Image Of A Female Athlete Dealing With Menopause Taking A Break From Exercising With A Bottle Of Water

An Athlete’s Guide to Dealing With Menopause

BY Karen Parnell

While menopause poses both psychological and physiological challenges to aging women, positive changes in diet, exercise, and hormone therapy can help minimize negative effects.

General awareness of menopause and how it affects every woman is, thankfully, on the rise. But how does this life change affect female athletes, in particular? This article offers a brief overview of training tactics and nutritional needs for female athletes who are entering or have already gone through menopause.

Dealing With Menopause: Symptoms and Overview

Menopause is a natural biological process that occurs in women typically between the ages of 45 and 55 and marks the end of the reproductive years. It is defined as the absence of menstrual periods for 12 consecutive months, which indicates the depletion of the ovaries’ supply of eggs and the cessation of hormone production, particularly estrogen and progesterone.

As a result of this hormonal shift, women may experience various physical and emotional symptoms, which, according to NHS Inform, include the following:

  • Anxiety and changes in mood, such as low mood or irritability
  • Changes in skin conditions, including dryness or increase in oiliness and onset of adult acne
  • Difficulty sleeping, which may make you feel tired and irritable during the day
  • Headaches or migraines
  • Hot flashes (i.e., short, sudden feelings of heat, usually in the face, neck and chest, which can make your skin red and sweaty)
  • Joint stiffness, aches, and pains
  • Loss of self-confidence
  • Night sweats (i.e., hot flashes that occur at night)
  • Palpitations (i.e., heartbeats that suddenly become more noticeable)
  • Problems with memory, concentration and ‘brain fog’

Menopause can also increase your risk of developing other health issues, such as weak bones (i.e., osteoporosis) or cardiac disease. In addition to these female-specific physiological phenomena, aging adults will also experience sarcopenia, which is characterized by loss of muscle mass and strength. 

While weaker bones and lower muscle mass have a direct effect on athletic performance, rest assured that you can still train and race well into later life. One particularly inspiring example is Sister Madonna Buder, or the “Iron Nun”, whose Ironman finish at the age of 82 qualifies her as the current world record holder for the oldest woman ever to finish an Ironman Triathlon.

Training During Menopause

From a holistic perspective, postmenopausal women should combine endurance (aerobic), strength, and balance exercises to maintain physical fitness. It is recommended that postmenopausal women practice 150 minutes of moderate aerobic activity per week combined with resistance training three times a week. 

Aerobic or cardiovascular exercise, such as brisk walking, cycling, or swimming, is essential for postmenopausal women as it helps improve heart health, circulation, and respiratory function. It can also help manage weight, reduce the risk of type 2 diabetes and some cancers, and improve mental health and mood.

Strength training or resistance training can help improve bone density in postmenopausal women, who are at an increased risk of developing osteoporosis due to declining levels of estrogen. Estrogen plays a crucial role in bone metabolism, and its decline during menopause can lead to decreased bone density, making bones more brittle and susceptible to fractures.

Strength training works by putting stress on the bones, which signals the body to create new bone tissue and improve bone density. When muscles contract against resistance, it creates tension on the bones, stimulating the bone-building cells known as osteoblasts. These cells respond to the stress by laying down new bone tissue, which can help increase bone density over time.

The Bone Health & Osteoporosis Foundation recommends that postmenopausal women engage in weight-bearing and resistance exercises to help maintain or improve bone density. These types of exercises can include weightlifting, bodyweight exercises, resistance band exercises, and using weight machines.

Every woman should be aware of her target heart rate and track exercise intensity because it can help achieve your fitness goals safely and effectively. Target heart rate is the number of heart beats per minute that a person should aim for during exercise to get the most benefit from their workout without overexerting themselves. It varies based on age, fitness level, and other factors, so it is personal to you.

Tracking exercise intensity, such as monitoring by heart rate during a workout, can help women make sure they are working out at the right level to improve cardiovascular fitness and build endurance. It can also help avoid overtraining, which can increase the risk of injury or other health problems.

