Exercise during the peri and menopause years – training adaptations

As someone who has always been very active, I became aware in my mid-forties that changes in my body were starting to affect my training. I have a particular passion for triathlon and multisport events, and always believed that consistent training would keep me at the top of my game. But suddenly I was experiencing all sorts of weirdness – disrupted sleep, night sweats, bloating, fatigue, and recurring muscle aches and injuries. Despite my exercise and eating patterns not changing, my shape was, as I gained weight, particularly around my middle.
Could this be the start of the menopause? What was happening and how could I prevent this from affecting my sporting ambitions?

So what is going on?
What is the menopause? Well, this is where the language that is used can be confusing. Technically the menopause is just one point in time, it marks the exact 12-month mark since your last period. From this point onwards we move into post-menopause, what people usually term menopause, or our menopausal life.
But things start to change around five years prior to this during the menopausal transition we call perimenopause, where your regular menstrual cycle starts to change. Our hormones at this point are in a state of flux, with oestrogen becoming dominant, as we start to have more anovulatory cycles. This means that as an egg isn’t being released, there isn’t the stimulus to produce progesterone, so causing a hormonal discrepancy.
This is where we start to feel those confusing changes in our bodies. Where we start having night sweats, putting on belly fat, losing lean mass, not feeling as strong, not hitting high intensities. We don’t understand why all the things that we’ve been doing up to this point now aren’t working for us, and the closer we get to the actual cessation of our periods, the worse these become.

How does this affect our training and body composition?
Oestrogen often promotes inflammation, whereas progesterone is anti-inflammatory. This leads to an increase in total body inflammation, and a poor ability to adapt and respond, with a predisposition to things like iron deficiency, sore joints, puffiness, picking up respiratory tract infections and so on. We also have a decreased sensitivity to insulin, primarily due to the interaction of oestrogen and progesterone and how they moderate blood sugar control.

What can we do?
Although there is now a slowly increasing amount of information out there, the studies into perimenopause and menopause particularly in terms of training have been slow to come to the fore. Through personal research and study into this area I became very aware of how our training patterns need to adapt to these hormonal changes.
We really want to maintain neuromuscular stimulation and muscle integrity, as our ability to maintain fast-twitch fibre action and a really strong, fast contraction, or power and speed, for the most part, really take a hit when we hit that perimenopause and post-menopause aspect of our lives.

What about HRT?
Hormone replacement therapy definitely benefits many women, especially where their symptoms are very debilitating – for things like vasomotor symptoms, sleep issues, vaginal dryness and mood.
However, as it has a different molecular structure to our endogenous hormones, it is not effective for building lean mass or mitigating body fat gain. This is where exercise really comes into play, and particularly the way in which we train.

Embracing, and adapting to the changes
We in the Western world tend to use a lot of negative language when speaking about this time of change in a woman’s life. Many Eastern cultures however have viewed this as a natural transition in life and they have a freeing sensation where they don’t have to deal with a period anymore, they are now in a new chapter of life, having the ability to do other things that they weren’t previously able to because they were hindered by a period or hindered by responsibilities of being a younger reproductive woman. We should embrace this new freedom – this is all your positive scope, in developing and saying, yes, now I’m ageing, but I’m ageing gracefully, and I’m powerful, and I’m strong and I can do all these new things. Women do have the capacity to continue to be strong and competitive beyond the menopause.

​However, there are some key considerations we need to take into account when planning our training:
Lift heavy – we really need to build in some quality resistance training, low-rep heavy weights. Not only does this help with neuromuscular action, it also increases the stress on the bone and helps with bone turnover, increasing bone density, or really preserving it and not allowing our bodies to lose it as fast.
High intensity interval training – one of the best ways to stimulate muscle production, these short, sharp interval workouts prompt your body to build lean muscle and shrink visceral fat more effectively than a slow burn endurance workout. It also helps your body to process insulin efficiently, making you less prone to insulin resistance, or becoming overweight. 
Plyometrics – working on power and muscle integrity, maintaining fast twitch and neuromuscular stimulation for a strong, fast contraction. We are talking here about jumping or some fast explosive movements, of course always done in a really safe manner.
Do less volume and more intensity – this is the area where a lot of people struggle. The tendency at this time is to push harder and longer to get rid of this newly acquired body fat, but ultimately that backfires, putting you into a state of low-energy, high stress cortisol cycling. This elevated baseline cortisol impacts on our sleep quality, which in turn decreases our insulin sensitivity and increases our body's stimulus to store the visceral adipose tissue, i.e belly fat. Sleep is the integral part of our recovery - we don't get fitter during our training, but the recovery around it. Good sleep enables muscle recovery, aerobic endurance and the rate of perceived exertion.
As an endurance athlete myself, I must admit this reduction of the volume of my training was something I struggled with, but we have that inherent ability to go long because of the sex differences within the muscle enzyme activity, as well as the body being predisposed to endurance. What is missing is the strength component and the anaerobic component to make you competitive.
All of these specific interventions work to not only to decrease visceral abdominal fat, increase our insulin sensitivity, increase our lean-mass development and the way our muscles fire. They also help with our mood and cognitive focus.
One thing I will add as a caveat to all training, is to think about the timing of your workouts, which is very important. Take a look at my blog post here to find out how to make sure this works with, not against you!

Working with a coach
The term ‘adaptive coaching’ is often used in a work environment, allowing managers to identify their employees’ level of ability of a given task or skill, then coaching them accordingly. I believe this should be the way we work with athletes too, especially as our bodies change as we get older. We should never be using an ‘off the shelf’ training plan, especially when so many of them have been adapted primarily for men, and do not take into account these inherent sex differences throughout our lives as females, let alone during this time of change.
I work in a very holistic way, constantly listening to my clients and the way they are adapting not only physically, but also mentally to the training I am setting them. There is nothing more discouraging than being set a plan with targets you may miss due to changing hormonal symptoms. Through making the necessary adaptations to my own training, at 54 years old I am achieving better results in my sports than I was in my early thirties. I use the same methodology, albeit in a way that is bespoke to every individual that I work with, to ensure they are also able to achieve their personal goals, and to be the best version of themselves.