The common symptoms of the menopause - hot flushes and night sweats - can lead to dehydration to some extent. If you're an athlete and regularly getting sweaty, the combination of training and the menopause increases the risk of you becoming dehydrated. Although there are ways you can alleviate the symptoms of menopause...
Menopause. The mere mention of the word strikes fear into the hearts and minds of middle-aged athletes (and not only the female ones...). It's only saving grace seems to be the freedom from regular bleeding and the purchase of taxable feminine hygiene products!
Although it's an inevitable stage in every woman’s life, it’s physical, mental, and emotional manifestations can have a significant impact on everyday activities, including training and competing.
Amongst the common symptoms of 'the change', two have an impact on hydration; hot flushes (flashes) and night sweats.
Hot flushes (flashes)
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, a red flush (blushing), and they vary in severity from woman to woman. Three out of four women experience hot flushes during their menopause.
Some women only have occasional hot flushes which don’t really bother them at all, while others report 20+ hot flushes a day that are 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 oestrogen levels - and in your body's thermostat (the hypothalamus), which makes your body think it's too hot. This in turn stimulates a response designed to cool your body down. More blood is diverted to your skin (giving rise to the characteristic redness) and your sweat glands start working overtime.
When hot flushes occur at night time, they're known as "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.
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 these symptoms, dehydration.
Menopause and dehydration
In simple terms, dehydration is 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.
Independent of the 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.
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, the risk is further compounded!
Your performance can suffer when you’re as little as 2% dehydrated, though the threshold is different for everyone and sodium depletion has also been linked to exercise-related muscle cramps. In a nutshell, 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 recently…
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've struggled with this for at least 2 years, possibly more.
Being an athlete, I always thought the cramps I had were somehow related to training, or shoe drop, or wearing sandals or how I hung on the wall when swimming 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 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.
I came across you guys through your sponsorship of the ÖTILLÖ Swimrun World Series and had an Advanced Sweat Test at Four3 Performance in New Jersey. They gave me a plan for everyday hydration and also a plan for races.
I'm not a salty sweater - pretty average really - but constant hot flashes are just a steady drip, drip on the electrolyte and fluid level that I had not realised.
I take a 500ml (16oz) 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.
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 it's a story PH hear fairly often.
How to reduce the symptoms of menopause
Whilst regular exercise isn't a proven way to reduce symptoms such as hot flashes and sleep disturbances, it can help you maintain a healthy weight and relieve stress 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.
Being well hydrated before, during and after training and competition is key. But don't just rely on plain water, especially after hot flashes and night sweats. Adequately replacing the sodium you’ve lost in your sweat is crucial and it might also help you avoid exercise-related muscle cramps.
If you're prone to night sweats, having an electrolyte drink by your bedside can help you stay on top of your losses and sipping the odd bottle throughout days where you think dehydration is a particular risk is another good idea.
Precision Hydration's free online Sweat Test is a good first step for deciding which strengths are right for you in different scenarios.