TOPLINE:

Female endurance athletes aged 40-60 years had a high prevalence of menopausal symptoms ― similar to the general population ― with sleep problems being the most common. Joint and muscular discomfort, weight gain, exhaustion, and sleep problems were perceived to have the greatest negative impact on training and performance.

METHODOLOGY:

• Despite evidence that physical activity benefits women with menopausal symptoms, little is known about how specific menopausal symptoms affect their participation in physical activity and sports.
• Researchers conducted a cross-sectional study to determine the frequency and perceived effects of menopausal symptoms among 187 female endurance athletes aged 40-60 years.
• Participants were required to have engaged in running, swimming, cycling, and/or triathlon for at least the previous 5 years; train in running, swimming, and/or cycling at least 3 days per week; and perform at least 3 hours of physical activity weekly.
• Data were collected through an anonymous online survey, in which the participants reported their menopausal status, completed the Menopausal Rating Scale (MRS) assessment, and answered questions about how these symptoms affected their training and performance.

TAKEAWAY:

• The most commonly reported menopausal symptoms were sleep problems (88%), followed by physical and mental exhaustion (83%), sexual problems (74%), anxiety (72%), irritability (68%), depressive mood (67%), weight gain (67%), hot flushes (65%), and joint and muscular discomfort (63%).
• Joint and muscular discomfort, sleep problems, exhaustion, and weight gain had the strongest negative effects on both training and performance.
• Perimenopausal women had significantly higher total MRS scores than premenopausal (P < .001) and postmenopausal (P = .009) participants.
• Female athletes who reported a strong negative effect of symptoms on training and performance had significantly higher total MRS scores than those who reported slight negative effects (P = .001) or no negative effects (P < .001).

IN PRACTICE:

“Despite evidence suggesting that exercise improves menopausal symptoms, frequency of menopausal symptoms among female endurance athletes is high and severity of menopausal symptoms is similar to that reported in the general population. Sleep problems and physical and mental exhaustion were the most common symptoms reported, and together with joint and muscular discomfort and weight gain had the greatest perceived negative effect on training and performance,” the authors wrote. 

“Healthcare providers and rehabilitation clinicians need to address these symptoms in this population to promote continued participation in physical activity,” they added.

SOURCE:

This study was led by Heather M. Hamilton, School of Rehabilitation Sciences, Ellmer College of Health Sciences, Old Dominion University, Norfolk, Virginia. It was published online on December 17, 2025, in PLoS One.

LIMITATIONS:

The cross-sectional design of this study prevented the establishment of causal relationships among menopausal symptoms, training, and performance. Demographic information such as race/ethnicity, education level, and income was not collected. Additionally, the study did not account for other personal factors such as work-related stress, caregiving responsibilities, and other health conditions.

DISCLOSURES:

This study was funded by the National Heart, Lung, and Blood Institute and the Old Dominion University through a grant or salary support. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.