Perimeno & menopause

[Marjaana]

Hey hey lovelies,

I’m finding myself being drawn to a deep dive into perimenopause and menopause lately, perhaps because of my own increasing age.

I found this interesting case study article :
https://www.researchgate.net/publication/372967128_Case_Reports_From_Women_Using_a_Quantitative_Hormone_Monitor_to_Track_the_Perimenopause_Transition
Note it’s not yet peer reviewed but what’s interesting is the case study subjects that used Mira care fertility tracker, just like the one we used with the Female Athlete study with Athletica, Mira care and HRV4training.

This study nicely illustrates how different the cycle characteristics are between women. It is a nice illustration of the changes that happens
. It is far from universal change and if you as an individual athlete want to learn what’s going on in your body as you transition into the next phase of womanhood, you need to do a study on yourself.

This study suggest that women past 47 don’t have regular cycles anymore. My cycle has been like a clockwork for years since I stopped taking OC 14 years ago. I have another year before hitting that “magical” 47 which this study suggest is the ceiling for normal cycle (at least based on these women in the study) I am curious to find out: am I blinded by my clockwork MC? Is it possible under the hood my body is working hard to keep those eggs coming? Do I even have an ovulation anymore?

To find out, I’m going to pull out my Mira care tracker and start a study of n=1.

What did you walk away with from the case study ?
What are your thoughts about what happens during perimenopause.? Do you have any signs? how do you think you should train during this transition? Let’s get the discussion going!

MJ

[KCamp]

I am 57 this year and was confirmed post menopausal at 52. I had a hysterectomy at 35 with my ovaries remaining. My oestrogen is very low and no HRT was suitable for me for many reasons. I could list many symptoms however I still train for Ironman races. I get slower by the year and my weight is unstable. I just recently checked in with my nutrition (using Stacy Simms book ROAR) and found my protein intake was way out (by 80gms) a day at least. I also now use BCAA tablets and clear protein powder. I will give you an update. Race is IM Switzerland 7 July. Any tips much appreciated ps I love my training plans.

[Marjaana]

Hey @KCamp i don’t know how this post slipped my attention but better late than never …

Here are my two cents:

1. Strength training backed by sufficient protein and overall energy intake with minimally processed foods. If you struggle to get enough protein (2-2.2g/kg) then opt for protein powder to aid overall intake.

Strength training as functional sports specific (strength endurance work on the bike, run uphill etc) and weight training, progressively getting into heavier weights and less reps. Let me know if you need help programming.
2. Sleep as hard as it can be for us. I’m sure you know the sleep hygiene tips already.
3. HIIT - I would possibly opt for short intervals to minimize overall strain. I find I recover way faster from short rather than long intervals.

I’m sure you’ll kick some butt again as always Kim!

[KCamp]

Thank you for your reply. When you get a chance, can you help with the weight programming. I have no clue where to start and what equipment to use. I have access to a good gym, so most equipment readily available.
Muchly appreciated!!

[Marjaana]

Yes I would love to!! Send me private message with your email and we will get started

[Marjaana]

@KCamp

Hey, send me an email to info@tiredmomruns.com - I’ve just finished building a fun strength training program specifically for peri-and menopausal women.

The aim is to build strength, mobility and bone health from the bottom up, starting with a body weight (no equipment) program and taking you in a journey to healthy, fit, strong menopausal and post-menopausal years. The program will move to weights eventually but there will always be alternative exercises to scale up or down depending on what you have available/ your strength etc.

I also have another program that teaches the basic lifting techniques that you may want to take before moving on to lifting heav(ier). And hey, remember, lifting heavy is relative and individual!

I will also help you schedule the workouts to fit and compliment your endurance training.

Let’s get this journey started!

If you are one of our perimeno-meno-or post-menopausal athletes, and want in on this - reply to this message.

