Menopause and Training: Do You Really Need to Change the Way You Train?

A 48-year-old athlete recently told me she felt as though she “didn’t have abs anymore” and felt “softer”. That wording is obviously not scientific, but it caught my attention because I had not noticed any obvious dramatic physical change in her over the previous two years.

That feeling can reflect several different things: less visible abdominal muscles, more fat around the midsection, a reduced sense of muscular tone, or simply the impression that the body no longer responds quite as it used to.

Comments like this are common among athletes around the age of 50. Some mainly talk about recovery or sleep. Others tolerate heat less well, gain weight without feeling that their diet has changed, or notice more aches and pains. Others, however, move through this stage with few obvious problems.

At the same time, social-media advice has become increasingly simplified. Women are told to run less, avoid “cardio” because it supposedly raises cortisol, lift heavier weights and replace part of their endurance training with high-intensity work.

These messages are easy to remember. They stand up much less well to the scientific literature, which describes a far more variable picture from one woman to another.

Menopause is not a smooth hormonal decline

As a male coach in my thirties, I have to admit I did not seriously engage with this topic earlier. Coach education still covers it poorly. I therefore started by reviewing the literature myself.

Menopause is often presented as a period in which female hormones gradually decline until periods stop. That is a convenient picture, but it only partly reflects reality.

Menopause actually refers to the final menstrual period and is only identified retrospectively, after twelve consecutive months without menstruation. It is preceded by a transition known as perimenopause, which can last several years [1].

During this period, ovarian function becomes irregular rather than simply declining in a straight line. Cycles can shorten, lengthen, disappear temporarily and then return. Oestrogen and progesterone concentrations can fluctuate markedly. Marianne Canonico describes possible alternation between periods of higher and lower oestrogen activity rather than a simple continuous fall [2].

For an athlete, that instability can have practical consequences. One week of training may feel entirely normal, while the same sessions feel much harder a few days later.

Hot flushes, night sweats, disturbed sleep, fatigue, migraines, muscle or joint pain, mood changes and changes in body composition can all occur, with very different intensity between women.

Two women of the same age can therefore experience this transition very differently. That makes the idea of one identical programme for everyone difficult to defend.

This individualised approach is the same one we advocate more broadly for masters athletes: running after 40: how to keep improving .

Women aged 45 to 60 are still under-studied

After decades of exercise-physiology research, you might expect us to know exactly how menopause affects sports performance. We do not.

Exercise physiology was built for a long time mainly on male populations. When women were included, attention was often focused on younger adults, the menstrual cycle or hormonal contraception.

In 2024, Kelly McNulty and colleagues wrote in the British Journal of Sports Medicine about the “invisibility” of women in midlife and beyond in sport and exercise science [3].

Findings from 25-year-old women are not necessarily transferable to a 50-year-old runner. At the other end of the spectrum, studies of sedentary women aged 65 or 70 do not necessarily answer the questions of a masters athlete training four or five times per week.

A 2025 review on exercise, muscle and bone during perimenopause and early postmenopause found only a limited number of trials conducted specifically during this period [4].

We therefore have strong reasons to say that physical activity remains beneficial during and after menopause. We have far less evidence to say that a 48-year-old woman should replace her long run with HIIT or completely restructure her training.

Being fit does not protect you from every symptom

Another idea needs nuance: the assumption that a highly trained woman will necessarily experience menopause with fewer difficulties.

A 2025 study looked specifically at women aged 40 to 60 who participated in running, cycling, swimming or triathlon [5]. Sleep disturbance, physical or mental exhaustion, hot flushes and muscle or joint pain were frequently reported.

These findings need to be interpreted cautiously because the study used an online questionnaire, and women experiencing more difficulties may have been more motivated to respond.

Even so, the main message is useful: being very active does not make someone immune to the menopause transition.

Sport can also create the idea that a trained person should be able to tolerate more, recover better and keep going despite discomfort. An athlete may then feel she should be able to overcome symptoms through greater discipline.

At the opposite extreme, menopause is still sometimes associated with a sense of decline or loss of value. A 2024 Franceinfo article on the subject used a deliberately brutal phrase: “Once you are menopausal, you are good for nothing” [6].

Between those two narratives is a much more ordinary reality: a woman who simply wants to keep training, sometimes with a few adjustments and sometimes without needing any.

“I don’t have abs anymore”

Let us return to the 48-year-old athlete mentioned at the beginning. Her perception is not irrational. Body composition changes with age, and the menopause transition can favour a more central distribution of body fat.

That obviously does not mean the abdominal muscles have disappeared.

