by Precision Hydration
The mere mention of the word strikes fear into the hearts and minds of middle-aged athletes (and not only the female ones!). See 'menopause', think 'old', 'slow', 'fat', to name but a few adjectives that spring to mind. In fact, most women I know who’re experiencing “The Change” wish it would bloody well menostop.
Menopause is when a woman stops having periods and is no longer able to get pregnant naturally. The periods usually start becoming less frequent over a few months or years before stopping altogether. Sometimes they stop suddenly.
This is a natural part of ageing that usually occurs between the age of 45 and 55 as a woman's oestrogen levels decline. In the U.K., the average age for a woman to reach menopause is 51, but around 1% of women experience peri-menopause before they turn 40.
The only saving grace seems to be the freedom from regular bleeding and the purchase of taxable feminine hygiene products!
The seven dwarves of the menopause
Although menopause is an inevitable stage in every woman’s life, it’s physical, mental, and emotional manifestations can vary greatly from one woman to the next. However, most women will experience a core set of menopausal symptoms. Some of these can be quite severe and have a significant impact on everyday activities, including training and competing.
Common symptoms include…
- hot flushes (flashes)
- night sweats
- vaginal dryness and discomfort during sex
- difficulty sleeping
- low mood or anxiety
- reduced sex drive (libido)
- problems with memory and concentration.
Menopausal symptoms can begin months or even years before your periods stop and last around four years after your last period, although some women experience them for much longer.
Of course, menopause is not a modern phenomenon. These symptoms have been familiar to women of a certain age through the ages and while we think we're going through a hard time, spare a thought for what our predecessors experienced.
In her book, 'Hot Flushes, Cold Science: A History Of The Modern Menopause', Louise Foxcroft charts the fascinating and - more often than not, gruesome - history of The Change. From the time of the Ancient Greeks up until the 18th Century, menopause was seen as a natural phenomenon.
But over the course of the next three centuries, it came to be regarded as a disease and 'sufferers' were subjected to a raft of treatments ranging from the bizarre to the downright dangerous...
The renowned Victorian physician Dr Edward Tilt documents how he prescribed Mary, a 45 year old mother struggling with depression, hot flushes and insomnia caused by 'cessation', his 'usual mixture before meals' of carbonated soda and various other remedies, including opium, a large belladonna plaster to be placed at the pit of the stomach and vaginal injections with a solution of acetate of lead.
Further prescriptions included opium, hydrochlorate of morphine, chloric ether and distilled water. I won't even start on the clitoridectomy...
And it's not that long ago that menopausal women were just locked up on account of being insane.
It's enough to drive you to drink
But back to the 21st century.
If you've experienced/ are experiencing/ are observing (possibly from as far away as possible) menopause, you'll probably know something about the two most commonly reported and perhaps most irritating symptoms: hot flushes (or 'flashes' if you're from across the pond in the US of A) and night sweating.
Hot flushes are the most common symptom of the menopause when the ovaries gradually begin to make less estrogen and periods become less frequent (called 'perimenopause'). In fact, three out of four women experience hot flushes during peri/menopause.
Hot flushes are characterised by a sudden feeling of heat which seems to come from nowhere and spreads through the body. They can include sweating, palpitations, and a red flush (blushing) and they vary in severity from woman to woman.
Some women only have occasional hot flushes which don’t really bother them at all, while others report 20+ hot flushes a day that is not only uncomfortable but potentially disruptive and embarrassing. Hot flushes usually continue for several years after your periods stop. But they can carry on for many, many years – even into your 80s!
The precise cause of hot flushes isn't known, but it's most likely related to the changes in your reproductive hormones - specifically a fall in estrogen levels - and in your body's thermostat (the hypothalamus), which makes the body think it's too hot. This, in turn, stimulates a response designed to cool the body down. More blood is diverted to the skin (giving rise to the characteristic redness) and the sweat glands start working overtime.
When hot flushes occur at night time, they are called "night sweats". People who suffer night sweats will typically wake in the night to find their bedclothes and bedding drenched, even if their bedroom temperature is cool. Although harmless, night sweats can wake you from sleep and, over time, can cause chronic insomnia.
Sweating the small stuff
Despite the frequency and severity of hot flushes/night sweats in many menopausal women, there’s scant literature - or even anecdotal accounts - of another unwanted side-effect of The Change”…dehydration.
Regular readers of the PH blog will be no stranger to the definition, causes, and effects of dehydration. In simple terms, it’s when your body fluid levels drop significantly below the small normal day to day fluctuations that characterise being well hydrated. In practice, this is when you lose around 1% or more of your total body fluid.
Most people use the term 'dehydration' to describe this situation, but if we’re being picky, dehydration actually refers to the process of losing body water, “hypohydration” is actually the state in which we find ourselves when those losses become significant. If you’re interested in finding out more about how you can tell if you’re dehydrated, Andy’s blog on the topic is well worth a read.
