If you’re an athlete who has undergone surgical menopause, you’ve probably noticed something frustrating. There’s almost no research that speaks directly to your experience. You’re not imagining it. While we know that menopause impacts performance, recovery, muscle mass, and bone health, the studies that exist mostly focus on natural menopause. Athletes in surgical menopause? That’s an afterthought—if it’s considered at all.
So why isn’t more research being done? Let’s dig into it.
The Numbers We Do Have
Every year, around 500,000 to 600,000 women undergo hysterectomies in the U.S. A significant percentage of these procedures include oophorectomies, meaning the ovaries are removed, plunging these women into immediate menopause. Unlike natural menopause, where the transition happens over years, surgical menopause happens overnight. The hormonal shift is drastic, and it can have major implications for energy levels, muscle retention, metabolism, and endurance.
If we assume that 15-20% of these women are athletes (based on national activity levels), that means roughly 75,000 to 120,000 athletes undergo surgical menopause every year. That’s not a small number. So why isn’t this group getting more attention?
The Gaps in Research
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It’s a niche population
Studies are often designed to have broad public health implications. Since athletes in surgical menopause are a smaller subset of both the athletic and menopausal populations, they tend to get overlooked. -
Funding is scarce
Medical research follows the money. Funding typically goes toward research that affects the largest populations or the most pressing public health concerns. While surgical menopause presents serious challenges, it hasn’t been prioritized in sports science research. -
Menopause research is already behind
We’re just now starting to see an uptick in research on natural menopause and athletic performance. Even within that, there’s a lack of studies focusing on peri- and postmenopausal women in endurance sports, strength training, or competitive settings. Surgical menopause is even further down the list. -
It’s complicated to study
Researching athletes in surgical menopause means accounting for a lot of variables: different sports, training loads, hormonal interventions (like HRT), and the effects of estrogen loss on recovery and performance. This makes large-scale, well-controlled studies more challenging and expensive to conduct. -
Historical gender bias in sports science
Women have been underrepresented in sports science research for decades. Most training studies have been based on male physiology, and only in recent years have we seen more focus on female-specific needs. Surgical menopause just isn’t on the radar for many sports scientists yet.
What We Do Know
Despite the lack of direct studies, we can pull insights from existing menopause and sports science research. Here’s what we know:
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Strength training is critical. Postmenopausal women benefit greatly from resistance training to preserve muscle mass and bone density. This is especially true for those in surgical menopause, who experience an abrupt decline in estrogen.
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Protein intake should be higher. Research suggests that postmenopausal athletes need more protein (at least 1.2g per kg of body weight) spread evenly throughout the day to help maintain lean muscle.
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Hormone Replacement Therapy (HRT) can help. HRT may help mitigate some of the muscle loss and metabolic slowdown associated with estrogen depletion. However, it’s not a one-size-fits-all solution and should be approached with medical guidance.
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Recovery takes longer. Women in menopause, especially those who’ve gone through it surgically, may need more focus on recovery strategies, including sleep, nutrition, and periodization in training.
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Bone health is a priority. Weight-bearing exercise, vitamin D, and proper strength training are essential to maintaining bone density, especially since surgical menopause increases the risk of osteoporosis.
Where Do We Go From Here?
More research is needed. Full stop. Athletes in surgical menopause deserve better data, better guidelines, and better support. If we can push for more studies, we can start building training protocols that help this population thrive instead of just getting by.
In the meantime, the best approach is to combine what we know from menopause research with individualized training and recovery strategies. Working with coaches and medical professionals who understand the unique challenges of surgical menopause is key.
The more we talk about it, the more we can change the narrative. If you’re an athlete in surgical menopause, you’re not alone. And it’s time the sports science world caught up to that fact.