Best; MJ

[Marjaana]

Hey all,

you may have seen this interesting article on Outside magazine by Alex Hutchinson: https://www.outsideonline.com/health/training-performance/new-study-womens-vo2-max/

In a nutshell, the article discusses the declining VO2max in recreational runners vs. non-exercising , sedentary women under & over 50. He refers to this article: https://www.sciencedirect.com/science/article/pii/S0531556524001189 a study done in Brazil, where they looked at impact of aging on VO2max.

They found:

1. Female runners had higher vo2max than sedentary women in both under 50, and over 50 year old age groups. (no surprise there)
2. Vo2max declined in both runners and sedentary women over 50 (no real surprise there either, although the next point is rather surprising to me).
3. The study states that “aging has a greater impact on VO2max in the runners group” as VO2max declined MORE than in the sedentary group over 50. (more on that below)
4. Looking at the VO2max adjusted by lean mass (they did a DEXA scan, and calculated VO2max ml/kg of lean muscle mass (typically expressed as whole body mass including muscle, tendon, bone, fat mass) and found that VO2max per lean mass was significantly influenced by aging.

When I first read this study, I was a bit confused. How can this be? Surely runners would retain their higher VO2max as they aged, and for sure, it would not declined MORE than in sedentary group. Right?!

Then I remembered I’m a sport scientist so I dug deeper into the study design.

Here’s my hot takes:

1. To better understand what happens with VO2max as women age - don’t take a snapshot but follow up with the participants after a period. Would be interesting if they repeated the VO2max and DEXA scans together with hormone profiles (to determine menopause status) after 5-10-15 years. Although the study has quite large group sizes (85 runners, 62 sedentary women), they only took the measurements once so they really got a snapshot.
2. Training status: the study gathered voluntary training history from the participants, 10k run time, running and strength training volume per week. The group over 50 trained less overall hours, but actually trained more strength than the group under 50 (3hrs vs. 2.5hrs). No description of how they trained. Steady runs, zone 2, HIIT?
3. 10K time comparison between groups.(64min for women over 50 vs. 51min women under 40). Notably, the group that consistent of women under 50, included age range 20-49. That is a rather large range from 20-49 yo, it goes without saying that one’s vo2max at 20 can be quite lot higher than at 49. Similarly, I assume the increase of 10K time from someone at 50 vs. at 70 years would tell us more about the inevitable VO2max decline rather than comparing a group seemingly arbitrary divide at 50. Were some of the women under 50 already in menopause? Possibly, because the study did not do hormone profiling at all. Are we comparing apples to older apples, or apples to oranges?

We know that women can experience perimenopause anywhere between 35 to 50 and perimenopause can last 5-10 years. In average, women go through menopause (defined as a timepoint when last period was 12 months ago) at 51 years of age. There are large individual differences in WHEN women get into perimenopause and the time line of how LONG their perimenopausal symptoms last before they get into menopause. This study did not really mention menopause at all, which I’ll talk about next.

I think menopause is relevant as we know that women who are approaching or in menopause experience:

1. declining estrogen and it’s effect on muscle, tendon tissue (women in perimeno and menopause often suffer tendon and ligament issues and it takes longer to recover from injuries). How does this affect training?
2. accelerated bone mass and muscle mass (strength and bone stimulating exercise essential)
3. weight gain - often around mid-line (caused by metabolic syndrome?)
4. increased intra-muscular fat tissue (does not necessarily cause loss of strength https://www.researchgate.net/publication/272514355_The_Relationship_between_Intramuscular_Adipose_Tissue_Functional_Mobility_and_Strength_in_Postmenopausal_Women_with_and_without_Type_2_Diabetes)

The study from Brazil does mention intra-muscular fat tissue as possibly explaining some of the decline of vo2max shown in their study. Will keep my eyes out for more on this.