By monitoring heart rate during exercise and staying within the right target heart rate zone defined in the session plan, a woman can tailor workouts to meet specific needs and goals — whether that’s to improve overall fitness or train for a specific event. So, it’s important for every woman to be aware of her target heart rate and track exercise intensity to get the most out of every workout to make the right physical adaptations and stay safe while doing so.

In addition, body and mind exercises (e.g., yoga, Pilates, and stretching) can help to manage menopause-related symptoms. Specifically, it has been shown that low-volume resistance training three times a week improves muscular strength among post-menopausal women. 

While low-volume resistance training improves fat mass and muscular strength, high-volume resistance training is necessary to reduce abdominal fat and increase metabolism in postmenopausal women. This means that both lifting heavy weights and aerobic exercise like walking, running at a lower heart rate, swimming, and cycling are essential for post-menopausal women.

Triathletes may need to reign in the volume of high-intensity sessions and increase the volume of resistance training. Benefits include a reduction of injury risk and an increase in power when running, cycling, and swimming.

Nutrition for Menopausal Women

Increase Protein Intake

Research has shown that pre- and post-menopausal women benefit from an increase in protein above the daily recommended amount. The standard recommended daily amount is 0.8 grams of protein per kilogram of body weight, but researchers have found that increasing this to 1.2g/kg or more, combined with high-volume resistance training and anaerobic exercise, was beneficial in increasing lean body mass. 

The researchers also recommended that between 20-25 grams of high-quality protein should be consumed during each main meal (breakfast, lunch, dinner) throughout the day. In other words, loading your daily protein intake in one meal is less effective than spreading it equally amongst meals. 

Take a Vitamin D Supplement

Vitamin D is essential for synthesizing protein and calcium for muscle use. In women, estrogen increases the function of the enzyme responsible for activating vitamin D; therefore, vitamin D deficiency is a key concern for menopausal women who are experiencing declining estrogen levels. This is associated with a loss of muscle mass and strength in older people, alongside a decline in physical performance. Depending on where you live and how much sunlight you’re exposed to, you may need to take a vitamin D supplement in order to get the level required to enable effective training.

Omega-3s and the Mediterranean Diet

There is growing evidence that older women can benefit from omega-3 polyunsaturated fatty acid (PUFA) supplementation due to several reasons:

  • Reduced risk of heart disease: Omega-3 PUFAs, particularly EPA and DHA, have been shown to help reduce the risk of heart disease in older women. Studies have found that these fatty acids can help lower blood pressure, reduce triglyceride levels, and improve overall cardiovascular health.
  • Improved cognitive function: Omega-3 PUFAs have been linked to improved cognitive function and memory, which can be particularly important for older women who may be at risk for age-related cognitive decline. Some studies have suggested that omega-3 PUFAs may help improve brain function by reducing inflammation and improving blood flow to the brain.
  • Reduced risk of depression: Depression is more common in older women, and studies have suggested that omega-3 PUFAs may help reduce the risk of depression and improve mood. It is thought that the anti-inflammatory properties of these fatty acids may help reduce inflammation in the brain, which has been linked to depression.
  • Improved bone health: Omega-3 PUFAs may also be beneficial for older women’s bone health. Studies have suggested that these fatty acids may help reduce bone loss and increase bone density, which can help reduce the risk of osteoporosis and fractures.
  • Reduced inflammation: Inflammation is thought to play a role in a variety of age-related health conditions, and omega-3 PUFAs have been shown to have anti-inflammatory properties. This can be particularly important for older women who may be at risk for inflammation-related conditions such as arthritis, diabetes, and cancer.

Foods high in omega-3s include fish, vegetable and flaxseed oils, nuts, flax seeds, and leafy vegetables — all of which are hallmarks of the Mediterranean diet. The Mediterranean diet has been linked to many other health benefits, including reduced risk of cardiovascular disease and mortality.

A Note on Hormone Replacement Therapy

No matter your personal views on Hormone Replacement Therapy (HRT), there is substantial evidence that it helps relieve menopausal symptoms and has a positive effect on muscle mass and bone density by normalizing estrogen levels. HRT has also been proven to increase power. 

