Menopause and the Active Female Aquatic Athlete: navigating the transition

As women approach the age of 40, many will enter the phase known as perimenopause, the years leading up to menopause.

For those who have been active throughout their lives, this transition presents a unique set of challenges and considerations. From hormonal shifts to changes in energy, mood and recovery – understanding how menopause impacts the body is essential for maintaining a healthy and effective exercise routine.

This resource explores the stages of menopause, how it affects the female body and practical strategies to support your ongoing performance and overall wellbeing for active women, especially those who enjoy aquatic activities.

What is the menopause?

The menopause is a natural biological process that marks the end of a woman’s menstrual cycles. It typically occurs between the ages of 45 and 55, with the average age being 51 in the UK.

Menopause is diagnosed when a woman has gone 12 consecutive months without a period. The process is accompanied by hormonal changes, which lead to various physical and emotional symptoms.

Before menopause, women go through a transitional phase called perimenopause, where hormonal fluctuations begin to occur. This can last several years and brings about changes that can impact everything from mood to physical fitness.

The new menopause generation

In the UK, attitudes toward menopause have evolved significantly in recent years. As more women live active lives, there is a growing awareness of how menopause impacts health and performance.

According to a 2021 report by Menopause Matters, more than 13 million women in the UK are affected by menopause and the number is expected to rise as the population ages. Many of these women are staying active and continue to pursue sports well into their 40s and 50s and beyond.

How active are women in the UK in terms of exercise?

Recent statistics suggest that physical activity among women in the UK is increasing, though there is still work to be done. According to Sport England¹, 38 per cent of women aged 45-54 do not meet the recommended levels of physical activity and 23 per cent are considered inactive*.

Menopause can be a time when women drop out of being active, as it can be a complicated, confusing and deeply personal experience for women, which can result in them disengaging from sport and physical activity.

Menopause can symbolise a loss of health, fertility, youth and femininity for some women. But it is also a time of rediscovery – a changing body free of menstrual cycles, more free time, time to focus on you and your health – it can be a positive time of transformation.

Many women are dedicated to staying fit as they enter and navigate the menopausal transition and water-based exercise remains one of the most popular forms for women, especially among those looking for low-impact, full-body workouts or those looking for an alternative to more strenuous forms of exercise they once did – to reduce the impact on ageing bones and joints.

For example, according to Swim England research, in the last 12 months, 12.5 million adults (26.9 per cent of the nation) went swimming – 6.8 million women and 5.6 million men. 2.3m women swim at least twice a month (9.9 per cent of the female population).

Those who are regulars in the pool know the benefits it can bring – developing, strengthening and stabilising muscles, joints and connective tissue throughout your body while also building cardiovascular health. The boost to mental health and mood from being in the water regularly should also not be underestimated.

Aquatic sport also contributes to:

• Improving / correcting posture – It can help counter the tendency for slouching and a rounding of shoulders by strengthening your core and allowing you to sit and stand up straight, in a position that helps supports your entire body appropriately.
• Improves proprioception – Proprioception is the awareness you have of your body and how it is moving within its environment. Proprioceptive ability can also decrease naturally as you age. This is part of what makes balance and coordination more difficult for older adults and it may also be part of why some older adults tend to walk with stooped posture or have difficulty climbing stairs. Being less active can speed this decline. But regular water-based exercise can help your body reinforce its innate sense of itself in space and help delay or offset declines in proprioceptive ability.
• Low-impact resistance training – Unlike running and other high-impact forms of exercise, water-based exercise is gentle on your joints. There is no pounding on your feet, knees, hips, lower back and spine, and the water provides gentle resistance that can help build strength and muscle tone without the jarring impact that weight-bearing, land-based exercises can have. All of these are great reasons to continue water-based exercises as you transition through menopause and beyond.

Let us explore what is happening to the body a little more in this transition period and what you can do to support yourself to minimise any upheaval and keep you in the pool.

Perimenopause: What’s happening to my body?

Perimenopause is the phase leading up to menopause, often starting in the late 30s or early 40s. During this phase, the ovaries gradually produce less estrogen and menstrual cycles become irregular.

Hormonal fluctuations can lead to changes in mood, energy levels, sleep patterns and even physical performance.

Signs and symptoms through the menopause transition

Common signs of menopause include:

• Hot flashes
• Night sweats
• Irregular and unpredictable periods
• Sleep disturbances
• Mood swings or irritability
• Decreased libido
• Vaginal dryness
• Joint pain or stiffness
• Weight gain, particularly around the abdomen.

It is important to note that not all women will experience all these symptoms and their severity can vary. During perimenopause, your cycle may fluctuate and you might feel more fatigued or moody. Listen to your body and adjust your exercise routine accordingly.

Women may notice:

• Fluctuating energy levels – Some days might feel like you are exercising effortlessly, while other days, it feels like you are fighting through every exercise. Track your cycle (or symptoms) to anticipate changes in energy levels and performance.
• Fatigue – Plan lighter training sessions during times of heavier fatigue. During perimenopause, your cycle may fluctuate and you might feel more fatigued or moody. Listen to your body and adjust your routine accordingly.
• Disrupted sleep – Hormonal changes can interfere with sleep, leading to more pronounced fatigue and a lack of desire to hit the pool.
• Joint discomfort or stiffness – Estrogen plays a key role in keeping tissues flexible and lower levels can contribute to stiffness in muscles and joints.
• Difficulty in managing periods and flow.

Menopause: What’s happening to my body?

Post-menopause refers to the years after a woman has not had a period for 12 consecutive months. At this point, the ovaries have significantly reduced their production of estrogen and progesterone, which can affect muscle mass, bone density and overall metabolic function.

