experience