More and more women are continuing to lace up their sneakers to train and race hard later in life. But the physiological changes brought on by menopause can be tricky to navigate for many women, particularly when paired with the physical toll of training. Fortunately, the challenge of training through menopause can be worth it in the long run—research shows that active women fare better than their sedentary counterparts later in life.
Much like how each woman’s menstrual cycle is different, symptoms associated with menopause will vary between individual women. If you want to learn more about what happens to your body during menopause and why, you will definitely want to give this blog a read.
Aerobic capacity changes as we age—but there's good news
Though we can certainly make lifestyle choices to hedge the aging process, the physiological changes we face as we age eventually become unavoidable. This is particularly true for exercise and physical output due to decreases in objective measures like aerobic capacity. Aerobic capacity (also termed VO2max) quantifies the largest amount of oxygen the body can consume during a workout at maximum effort. The higher the aerobic capacity, the higher the physical output during endurance exercise, making this number quite indicative of a successful endurance athlete.[1] And though age-related decreases in VO2max take place in both male and female athletes, women can experience a greater decline—up to 10% more compared to male counterparts.[1] The good news? Even across age groups, active women will always have a VO2max up to 30-50% higher than females who do not engage in regular exercise.[1]
Other changes that will impact aerobic capacity and performance include:
- Lower stroke volume (blood output from the heart) and max heart rate [1,2]
- Changes to lung function, affecting the amount of oxygen in the blood [1,2]
- Decreases in the amount of and changes to composition of skeletal muscle fibers [1,2]
Biomarker changes to expect during menopause
Certain biomarker changes are to be expected during menopause and during aging in general. Here's what to anticipate and the causes of some of these transitions.
DHEAS decreases
DHEAS is an estrogen precursor. And since DHEAS declines with age, it contributes to estrogen’s downward trend across the menopausal transition.[3] But estrogen plays an important role in multiple areas, from bone strength to angiogenesis (development of blood vessels), so it's best for postmenopausal women to try to maintain levels as much as possible. High stress, low calorie intake (particularly low fat intake), and excessive levels of activity can can contribute to low DHEAS.
Testosterone decreases
Testosterone plays an important role in maintaining an active lifestyle, as it helps maintain energy levels, muscle development, and bone health. But both general aging and menopause can cause ovarian testosterone production to decrease.[3] Fortunately, moderate testosterone will still remain in circulation due to continued production by the adrenal glands.
Sex hormone binding globulin (SHBG) increases
SHBG binds estrogen and testosterone to reduce their effects, so women with high levels of SHBG have less testosterone available, which can play a role in physical output as mentioned above. But low levels aren't much better—they're associated with abnormal glucose and cholesterol metabolism and excess weight.[4] It's best to monitor SHBG throughout the menopausal transition to ensure you're staying in the optimal zone in the middle ground.
Calcium becomes king
As one of the major structural components of bone, calcium’s importance during menopause cannot be overstated. Sometime in her 30s, a woman’s body stops being able to produce new bone cells at the same rate at which they naturally degrade. This causes a decline in bone calcium content over time, making women prone to things like osteoporosis and bone fractures. Although serum calcium levels are tightly regulated and rarely indicate deficiency, this biomarker cannot go overlooked.
Vitamin D decreases
Aging can cause a decrease in the formation of active vitamin D in our bodies, so your levels during menopause will reflect this. But vitamin D is incredibly important during the menopausal transition and beyond; it’s necessary for calcium absorption and the building of new bones. Even if you've never taken a vitamin D supplement before, this might be the time to do so. A blood test will help to identify which dosage is appropriate for you.
Exercise can help mitigate weight gain associated with aging in postmenopausal women
Weight gain—particularly around the abdomen—is a dreaded but a common challenge for women experiencing menopause. This change can actually independently impact health, as abdominal weight gain is associated with a higher risk of certain chronic diseases, including coronary heart disease, cardiovascular disease, diabetes, and hypertension.[5] Though some believe this occurs due to the hormonal changes associated with menopause, in reality, it's mostly caused by aging. A study in the American Journal of Epidemiology looked at weight status in 3,000 women over three years with the initial ages ranging from 42 to 52. Over this time period, women gained an average of 4.6 pounds—regardless of menopause status.[11]
And so, exercise during menopause is of acute importance for weight maintenance. A study from the American College of Sports Medicine found that higher levels of physical activity in middle-aged women were associated with less weight gain during menopause.[6] Another study showed that, though fat-free (muscle) mass did not differ between pre- and postmenopausal female runners, post-menopausal women had higher body fat percentages and fat mass in comparison.[7]
Despite this finding, staying active was still beneficial—postmenopausal women who participated in regular exercise had lower body fat percentages, fat mass, waist circumference and abdominal fat than those who did not.[7] The takeaway? Though some weight gain around the time of menopause may be unavoidable, regular exercise can still be a mitigating factor.
Some high-impact tips for staying active through menopause
So what are the best ways to emerge from menopause feeling most like your premenopausal self? Though the physiology of menopause is complicated, you can find comfort in knowing some of the most powerful actions you can take are the simple, tried and true ones.