Feeling “softer” may reflect several things: more fat around the trunk, reduced strength, less strength training, poorer recovery or simply a different perception of the body.

It would be tempting to attribute all of these changes to menopause. That would probably be too simple.

Muscle mass and strength gradually decline with age in both women and men. Hormonal changes may contribute, but they occur alongside many other factors: sleep, nutrition, activity level, injury, stress and work or family demands.

One point is well established: women continue to respond to resistance training after menopause. A 2024 meta-analysis found significant strength gains following training in postmenopausal women [7].

There are therefore good reasons to maintain or develop strength training. That does not mean endurance suddenly becomes secondary or harmful.

Muscle, bone and mechanical loading

Bone health is probably one of the strongest arguments for maintaining physical activity that provides a meaningful training stimulus.

Bone mineral density loss accelerates around menopause. Physical activity can help limit that decline, particularly when it places sufficient mechanical load on the skeleton [8].

Different activities therefore do not have identical effects. Swimming and cycling are excellent for cardiovascular health, but they impose relatively little mechanical loading on the skeleton. Running, jumping and strength training load bone differently.

This does not mean that a woman with osteoporosis or little history of impact activity should suddenly begin plyometric training. Loading needs to match the starting point and be introduced progressively.

For a runner who already tolerates impact well, however, automatically removing running at menopause in order to “protect the bones” is difficult to justify.

Endurance and cardiovascular fitness

This is probably where current messaging becomes most confused. The word “cardio” is sometimes used to lump together an easy jog, a two-hour long run and a high-intensity interval session.

It is then claimed that this kind of exercise raises cortisol and should therefore be limited after menopause.

Cortisol does rise during some forms of exercise. That response is part of normal exercise physiology. An acute rise in a hormone during a session is not enough to show that the exercise is harmful.

Studies in postmenopausal women instead show that aerobic training continues to improve cardiorespiratory fitness and several markers of cardiovascular and metabolic health [9].

The useful question is therefore not whether “cardio” becomes bad after 45. It is how much training, and at what intensity, each athlete can tolerate and recover from well.

What about HIIT?

The same caution is needed when discussing high-intensity training. HIIT is a useful tool. It can absolutely have a place in the programme of a 50-year-old athlete when her training background and goals justify it.

The available evidence does not, however, show that every woman entering perimenopause should dramatically increase HIIT or replace endurance sessions with high-intensity work.

Nor is there a strong basis for automatically removing threshold sessions or long runs.

For a woman preparing for a 10K, half marathon or marathon, those sessions serve physiological and race-specific purposes.

A woman who starts running at 50 can still improve enormously. An experienced athlete can also improve specific qualities if she still has room to progress or if her training develops.

Menopause is not a physiological border beyond which performance is no longer possible.

Physical activity does not remove every symptom

The opposite overstatement should also be avoided. Because physical activity is beneficial, it can be tempting to present it as a treatment capable of reducing every menopause symptom.

The evidence is much less convincing when hot flushes are considered specifically. A 2022 meta-analysis of 21 randomised trials found a possible modest effect of exercise on symptom severity, but no clear effect on frequency [10].

Physical activity can therefore be highly beneficial during menopause without necessarily removing the most troublesome symptoms.

That distinction matters: an athlete who continues to struggle despite regular exercise has not failed, and she does not necessarily need to exercise more in order to “manage her hormones better”.

Listen to what women are actually experiencing

The shortage of specific evidence raises another question: what should we do when studies are still too limited to provide a precise answer?

The answer cannot be to replace scientific gaps with certainty. But it also cannot be to ignore the experience of the women concerned.

One person’s experience cannot prove that a method works. But it can reveal problems or needs that are not always captured well in research.

Qualitative work on the menopause transition shows, for example, that women often describe the need for flexibility in exercise, the importance of social support, access to female role models and the ability to discuss symptoms without embarrassment [11].

An athlete may not need a “menopause programme”. She may simply need Thursday’s hard session moved to Friday after several poor nights of sleep, or permission to stop a planned six-repetition session after four without treating it as failure.

That is less dramatic than a method marketed as revolutionary. It is probably much closer to the reality of individualised coaching.

Do you need to change your whole training programme?

Not necessarily.

A woman who is still recovering well, progressing and tolerating her training has no reason to overhaul her programme simply because she has reached a certain age.

When a problem appears, the first step is to identify what has actually changed. Has sleep deteriorated? Are hard sessions taking longer to recover from? Has strength fallen? Are certain aches more frequent? Is heat harder to tolerate?

