Perimenopause, Menopause, and Performance
This presentation explores how perimenopause and menopause can influence training, recovery, health, confidence and performance. It is designed for coaches, athletics leaders and support staff who want to better understand the athlete, official or coach in front of them, not just the session on the page.
Watch the full presentation
A detailed lecture on hormonal change, symptoms, musculoskeletal health and practical implications for sport.
Why this matters in athletics
Perimenopause and menopause are not simply health topics that sit outside coaching. They can affect how a person sleeps, recovers, manages load, interprets effort, responds to pressure and experiences pain, fatigue or confidence.
In athletics, this may show up in a masters endurance athlete who is suddenly struggling to recover, a throws coach dealing with poor sleep and brain fog, a team manager trying to perform under pressure, or an official managing hot flushes, irritability and fatigue across a long competition day.
Key takeaways for coaches
1. Think in stages, not stereotypes
Menopause is defined after 12 months without a period. Perimenopause is the transition around that point, where hormone levels fluctuate and symptoms can vary. The stage matters because symptoms and management options are not identical across the transition.
2. The period pattern gives important information
Changes in cycle timing, heavier bleeding or skipped periods can be meaningful. Coaches should never ask intrusive questions in public, but they can create a culture where athletes feel safe to raise menstrual and hormonal health concerns.
3. Symptoms are real, but not every problem is hormonal
Sleep disturbance, mood changes, headaches, palpitations, brain fog, hot flushes, sweats, aches and pains can all be part of the picture. At the same time, coaches should avoid assuming that every performance dip is menopause related.
4. Musculoskeletal health needs attention
Tendinopathy, joint pain, reduced muscle mass and bone health changes are especially relevant for athletics. Coaches should be alert to repeated bone stress injuries, sudden increases in tendon pain or recovery that no longer matches the training load.
5. Fatigue is not always a fitness problem
Heavy or irregular bleeding can increase the risk of iron deficiency, which can affect performance. When an athlete is unusually fatigued, struggling to recover or losing capacity, the answer is not always to push harder.
6. Strength work remains central
Progressive strength training, careful exposure to intensity and thoughtful recovery are important themes. The practical question is not whether an athlete should train hard, but whether the loading, recovery and nutrition match their current capacity.
7. Endurance is not the enemy
The lecture challenges simplistic claims. Some athletes may benefit from more strength, power and recovery emphasis, but endurance athletes still need endurance. The better approach is individual load management, adequate fuelling and careful monitoring.
8. Medical care is individual
Menopause hormone therapy, contraception, non hormonal treatments, nutrition and other supports are medical decisions. Coaches can encourage athletes and colleagues to seek qualified advice, but should not prescribe or promote a one size fits all solution.
Practical coaching implications
Build trust before you need it
Normalise conversations about health, recovery, energy, pain and wellbeing. Athletes are more likely to disclose concerns when the environment is respectful, private and matter of fact.
Track patterns
Use training notes to observe sleep, soreness, session rating, cycle changes, mood, heat symptoms and recovery. One poor session is noise. A repeated pattern is useful information.
Protect recovery like a training variable
If sleep is poor, symptoms are high or stress is elevated, consider adapting volume, density, intensity or technical complexity.
Be careful with rapid loading spikes
Tendon and bone symptoms deserve respect. Progress plyometrics, hill running, heavy lifting and high intensity work gradually, especially when symptoms or recovery are changing.
Refer early when red flags appear
Encourage medical review for stopped or irregular periods under 45, very heavy bleeding, repeated stress fractures, severe symptoms, significant mood change or symptoms that disrupt daily life.
Support the whole athletics workforce
This is relevant beyond athletes. Coaches, officials, managers and volunteers may also be performing under pressure while managing symptoms across long training nights and competition days.
Questions for coach reflection
What coaches should avoid
Do not diagnose from the trackside
Coaches can notice and ask supportive questions, but diagnosis and treatment belong with qualified health professionals.
Do not make it a character issue
Irritability, fatigue, pain, low confidence or poor recovery are not proof that someone is uncommitted. Look for context before judgement.
Do not sell certainty where evidence is still developing
There is interest in training changes, supplements and hormone therapies, but the evidence is not equally strong for every claim. Keep advice measured and individual.
Do not ignore the person’s role outside sport
Work, family, caring responsibilities, sleep disruption and stress often sit alongside training. The athlete’s life is not a side quest.
Health advice boundary
This resource is for coach education and general awareness. It does not replace medical advice, diagnosis or treatment. Athletes, coaches, officials or volunteers experiencing significant symptoms should speak with a GP, sport and exercise physician or appropriately qualified health professional.
Coaches play an important role by creating a respectful environment, adapting training intelligently and referring early when support sits outside coaching scope.
Use this resource with your coaching group
Watch the presentation, then use the reflection questions above to discuss how your squad or club can better support athletes, coaches and officials through midlife hormonal transition.
Open the presentation on Vimeo