Keep moving
In addition to the benefit of weight management, research indicates that exercise is associated with increased HDL ("good") cholesterol, lower risk of cardiovascular disease, and increased insulin sensitivity in postmenopausal women.[1] A mix of both resistance training and impact exercise (e.g. running) will help to maintain optimal bone mass.[8,9]
Stay hydrated
Adequate hydration is obviously key for an active person. But this is especially true for post-menopausal women, as dehydration is more common in older individuals due to physiological changes during the aging process. First, due to slower kidney function and hormonal responses, the rehydration process is slower. Interestingly, the thirst sensation both during exercise and in everyday life is also dampened in postmenopausal women. Older women are also slower to excrete water, putting them at increased risk for hyponatremia.[10] Since adequate hydration is critical for virtually all bodily processes and both mental and physical function, it's important to drink water even if you don't feel actively thirsty.
Focus on a balanced diet
While it is always important to provide your body with the macro- and micronutrients it needs to support physical activity, certain nutrients are of particular importance through menopause. Getting adequate calories from carbohydrates (mainly whole grains, fruits, and veggies), protein and fat will help to support bone health, a healthy body weight, and prevent illness and injury.[1]
Certain micronutrients also help to support metabolic and physical function. Here are a few of particular importance to active postmenopausal women:
- Calcium
- Vitamin D
- Vitamin E
- Zinc
- Vitamin B12
- Folate
- Riboflavin (Vitamin B2)
- Pyridoxine (Vitamin B6)
What’s the best way to make sure you aren’t falling short? Focus on a balanced diet with a variety of whole foods and adequate calories.[1]
The takeaway on the effects of menopause on endurance training
The physiological changes experienced during menopause and aging are inevitable, but this doesn’t have to put a halt to your active lifestyle. Knowing how your biomarkers will change and how to adapt your nutrition, hydration, and training can help you to achieve your health and wellness goals through this phase of the life cycle.
Stevie Lyn Smith, MS, RDN, CDN
- Stevie Lyn is a Content Strategist and Team Nutritionist at InsideTracker. As a Registered Dietitian and Ironman triathlete, she enjoys combining her passions to help educate others on how to fuel for overall health and performance. When she’s not swimming, biking, or running with her dog, you’ll find her in the kitchen working on a new recipe to improve her biomarkers.
References
[1] Serra, Monica, et al. “Aging in Women Athletes.” An International Perspective on Topics in Sports Medicine and Sports Injury, 2012, doi:10.5772/32161.
[2] Tanaka H, Seals DR. Endurance exercise performance in Masters athletes: age-associated changes and underlying physiological mechanisms. J Physiol. 2008;586(1):55‐63. doi:10.1113/jphysiol.2007.141879
[3] Burger, Henry G., et al. "Hormonal changes in the menopause transition." Recent progress in hormone research 57 (2002): 257-276.
[4] Overlie, Inger, et al. "The endocrine transition around menopause-a five years prospective study with profiles of gonadotropines, estrogens, androgens and SHBG among healthy women." Acta obstetricia et gynecologica Scandinavica 78.7 (1999): 642-647.
[5] Folsom AR, Kushi LH, Anderson KE, et al. Associations of General and Abdominal Obesity With Multiple Health Outcomes in Older Women: The Iowa Women's Health Study. Arch Intern Med. 2000;160(14):2117–2128. doi:10.1001/archinte.160.14.2117
[6] Sims ST, Larson JC, Lamonte MJ, et al. Physical activity and body mass: changes in younger versus older postmenopausal women. Med Sci Sports Exerc. 2012;44(1):89‐97. doi:10.1249/MSS.0b013e318227f906
[7] Van Pelt RE, Davy KP, Stevenson ET, Wilson TM, Jones PP, Desouza CA, Seals DR 1998 Smaller differences in total and regional adiposity with age in women who regularly perform endurance exercise. Am J Physiol 275:E626-634
[8] Basat, Hande, Sina Esmaeilzadeh, and Nurten Eskiyurt. "The effects of strengthening and high-impact exercises on bone metabolism and quality of life in postmenopausal women: a randomized controlled trial." Journal of back and musculoskeletal rehabilitation 26.4 (2013): 427-435.
[9] Chien, M. Y., et al. "Efficacy of a 24-week aerobic exercise program for osteopenic postmenopausal women." Calcified tissue international 67.6 (2000): 443-448.
[10] Rehrer, Nancy & McLay-Cooke, Rebecca & Sims, Stacy. (2017). Nutritional Strategies and Sex Hormone Interactions in Women. 10.1007/978-3-319-44558-8_6.
[11] Barbara Sternfeld, Hua Wang, Charles P. Quesenberry, Jr., Barbara Abrams, Susan A. Everson-Rose, Gail A. Greendale, Karen A. Matthews, Javier I. Torrens, MaryFran Sowers, Physical Activity and Changes in Weight and Waist Circumference in Midlife Women: Findings from the Study of Women’s Health Across the Nation, American Journal of Epidemiology, Volume 160, Issue 9, 1 November 2004, Pages 912–922, https://doi.org/10.1093/aje/kwh299