While the worst of the hot flashes and night sweats may have subsided, there are other long-term issues to bear in mind as you live, work and exercise in a post-menopausal body from now on.

These can include:

• Lower estrogen levels can lead to a decrease in muscle mass, making it more challenging to maintain strength and performance in the pool.
• Bone health issues – Estrogen also helps maintain bone density, so post-menopausal women are at higher risk for osteoporosis.
• Weight gain and fat redistribution – Many women notice an increase in belly fat, which can alter overall body composition, swimming dynamics and one’s confidence in a swimsuit.
• Lower overall energy levels and slower recovery times, affecting overall athletic performance.
• Reduced endurance – Lower estrogen levels affect your cardiovascular system, potentially decreasing stamina and endurance during longer exercises.
• Changes in skin elasticity and increased dryness, making hydration and moisturisation key.
• Increased injury risk – Changes in collagen production and flexibility can lead to joint pain, stiffness and a higher risk of overuse injuries.
• Slower recovery – Decreased estrogen and progesterone can slow down muscle recovery, meaning you may feel more fatigued after training sessions.

As you transition through menopause, your body needs change, and so it is advisable to adapt your approach to fitness, considering a shakeup of your usual routine:

• Bring in some strength training / weight bearing activities – Building and maintaining muscle mass is crucial during menopause to combat muscle loss and you should consider upping the ante on some days and reducing it on others.
• Swimming is great for cardiovascular fitness, and as a form of low-impact resistance training, but incorporating weight-bearing exercises like walking / hiking, or a stronger form of resistance / strength training such as weightlifting or using resistance machines in the gym will help maintain bone density. Walking with a weighted vest is a great all-rounder.
• Prioritise flexibility – Regular stretching or yoga can help with joint stiffness and improve flexibility before and after a swim session.
• Moderate intensity workouts – Too much high-intensity or endurance exercise can increase stress and fatigue, so focus on a balance of moderate-intensity sessions, strength training sessions with rest days for an all-round exercise regime.
• Stay active consistently – Aiming for at least 150 minutes of moderate exercise per week will help manage weight, reduce stress and support heart health.
• Do not listen to anyone who tells you to take it easy just because you may be approaching 40, 50, 60 or 70 – go for it – mind over matter. The more active you are now, the better you will be in older age in terms of functional movement and overall health.
• Timing your workouts – Many women find they have more energy in the morning or after a good night’s sleep.
• Rest days are crucial – Take regular rest days to avoid burnout and help with recovery.
• Keep exercising – While you may need to adapt, the key is to play around with your routine so it works for you. Play around with the time you exercise, your number of sessions – intense sessions vs slower more gentle sessions – and using a mixture of exercise forms for all round fitness.

Diet for the menopausal woman: fuelling and exercising

Women in menopause may need to adjust their macronutrient ratios to maintain energy and focus:

• Protein: Aim to increase your protein intake to preserve muscle mass (especially important as estrogen levels drop), this means eating a healthy dose of protein with every meal.
• Carbs: Focus on complex carbs for sustained energy, particularly if you are swimming long distances or doing intense training.
• Fats: Healthy fats are key for hormonal balance, so include sources like avocados, nuts and olive oil.

Diet plays a pivotal role in managing menopausal symptoms while supporting an active lifestyle, so as well as looking at a healthy diet you may want to include some supplements too. Here is a list of key nutrients menopausal women often need:

• B vitamins: These help support energy, keeping these levels topped up as you age with a supplement is a great idea.
• Calcium and Vitamin D: These nutrients are essential for maintaining bone health.
• Healthy fats: Omega-3 fatty acids from sources like fish and flaxseeds can help manage inflammation and improve overall cardiovascular health.
• Magnesium (bisglycinate) is useful to the body in so many processes. Taking a supplement at bedtime can help to ease muscles and aid relaxation to support sound sleep.

For more information on nutrition for females undertaking sport, please refer to the Swim England female nutrition article.

If individual support is required, we suggest you arrange to see a SENR registered nutritionist or dietician.

For those with health issues, please contact your GP to seek medical advice around nutrition and supplements.

Sleeping well and recovering right

Quality sleep is essential for recovery and menopausal women often struggle with insomnia or night sweats. Tips for better sleep:

• Create a bedtime routine – Reduce screen time, make your room cool and dark, and practice relaxation techniques.
• Address night sweats – Wear moisture-wicking sleepwear and use cooling pillows.

Short overview of HRT and when you might want to seek medical advice

Hormone replacement therapy (HRT) is an option for some women to manage menopause symptoms like hot flashes, sleep disturbances and joint pain. It is essential to discuss HRT with a doctor to determine if it is the right choice based on individual health factors, including family history and any risk factors.

So often HRT can be the missing link in helping women to feel energised and ‘back to themselves’ again after the hormonal havoc of perimenopause. If you feel you want or need to take HRT, do bear in mind that it is better to start within the 10-year window of starting menopause – so do not leave it too late.

Conclusion

The transition into menopause is a significant change, but with the right approach to exercise, nutrition and self-care, active women can continue to thrive, both in and out of the pool.

Understanding the hormonal changes and adjusting your routine will help you maintain your fitness, manage symptoms and continue living an active, healthy lifestyle through every stage of menopause.

References

1. Sport England (2017) Active Lives Online [Query Criteria: women; age 45-54, inactive, fairly active, active] (https://activelives.sportengland.org). *According to the Chief Medical Officer (CMO), adults aged 19-64 should participate in at least 150 minutes of moderate intensity activity per week. These adults are described as active. Those that complete less than 30 minutes per week are inactive.