If the thought of taking HRT does not sit well with you, then there are natural alternatives in the form of phytoestrogens. Phytoestrogens — whose chemical structure is very similar to that of human estrogen — are found in soy protein. Studies have shown that soy protein and isoflavones can improve muscle density and reduce body weight.

Note: If you do choose to use supplements and/or HRT and also want to compete or race, it’s worth checking that the supplements you are taking are batch tested — therefore reducing the risk of contamination from banned substances. One such checker is Informed Sport.

The combination of a good diet, HRT (natural or not), and exercise will help reduce the development of sarcopenia and the negative effects of menopause on bone density. With a well-structured, progressive training plan as well as thrice-weekly heavy lifting, you could be finishing an Ironman triathlon well into your 80s!


(2018, December). Diet Review: Mediterranean Diet. Retrieved from. 

(2022, November 29). Menopause and post menopause health. Retrieved from

Alexander, D.D. et al. (2017, January). A meta-analysis of randomized controlled trials and prospective cohort studies of eicosapentaenoic and docosahexaenoic long-chain omega-3 fatty acids and coronary heart disease risk. Retrieved from

Buckinx, F. & Aubertin-Leheudre, M. (2022, June 23). Sarcopenia in Menopausal Women: Current Perspectives. Retrieved from

Calder, P.C. (2013, March). Omega-3 polyunsaturated fatty acids and inflammatory processes: nutrition or pharmacology? Retrieved from 

Gill, C. (2020, June 25). Now Is the Time to Take Steps to Avoid Osteoporosis. Retrieved from 

Gregorio, L. et al. (2014). Adequate dietary protein is associated with better physical performance among post-menopausal women 60–90 years. Retrieved from 

Grosso, G. et al. (2014, May 7). Role of omega-3 fatty acids in the treatment of depressive disorders: a comprehensive meta-analysis of randomized clinical trials. Retrieved from 

Kruger MC, Schollum LM, Kuhn-Sherlock B, et al. (2015). Bone metabolism, bone mineral density and low-dose oral silicon in postmenopausal women: a double-blind, randomized, placebo-controlled trial. Osteoporosis International, 26(1), 223-33.

Mozaffarian, D. & Wu, J.H.Y. (2011, November 8). Omega-3 fatty acids and cardiovascular disease: effects on risk factors, molecular pathways, and clinical events. Retrieved from 

Orchard, T.S. et al. (2010, December). Fatty acid consumption and risk of fracture in the Women’s Health Initiative. Retrieved from

Phillips, S.K. et al. (1993, January). Muscle weakness in women occurs at an earlier age than in men, but strength is preserved by hormone replacement therapy. Retrieved from 

Simopoulos, A.P. (2011). Importance of the Omega-6/Omega-3 Balance in Health and Disease: Evolutionary Aspects of Diet. Retrieved from 

Su, K.P. et al. (2018, September 7). Association of use of omega-3 polyunsaturated fatty acids with changes in severity of anxiety symptoms: a systematic review and meta-analysis. Retrieved from

Yurko-Mauro, K. et al. (2015, March 18). Docosahexaenoic acid and adult memory: a systematic review and meta-analysis. Retrieved from 

Zhang, X.W. et al. (2016, February). Omega-3 fatty acids and risk of cognitive decline in the elderly: a meta-analysis of randomized controlled trials. Retrieved from

Graphic Depicting A Resource Page For Women In Endurance Sports

Resources for Female Athletes

Training for Women

Endurance training isn't one-size-fits-all. Here's your one-stop shop for training tips, inspiration, training plans, and stories from women in endurance sport.

Coach Karen Parnell
About Karen Parnell

Karen Parnell is British Triathlon Federation (BTF) Level 3 High Performing Coach and Tutor, Nivel 3 Técnicos Federados FATRI España, and an ASA Open Water Swimming Coach. She is also a qualified NASM Personal Trainer and IRONMAN® Certified Coach as well as being a Stryd running with power coach and author. Karen is based near Malaga in Southern Spain where she runs ChiliTri coaching and camps.

View Karen’s Coach Profile here

Related Articles