The adjustment comes afterwards.

A six-repetition workout can become four. A recovery interval can be slightly longer. A long run can be shortened. A demanding session can move by twenty-four hours.

The aim is to preserve the useful stimulus without turning every temporary difficulty into a complete reassessment of the programme.

At the same time, strength training probably deserves more space for many runners. Not because it has a special hormonal effect, but because maintaining strength, power and sufficient mechanical loading becomes increasingly important with age.

The quadriceps, hamstrings, calves, hip muscles and trunk need to be trained properly. A few occasional mini-band exercises are not always enough to produce a meaningful adaptation.

It is also useful to keep speed and intensity when they are well tolerated. Running fast, accelerating, producing force and developing power are not activities reserved for 25-year-old women.

More individualisation

There has never been more specific advice aimed at women over 45, even though this population remains under-studied.

We do, however, have several solid reference points. Endurance training remains beneficial. Strength can improve after menopause. Mechanical loading matters for bone health. Intensity is not forbidden.

On the other hand, sleep disturbance, fatigue and some symptoms can make recovery less predictable.

The answer is therefore probably not to build a completely different type of training after menopause, but to accept that the response to the same training load may become more variable and that some qualities, particularly strength and power, may deserve greater attention.

This approach also means listening more closely to the athletes themselves. When a woman says that she no longer quite recognises her body, that recovery feels different or that certain sessions have become harder, it is reductive to answer only with a hormonal graph or a population average.

First understand what has changed for her. Then decide whether training actually needs to change and, if so, how.

That is probably less dramatic than a “special menopause” method, but much closer to what individualised coaching should be.

Further reading

• Running after 40: how to keep improving
• Menstrual cycle and training

Need a coach?

Oregano Athletics works primarily with women and masters athletes, without restricting coaching to a particular performance level.

See our coaching and get in touch .

References

1. Harlow SD, Gass M, Hall JE, et al. Executive summary of the Stages of Reproductive Aging Workshop +10: addressing the unfinished agenda of staging reproductive aging. Menopause. 2012;19(4):387-395. DOI: 10.1097/gme.0b013e31824d8f40.
2. Université Paris-Saclay. « Marianne Canonico : l’influence des hormones sur la santé ».
3. McNulty KL, Olenick AA, Moore S, Cowley E. Invisibility of female participants in midlife and beyond in sport and exercise science research: a call to action. British Journal of Sports Medicine. 2024;58(4):180-181. DOI: 10.1136/bjsports-2023-107165.
4. Whitman PW, Alexander CJ, Kaluta L, Burt LA, Gabel L. Does exercising during peri or early post menopause prevent bone and muscle loss: a systematic review. Bone. 2025;201:117650. DOI: 10.1016/j.bone.2025.117650.
5. Hamilton HM, Yarish NM, Heron KE. Frequency and perceived influence of menopausal symptoms on training and performance in female endurance athletes. PLOS ONE. 2025;20(12):e0335738. DOI: 10.1371/journal.pone.0335738.
6. Franceinfo. « Une fois ménopausée, on est bonne à jeter » : comment le sport peut aider à briser un tabou encore trop répandu. 2024.
7. González-Gálvez N, Moreno-Torres JM, Vaquero-Cristóbal R. Resistance training effects on healthy postmenopausal women: a systematic review with meta-analysis. Climacteric. 2024;27(3):296-304. DOI: 10.1080/13697137.2024.2310521.
8. Kemmler W, Shojaa M, Kohl M, von Stengel S. Exercise training and bone mineral density in postmenopausal women: an updated systematic review and meta-analysis of intervention studies with emphasis on potential moderators. Osteoporosis International. 2023;34:1145-1178. DOI: 10.1007/s00198-023-06682-1.
9. Huynh E, Wiley E, Noguchi KS, et al. The effects of aerobic exercise on cardiometabolic health in postmenopausal females: a systematic review and meta-analysis of randomized controlled trials. Women’s Health. 2024;20:17455057241290889. DOI: 10.1177/17455057241290889.
10. Liu T, Chen S, Mielke GI, McCarthy AL, Bailey TG. Effects of exercise on vasomotor symptoms in menopausal women: a systematic review and meta-analysis. Climacteric. 2022;25(6):552-561. DOI: 10.1080/13697137.2022.2097865.
11. McNulty KL, Lane A, Kealy R, Heavey P. Experience of the menopause transition in Irish women and how it impacts motivators, facilitators, and barriers to physical activity engagement. BMC Women’s Health. 2024;24:666. DOI: 10.1186/s12905-024-03524-y.