I have so many questions that I would love to discuss with you.
Did the over 50 yo women run less because they were getting older and it gets harder ?
Did they know strength training is important as we age and were dedicating their time to strength training rather than running?
Did participant do VO2max specific interval work? Did training quality differ between the groups?
Is it possible to hold on to your higher VO2max by dedicating your time in a well-designed concurrent strength and endurance training program that takes care of your strength, balance, agility AND endurance (specifically VO2max) needs? I would be inclined to think that if you can hold on to your muscle mass, stimulate your bone mass, and work on your endurance with well-designed combo of Zone 2 and HIIT work (such that you can already find with Athletica) you should be able to hold on to VO2max and fight against the decline.

Keen on hearing your thoughts here everyone! Did I miss something ? Am I totally out in the woods? What did you take from the study? What would you change if you could design a study to assess decline in VO2max as women age.

I love reading more studies on aging women, please share if you know of any others looking at vo2max.

1-2-3 go!

[Marjaana]

Here’s an amazing podcast with Mary Claire Haver Dr. Mary Claire Haver on the N–Unlocking Us with Brené Brown – Apple Podcasts

[Marjaana]

Check out the latest episode of the Athlete’s Compass where we interviewed Tenille Hoogland, an expert in coaching perimenopausal and beyond women.
Full of practical tips highlighting the importance of being in health. Something as you all know we emphasize in Athletica as well.
Listen : Balance, Stress, and Performance: Tenille Hoogland's Advice for Women Athletes - The Athlete's Compass or watch
https://youtu.be/rJoLNqRiwnk?si=EsOa7f5jB9AJvxrF

Questions, comments

[Marjaana]

Happy World Menopause Day!

In honor of World Menopause Day on October 18th, we have prepared something amazing for all women and coaches of female athletes. We’ve got three free resources to help you navigate training, nutrition, and mindset during perimenopause and menopause. These episodes of the Athlete’s Compass podcast and a free summit will empower you to keep training smart and feeling your best!

And remember, if you are a male coach, these resources come in handy when coaching female athletes, so don’t skip these!

The Athlete’s Compass Podcast Expert Editions

On the episode #45 of the Athletes Compass, we had the pleasure of talking with the incredible Dr. Mikki Williden. We spoke about the challenges women face over 40, such as hormonal shifts affecting insulin sensitivity, sleep, and recovery. Learn actionable strategies like increasing protein, adjusting carb timing, and optimizing supplements like creatine to support endurance and performance. Follow Dr. Mikki Williden on socials: @mikkiwilliden.​

Learn from Dr. Mikki Williden on YouTube:

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On the episode #46 we had an engaging and lively chat with former pro triathlete Tenille Hoogland, who shares her experience as a coach and athlete of perimenopausal female athletes on how to adapt training to hormonal changes. Tenille emphasizes the importance of health, strength training, and listening to your body. Her practical advice will help you feel strong and empowered through mid-life.

Learn from Tenille on YouTube:

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FREE Event: “Being Athletic in Perimenopause and Beyond”

Lastly, we know you want to stay active, and continue pursuing your passions for the long term. Whether it’s tackling challenging workouts, going on adventures with family and friends, or simply feeling great in your body again, it can feel overwhelming to navigate all the advice out there.

There’s a lot of noise around what you should be doing—training methods, supplements, mindset and nutrition. But it doesn’t have to be that complicated. At Athletica.ai, we believe that no matter where you are in your fitness journey, you can train smarter, not harder, and embrace what your body needs to thrive.

Join Marjaana Rakai and me at this free summit, where we’ll dive into how to make your HIIT and Endurance training work for you! You’ll gain practical strategies to optimize performance, manage stress, and stay resilient for life. It kicks off on October 18th—don’t miss it! Our interview will be aired October 22nd.

Starting on October 18th for 7 days, my friend and Integrated Health and Sport Performance Coach Tenille Hoogland shares interviews of 20+ internationally renowned experts, who will dive into everything from performance optimization, stress management, recovery strategies, to the future of fitness technology.

This summit is your ultimate guide to keeping you on track with your athletic ambitions while navigating life’s demands, and we are proud to be part of it.

Sign up and register for the Being Athletic in Perimenopause and Beyond Summit. Being Athletic in Perimenopause and Beyond

Team Athletica