I’m shaking with anxiety at the top of a Spanish mountain on a beautiful sunny day; however did I get here?

We need to talk about what changes as we age and the impact of menopause.

My Journey

Age Group Triathlete

Although I have always been active I hated PE in school.  I wasn’t interested in playing netball or hockey and my PE teachers seemed only to be interested in the ‘sporty’ girls who wanted to play in the school teams.  Fortunately this didn’t put me off sport for life and I kept fit throughout my 20s and 30s by doing whatever fad exercise was available; for me that started with callanetics and moved on to step aerobics!  I certainly didn’t think of myself as sporty though.

Like many people, my thirties was a busy time of parenting and working with whatever little time was left dedicated to exercise.  I started running in my early thirties and didn’t take up triathlon until my late thirties, so was somewhat of a late developer!

I love eating and so have always had to work hard to maintain a healthy weight and it can get a little wearing when people tell me how lucky I am to be ‘slim’ or ‘skinny’  because weight management doesn’t come easy. Most people have to work hard to maintain a healthy weight and what you eat is the key to this.  I believe you can’t out run (or swim or bike) an unhealthy diet!  Focusing on nutrition and body composition, rather than weight, has been the key to my performance improvements in my late 40s & early 50s. Having a progressive training plan was also important, and when you put these things together magic can happen!  During this time I managed to swim, bike and run faster than before and even qualified to represent GB at the European Sprint Tri Championships. 

Prior to this I did triathlon for the love of taking part with my friends and trying to beat my previous times and was never really competitive.  Until recently,  I’d always been mid-pack and it was exciting to finally be coming closer to the front than the back for a change!  It seems even more remarkable to me because throughout this time I was going through perimenopause and was struggling with motivation, fatigue, anxiety, muscle aches and pains (the list goes on). 

Early on in perimenopause I started to feel unlike myself, very flat and on occasion extremely anxious for no apparent reason.  I found myself riding up a mountain, in beautiful countryside, suddenly becoming anxious, shaky and tearful.  I remember descending in tears and not knowing why.  Understanding that these emotions can come from a fluctuation in hormones really helps when something similar happens again.  It’s also good to know that these symptoms are phases and will pass in time.

If I hadn’t already been active and managing my nutrition I wonder how much worse these symptoms might have been! I also focused more on strength training, eating more protein and definitely scheduled myself more recovery time. For me these changes to my routine helped me manage my symptoms better.

I’ve learnt that it’s vital to try and be active doing the things that you love, whilst mixing up social & solo training sessions; it makes it much easier to motivate yourself when you enjoy what you’re doing!

How we age

Whether you are an endurance athlete or like to keep active for general well-being, you probably want to feel healthy and strong.  As the years advance it can feel increasingly difficult to maintain athletic performance, let alone improve on it. It feels like the world promotes looking young above all else and tries to push everyone to keep young at all costs. The harsh truth is that from the age of 30 things are changing, such as a loss in muscle mass of between 3-8% per decade, but don’t despair all is not lost!  There are plenty of things we can do throughout our 30s, 40s, 50s, 60s, 70s & 80s to keep healthy & enjoy the things we love. 

Both females & males see a decline in hormones as they age. Although we describe testosterone as a male hormone and oestrogen as a female hormone the truth is that everyone has some of each, but at different levels.

For males a decline in hormones happens gradually over time, where they can exhibit a steady reduction in muscle mass, bone density & physical function.  Low testosterone can lead to increased belly fat, balance problems and contribute to chronic conditions such as obstructive sleep apnea, depression and chronic obstructive pulmonary disease to name a few.

For females the decline is most noticeable during perimenopause and menopause when oestrogen levels can fall off a cliff. During the first year after menopause, women lose on average 80% of their oestrogens and have an accelerated decline in muscle mass and strength.  Low oestrogen may lead to osteoporosis, heart disease and dementia.

Everyone experiences a decline, males more slowly and gradually over the decades and females more suddenly with a marked change.

Perimenopause & menopause

Until very recently, menopause was rarely discussed in public, something not to question or to try and understand. Certainly not something to be spoken about openly.

Fortunately, things are improving and wherever you look there are articles highlighting the effects of perimenopause & menopause on the lives of women and those around them & strategies to help with the transition.

It’s important for everyone (not just women) to understand the very real physical and mental changes they may have to endure.

Perimenopause happens in the years leading up to menopause; menopause is defined as a moment in time when a woman has stopped having periods for 12 months.  The perimenopause & menopause usually happen between the ages of 45-55.

