All women will experience menopause at some point in their life. Some have only mild symptoms but for others, the transition is debilitating.

A recent study in the U.K. conducted at the University of Gloucestershire by researcher Stephanie Bradley examined the impact of menopause and perimenopause on equestrians, and how it affected both sports performance and psychological well-being.

The average age of menopause is 51, but it can range from the early 40s to late 50s. Menopause is identified as the stage in life when a woman has not had a period for a full year. Perimenopause is the transition phase leading up to menopause when hormone levels fluctuate, which can cause symptoms such as irregular periods, hot flashes, sleep disturbances, and mood changes. 

“Everybody is different in terms of menopause symptoms,” said Dr. Wendy J. Smith, MD, MPH, a Portland, Oreg., based OB/Gyn who is an assistant professor at Oregon Health and Sciences University. “They can range from minimal symptoms to the classic hot sweats and flashes. Many women suffer from sleep disturbances — trouble falling asleep or waking up in the night — brain fog, memory issues, weight gain, libido changes, and urinary problems such as incontinence.”

During menopause, estrogen and progesterone levels drop sharply, while follicle-stimulating hormone (FSH) and luteinizing hormone (LH) rise because the body is trying unsuccessfully to stimulate the ovaries. The decrease in estrogen and progesterone can also lead to mood swings, irritability, depression, low self-esteem, and decreased resilience to stress.

“Women commonly have higher rates of mental health disorders during the menopause,” explained Dr. Smith, while the physical changes and lack of sleep can negatively impact mood. The reduction in estrogen also decreases the synovial fluid that lubricates your joints, increasing the likelihood of joint pain and inflammation, she added. “Therefore, you feel more pain when you are doing something active like riding, and equestrians may increasingly worry about falling due to the loss of bone mass and bone density,” Dr. Smith said. “This leads women to be less risky and more conservative, which can impact their confidence level. It can become a vicious cycle of fear.”

The 2024 U.K. study, titled The Impact of Perimenopause and Menopause on Female Equestrian Riders’ Performance, identified the challenges women experience with the aim of helping to improve coach awareness and support.

The key themes included:

• Physical discomfort and health changes, including joint pain (74%), weight gain (66%), and decreased physical strength (71%) affecting riding ability and enjoyment.

• Mental health and emotional well-being, with sleeplessness (74%), anxiety (78%), and a loss of confidence (76%).

• Riding confidence and ability, with a decrease in riding confidence (75%), particularly around jumping and faster work, fears of injury and a longer healing process, with 50% jumper/eventers opting for less risky disciplines or reducing the intensity of their riding.

• Support and awareness suggested there was a lack of support regarding menopause within the female equestrian community.

• Hormone Replacement Therapy (HRT) alleviated symptoms that interfere with riding and daily life.

From the 1,629 female equestrian respondents interviewed for the study, 71% rode at least twice a week; and more than 90% had ridden for over 20 years. They were asked questions such as “What happens to your confidence during peri-/menopause?”; “How does peri-/menopause impact coaching?”; and “What is the most impactful physical and emotional symptoms of peri-/menopause on your riding participation and performance?”

The respondents shared a multitude of issues that included finding competing more overwhelming and stressful than before; a lack of confidence; not having enough energy to ride; overheating; memory issues; urinary leakage; and physical, emotional and cognitive changes such as fear, joint pain, tiredness, weight gain, and anxiety. Many felt alone, embarrassed and ashamed due to the stigma around menopause, and 50% of riders stopped eventing or show jumping because of their symptoms.

Tracey Smale, who runs a boarding facility in Surrey, near London, wrote a dissertation titled The Experiences of Menopause in Female Equestrian Athletes for her MSc in Equine Science, at the Royal School of Veterinary Studies, University of Edinburgh. The 60-year-old former eventer stated that as equestrian sports are female-dominated and lifelong, they present a unique context for studying menopause. She conducted a 48-question survey with 147 respondents who either owned or leased horses. The results were similar to the University of Gloucestershire study, with participants citing fatigue, exhaustion, lack of motivation, and aching muscles as menopausal symptoms that led them to ride less than they used to. 

Conversely, Smale found that continuing equestrian activities and maintaining their riding schedule helped ease many women’s symptoms as it positively influenced their mental health and well-being. Positive comments included: “My horses kept me sane,” “My mare has been a good listener,” and “Equestrian activities kept me active and social.”

Dr. Smith agrees that physical activity — especially doing something you enjoy like riding — can decrease problematic menopause symptoms. “We know that exercise increases the ability to sleep and positively impacts your mood,” she said. “If it brings you joy and is uplifting, then it can absolutely help with menopause.” Studies show that staying active throughout life increases longevity and decreases many symptoms of aging for both genders.

The University of Gloustershire study recommended that when coaching clients who are going through menopause or perimenopause, trainers should:

• Be aware of symptoms; be kind, patient and understanding.

• Be sensitive and discrete.

• Support and encourage changed activities.

• Be flexible with coaching plans on the day.

• Sensitively signpost to relevant support networks.

Dr. Smith said that while menopause is still stigmatized, people are more forthcoming to talk about it than in past generations. “We need to continue to work on normalizing menopause as it is something that 50% of the population will go through,” she said. She encourages female equestrians to talk to their trainers and barn mates about their experiences. “If there is someone at the barn who is aligned with you, they may have had the same sort of reluctance to talk about it and will get a sense of relief if you bring it up with them. It just takes that initial opening to spark meaningful conversation and connectiveness.”

There are several treatments available to relieve menopause symptoms, ranging from hormonal therapy (HT or HRT); bisphosphonates to treat bone conditions; antidepressants such as SSRIs to improve mood; and Gabapentin for hot flashes. Supplements such as calcium or Vitamin D are beneficial, as are strength training, yoga, meditation and other relaxation techniques.

Above all else, Dr. Smith recommends finding a clinician, medical provider, physician, midwife or naturopath whom you are comfortable talking with who has a specialized knowledge in hormonal therapy and menopause so they can guide you as to all the options available.

October is World Menopause Month, visit the Menopause Society at menopause.org for more information and resources.