A significant new investigation has illuminated the pervasive influence of menopausal symptoms on highly dedicated female endurance athletes, with a substantial majority reporting that these physiological changes are actively hindering their training regimens and competitive outcomes. The findings, detailed in the open-access scientific journal PLOS One on December 17, 2025, were spearheaded by Heather Hamilton from Old Dominion University in the United States, in collaboration with her research associates. This study addresses a critical gap in understanding the unique challenges faced by female athletes at the peak of their athletic careers, during a life stage often associated with significant hormonal shifts.
While regular engagement in physical activity is frequently acknowledged for its role in mitigating various menopausal discomforts, particularly those affecting musculoskeletal health and overall well-being, the converse is also true: the onset of menopause-induced symptoms can present formidable obstacles to maintaining an active lifestyle. These symptoms can, in turn, create substantial barriers to consistent participation in demanding sports and structured training programs, potentially leading to a decline in athletic engagement for a considerable number of women.
The research team meticulously gathered data by surveying 187 female athletes who specialized in disciplines such as running, cycling, swimming, and triathlons. The participants were all within the age bracket of 40 to 60 years, a demographic commonly experiencing perimenopause and menopause. Crucially, all individuals were classified as highly active, engaging in training sessions at least three times per week for a minimum of three hours cumulatively each week, signifying their commitment and high performance standards. To comprehensively assess the menopausal experience, participants completed the Menopausal Rating Scale (MRS), a well-established and validated instrument designed to quantify the severity and frequency of a wide array of menopausal symptoms. Beyond symptom reporting, the athletes were also prompted to articulate the specific ways in which these symptoms influenced their day-to-day training routines and their overall athletic performance in competition.
The analysis of the survey responses revealed a striking prevalence of menopause symptoms within this elite athletic cohort. Sleep disturbances emerged as the most frequently cited issue, affecting a remarkable 88% of the participants. This was closely followed by reports of physical and mental exhaustion, experienced by 83% of the athletes. Other commonly reported symptoms that significantly impacted the athletes’ lives included sexual dysfunction (74%), feelings of anxiety (72%), heightened irritability (68%), a depressive mood (67%), noticeable weight gain (67%), episodes of hot flushes (65%), and discomfort in the joints and muscles (63%). These figures underscore that even women who maintain exceptionally high levels of physical fitness are not immune to the multifaceted physiological and psychological changes associated with menopause.
The study further delved into which specific symptoms posed the greatest impediments to consistent training and competitive participation. Joint and muscular discomfort, fluctuations in weight, disruptions in sleep patterns, and profound physical and mental exhaustion were identified as the symptoms most frequently linked to detrimental effects on athletic performance. For instance, among the athletes who reported experiencing joint or musculoskeletal discomfort, an overwhelming 97% indicated that this symptom negatively impacted their training sessions, while 91% stated that it had a negative effect on their performance in races or competitions. The research also established a clear correlation between symptom severity and the degree of challenge experienced; athletes reporting more severe menopausal symptoms were significantly more likely to describe greater difficulties. Approximately one-third of the participants indicated that menopause had a moderate to strong negative effect on their training, and roughly one-quarter reported a similar level of negative impact on their performance. This highlights a direct, quantifiable relationship between the intensity of menopausal symptoms and the ability of these athletes to maintain their current training load and competitive edge.
The authors of the study acknowledge certain limitations inherent in its design. The cross-sectional nature of the research, which captures data at a single point in time, means that causal relationships cannot be definitively established. Furthermore, the absence of highly detailed demographic information for each participant restricts the extent to which these findings can be generalized to all female endurance athletes. Nevertheless, the researchers firmly conclude that menopausal symptoms are indeed highly prevalent among this specific group of athletes, and that the severity of these symptoms appears to be comparable to that observed in the general population. This finding is particularly noteworthy, as it challenges the often-held assumption that high levels of physical activity inherently protect against or significantly reduce menopausal symptom burden. The study’s principal takeaway is the critical need for healthcare providers to actively engage with female endurance athletes regarding their menopausal symptoms. Proactive management and support are emphasized as essential for enabling these women to sustain their passion for and participation in physical activity throughout this life transition.
The researchers expressed a strong hope that their work will elevate awareness for a demographic that is both growing in number and consistently underserved by targeted guidance. They emphasize that this population is "eager for guidance in how to navigate the menopausal transition while continuing to participate in sport and exercise." This sentiment underscores a pressing need for evidence-based strategies, tailored advice, and accessible healthcare solutions that acknowledge the unique demands and aspirations of elite female athletes. The implications extend beyond individual athletes to coaches, sports organizations, and healthcare professionals, calling for a more informed and supportive ecosystem.
This scientific endeavor received financial backing from the National Heart, Lung, and Blood Institute, which provided a grant (K01 HL159348-01) awarded to N.M.Y. Additionally, Old Dominion University contributed by providing a salary for N.M.Y. The specific responsibilities and contributions of this author are thoroughly detailed within the "author contributions" section of the published study. It is important to note that the funding bodies played no role in the design of the study, the collection or analysis of the data, the decision to publish the findings, or the preparation of the manuscript itself, ensuring the scientific integrity and independence of the research.
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