The years approaching menopause can be daunting, but armed with good information female athletes can work with the menopause instead of trying to fight it.  To be able to work with the fluctuations in hormones it’s important to acknowledge the symptoms and plan strategies for dealing with them day to day.  According to Dr Stacey Sims, a leading exercise physiologist & nutrition scientist,  common symptoms in perimenopause which can be very disruptive for years are (1):

  • hot flushes
  • night sweats
  • weight gain
  • heavy periods
  • incontinence
  • vaginal pain
  • fatigue
  • brain fog
  • anger and awful moods
  • sleep disruption
  • headache & migraine
Other symptoms include:

  • light headedness
  • muscle pain
  • anxiety
  • dry skin
  • tingling, pins and needles in the extremities
  • low libido
  • burning tongue
  • heart palpitations
  • hair loss
  • cold flashes
  • tinnitus
  • the list goes on…

Interventions which might help

Hormone Replacement Therapy

Being active and eating a healthy diet should help ease the symptoms but women who are already active and eating well can still experience debilitating symptoms and HRT is becoming more and more popular.  There is evidence emerging that taking HRT could help prevent a number of chronic health issues in later life and help maintain:

  • bone health
  • heart health
  • metabolic health
  • skin health
  • brain health e.g.  a 2021 study showed that women taking HRT for 6 years or more were 79% less likely to develop Alzheimers. (2)
More studies are needed as research into women’s health has been marginalised for too long, but thankfully this is changing.  Scientists like Dr Sims champion the cause by highlighting that ‘women are not small men’. A phrase she used in her book Roar, which I would highly recommend to anyone interested in women’s health & well-being.  It wasn’t until I’d read this book in 2017 that I had even considered how unequal science has been in terms of women’s health. It seems so obvious that any scientific study should include women and not just be made up of the average 20 something male, as has been the case in the past.
More recently, I was still shocked to read (but shouldn’t have been surprised) that car safety testing has only just introduced ‘female’ crash dummies as part of testing protocols! Data suggests that when a woman is in a car crash she is up to three times more likely to suffer whiplash injuries in rear impacts in comparison with a man.   It’s hard to reconcile why with such data being around for years this hadn’t been addressed earlier.
    Strength & Conditioning
    Incorporate lifting heavy weights (6 reps or less) into your regime in order to build strength, boost metabolic rate, build stronger bones whilst also helping to maintain a healthy body composition.  It’s also important to include mobility and stretching as part of this plan.
    HIIT Sessions
    According to Dr Sims menopausal women can benefit from high intensity interval training in the form of SIT (Sprint Interval Training) which can provide the metabolic stimulus to trigger the performance boosting body composition changes that hormones used to do. The idea is to do very short sharp hard intervals in order to increase lean muscle mass and reduce fat.  Ideally 2 or 3 sessions a week with ample recovery time.
    Gut Microbiome
    More and more evidence is coming to light suggesting what a huge role a healthy, diverse gut microbiome plays in our physical and mental health.  An individual gut biome can be made up of 150-250 different types of bacteria and evidence suggests that healthier people tend to have more diversity and have closer to 250 types and people less healthier closer to 150.
    Probiotics and prebiotics are foods that work together to build and maintain a healthy gut biome.
    Probiotics are foods which contain healthy bacteria and can be found in fermented foods such as plain yogurt (no additives), cottage cheese, kefir, saurkraut.
    Prebiotics are foods rich in fibre, such as fruits, vegetables and wholegrains.
    Evidence on how we can achieve more diversity is scarce and we shouldn’t assume taking probiotic and prebiotic supplements is the answer. 
    The key seems to be in eating a diverse healthy diet where you consume mostly whole foods, fruits, vegetables, some meat, fish or alternatives, and ease off on processed fast foods and refined sugar.


    Carbohydrates, proteins & fats

    Current research suggests that as athletes we should be looking at eating approximately 40% carbohydrates, 30% proteins & 30% fats.

    These proportions should help keep energy levels up for workouts and daily life as well as helping to aid recovery.  It’s not quite as simple as ensuring you hit this 40/30/30 balance; how much you eat and when you eat it are key to maintaining a healthy weight & to optimise performance and recovery.

    The amount you eat each day will depend on several factors, such as your weight, the duration & intensity of a workout and how active you are generally. For less active days the amount eaten should be reduced.

    As you age it is vital to ensure you are eating enough protein to support the extra work you put in to maintain or build muscle mass.

    Recovery Days

    Taking more recovery days and allowing for shorter phases of training throughout training cycles can really make a big difference.  Recovery is always a key to making performance gains and you could maybe swap to a 3 weekly training cycle as opposed to a 4 weekly cycle.  So, 2 weeks on and 1 week of recovery.

    Adapting to Change

    So, if and when you are confronted with any of these issues, don’t despair, you are not alone!

    By introducing some or all of the strategies described above it is possible to adapt to the inevitable changes taking place and even possible to make performance gains as you age.

    About the Author

    Tina Peck holds a VTCT Level 3 Award in Nutrition for Physical Activity, plus Nutrition & Weight Management (Accredited by AFN)

    Tina is an Ironman Certified Triathlon Coach, Training Peaks Certified Coach and British Triathlon Federation Diploma Qualified Coach

    (1) Sims, Stacey and Yeager, Selene Next Level (Rodale Books, 2022), p.50
    (2) https://alz-journals.onlinelibrary.wiley.com/doi/full/10.1002/trc2.12174
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