Independent of menopause, the amount of water in our bodies decreases by ~15% (about 6L) between the ages of 20 and 80. With this decrease, the body becomes more susceptible to dehydration from the loss of a small amount of body water.
Our sensation of thirst also becomes dulled during exercise and this study suggests our body's ability to get back to 'business as usual' following dehydration is slower relative to younger individuals.
If you’re an athlete, increased periods of sweating when you’re training and competing already increase the risk of you becoming dehydrated, so if you suffer from menopausal hot flushes or night sweats, you're further compounding that risk.
In a sporting context, exercise performance can be impaired when you’re as little as 2% dehydrated. Losses in excess of 5% of body weight can decrease the capacity for work by about 30%. And sodium depletion has also been linked to exercise-related muscle cramps. Again, Andy’s written an excellent blog on the different potential causes of cramp that’s well worth a read if you suffer from them.
In a nutshell, one of the main theories behind exercise-related muscle cramp is the ‘Dehydration/Electrolyte Theory’. This speculates that if you lose a lot of sodium and don’t replace it (as is common when you sweat a lot), this can cause fluid shifts in the body that in turn causes cramps. If you suffer from cramps during or after periods of heavy sweating (either due to hot flushes or athletic activity), you may be interested in the advice of a recent convert to Precision Hydration.
Kerry (not her real name) wrote to the PH team earlier on this year and Andy shared this with me when I was researching this blog…
"Just wanted to let you know that I've been using PH to counter a big problem I’ve had with cramps from menopausal hot flashes. I have struggled with this for at least 2 years, possibly more. Being an athlete, I always thought the leg and body cramps I had were somehow related to training, or shoe drop, or wearing sandals or how I hung on the wall when swimming or ... or ... you name it, I changed it in an attempt to get to the bottom of this!
I pretty much had to give up running, I had an MRI on my calves etc, etc.
I came across you guys through your sponsorship of the OTILLO Swimrun World Series and I took your online Sweat Test, but wanted to get my hydration plan really dialled in, so took an Advanced Sweat Test with Jackie at Four3 Performance in New Jersey. She has me on a plan with PH for everyday hydration and also a plan for the race.
I'm not a salty sweater - pretty average really - but constant hot flashes just are a steady drip, drip on the electrolytes and hydration that I had not realised. I take a 500ml bottle of PH 500 with me to bed and it's usually all gone in the morning. This was key, previously I was starting the day already dehydrated and then never quite catching up. I take in another 500ml PH 500 bottle during the day, this is just for day-to-day “maintenance” and I drink on top of this when I’m training.
I felt old, really old - stiff joints, achy, cramps everywhere triggered by anything, wrecked legs post-race that had me missing a week of training, tendon cramps that were like sprained ankles afterwards (changing gears in the car caused my feet to cramp). It was bad.
Other than no longer suffering with cramps, the big difference I have noticed is that I feel about 10 years younger! Also I came out of a major brain fog. Yes, being able to work out without cramps (and the reassurance of no cramps) is fabulous, but the really valuable benefit is the day to day feeling of being back to normal. I still have the hot flashes, but now they’re manageable and have even reduced in frequency because my hydration plan is right for me.”
Of course, this is just one anecdote, but it shows the difference hydrating properly can make to your menopausal symptoms and PH tell me it's a story they hear fairly often.
It's not all blood, sweat, and tears
So, what are some of the things you can do to ease the symptoms of menopause?
Well, whilst regular exercise isn't exactly a proven way to reduce menopausal symptoms such as hot flashes and sleep disturbances, it can help maintain a healthy weight, relieve stress and improve your quality of life so, as difficult as it can feel sometimes, it’s advisable to keep your activity levels up when you’re going through The Change.
If you’re experiencing hot flushes it may also be better to train in the morning to avoid exercising during the hottest part of the day.
Staying well hydrated before, during and after training and competition is key, but don't just rely on water. You need sodium, in particular, to help you absorb and retain fluid and adequately replacing the sodium you’ve lost in your sweat can also help you avoid exercise-related cramp. Precision Hydration's electrolyte drinks come in different strengths and their free online Sweat Test is a good first step in deciding which strengths are right for you in different scenarios.
Mel Varvel is Founder of Totally Wonderful, a one-of-a-kind mobile catering business on a mission to help athletes of all ages and abilities to reach for the stars by providing honest, healthy, natural, nutritious and delicious food that's simply out of this world. Her most notable race results include a silver medal in the ITU World Duathlon Championships in Gijon, Spain in 2011, being First female and second overall in the inaugural Rat Race 'The Wall' Ultra (from Carlisle to Newcastle- 69 miles) in 2012 and Overall winner (male and female) of the Round the Rock Ultra (48 miles) in Jersey in 2013.