1. Hormones, Menopause and Swimming Performance Mary Pohlmann, M.D., Ph.D. Emeritus Clinical Faculty

2. Synonyms for Menopause The Change Climacteric Woman of a certain age “Silent Passage” Gail Sheehy

3. Definition of Menopause lack of menses for greater than one year usually comes naturally in women ages 45-55 can occur after oophorectomy, chemotherapy or irradiation perimenopause is the 3-6 years prior to menopause

4. Cause of Menopause Decrease in production of estrogen by the ovaries Some estrogen continues to be produced outside the ovaries, particularly in fatty tissue and the adrenal glands

5. Laboratory evidence of menopause Pituitary gland secretes  FSH and  LH in response to inability of ovaries to produce estrogen and progesterone

6. Symptoms of Perimenopause menstrual irregularity hot flashes or flushes night sweats insomnia vaginal dryness

7. How does menopause/perimenopause affect swimmers’ performance?

8. Fifteen female competitive Masters swimmers, ages 54 -74, completed a survey. They were asked about their training and performance during perimenopause/menopause. They were asked to what extent menopause seemed to affect their performance.

9. S/S Related to Menopause? Hot flashes/ flushes/ dehydration Decreased tolerance to warm water Muscle cramping Slower recovery from exercise Inadequate sleep/ night sweats/ fatigue Weight gain Aches and pains Improvement due to lack of menorrhagia

10. Other Factors unrelated to Menopause Interruptions in training Injuries (non-swimming activities) Moving No place to swim High blood pressure Arthritis, bad knees, fibromyalgia Stress Loss of strength and stamina Heart problems Asthma and other breathing problems

11. Hormone Replacement Use One had never used HRT. Four had not used HRT in the past 2 years Ten had used HRT in the past 2 years, but have discontinued use or are weaning off.

12. Bone Health 13 had bone densitometry done. One has osteoporosis and is taking medication for this. Two mentioned osteopenia - one is being treated for this. Two mentioned calcium supplementation. One mentioned weight-bearing exercise, but 11 indicated they do exercise other than swimming.

13. Are there gender differences in swimming performance as one ages? We compared 2004 USMS records for women over the age span of 40-59 with current USMS records for men over the same age span.

14. Method Current USMS men’s and women’s SCY records in all 18 events for age groups 40-44 through 55-59 were used. All times were converted to seconds. The ratio of the record for each event in each age group and for each gender was calculated with respect to the comparable record in the 40-44 age group. The ratios for all 18 events in a given age group were averaged (men and women separately). The averaged ratios were plotted over age groups for both men and women.

16. We also did a longitudinal comparison of individual males and females best times in each age group (40-54)

18. We also compared individual times longitudinally with current USMS records over the same age groups

21. There is a difference in the rate of slowing of swimming performance between men and women. Menopause alone is probably not the greatest factor influencing this difference. Keeping the age-related decline in swimming performance below 1% per year is definitely possible.