{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:53:45Z","timestamp":1791474825145,"version":"4.3.4"},"reference-count":52,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Heart, Blood, Lung Institute","award":["K01 HL159348-01"],"award-info":[{"award-number":["K01 HL159348-01"]}]},{"DOI":"10.13039\/100009980","name":"Old Dominion University","doi-asserted-by":"publisher","award":["N\/A (Salary)"],"award-info":[{"award-number":["N\/A (Salary)"]}],"id":[{"id":"10.13039\/100009980","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>\n                    Menopause is associated with several negative health concerns and common menopausal symptoms. Physical activity is essential to mitigate these negative effects, but menopausal symptoms may interfere with participation in physical activity. The purpose of this study was to determine the frequency and the perceived negative effect of menopausal symptoms among female endurance athletes. Female runners, cyclists, swimmers, and triathletes 40\u201360 years of age were recruited (\n                    <jats:italic>N\u2009=\u2009<\/jats:italic>\n                    187). Participants completed an online, anonymous survey that included self-reported menopausal status; the Menopausal Rating Scale (MRS), a validated measure for assessing menopausal symptoms; and the perceived effect of menopausal symptoms on training and performance. Kruskal-Wallis tests were used to examine differences in total MRS scores among participants reporting no, slight, moderate, and strong negative effects of symptoms on training and performance. The most commonly reported menopausal symptoms were sleep problems (88%), physical and mental exhaustion (83%), sexual problems (74%), anxiety (72%), irritability (68%), depressive mood (67%), weight gain (67%), hot flushes (65%), and joint and muscular discomfort (63%). The symptoms that were perceived to most negatively affect training and performance were joint and muscular discomfort, weight gain, sleep problems, and physical and mental exhaustion. Participants with a perceived strong negative effect of symptoms on training and performance demonstrated higher total MRS scores compared to participants reporting no negative effect or slight negative effect of symptoms on training and performance (p\u2019s\u2009\u2264\u2009.001), suggesting women with more severe menopausal symptoms had a greater perceived negative effect of symptoms on training and performance. In summary, frequency of menopausal symptoms among female endurance athletes is high and severity of menopausal symptoms is similar to that reported in the general population. Despite high physical activity levels in this population, clinicians should address these symptoms to promote continued participation in physical activity.\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0335738","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T18:21:48Z","timestamp":1765995708000},"page":"e0335738","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Frequency and perceived influence of menopausal symptoms on training and performance in female endurance athletes"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4685-2482","authenticated-orcid":true,"given":"Heather M.","family":"Hamilton","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie M.","family":"Yarish","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin E.","family":"Heron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"key":"pone.0335738.ref001","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1210\/jc.2011-3362","article-title":"Executive summary of the stages of reproductive aging workshop 10: addressing the unfinished agenda of staging reproductive aging","volume":"97","author":"SD Harlow","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"issue":"10","key":"pone.0335738.ref002","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1097\/GME.0000000000001424","article-title":"The menopause transition and women\u2019s health at midlife: a progress report from the Study of Women\u2019s Health Across the Nation (SWAN)","volume":"26","author":"SR El Khoudary","year":"2019","journal-title":"Menopause"},{"issue":"8","key":"pone.0335738.ref003","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1097\/GME.0000000000000499","article-title":"Sleep and menopause: a narrative review","volume":"22","author":"JL Shaver","year":"2015","journal-title":"Menopause"},{"issue":"3","key":"pone.0335738.ref004","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.maturitas.2007.01.009","article-title":"Assessing menopausal symptoms among healthy middle aged women with the Menopause Rating Scale","volume":"57","author":"P Chedraui","year":"2007","journal-title":"Maturitas"},{"issue":"6","key":"pone.0335738.ref005","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1097\/GME.0000000000001752","article-title":"Genitourinary syndrome of menopause: a systematic review on prevalence and treatment","volume":"28","author":"N Mili","year":"2021","journal-title":"Menopause"},{"issue":"11","key":"pone.0335738.ref006","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1089\/jwh.2012.3719","article-title":"The impact of menopausal symptoms on quality of life, productivity, and economic outcomes","volume":"22","author":"J Whiteley","year":"2013","journal-title":"J Womens Health (Larchmt)"},{"key":"pone.0335738.ref007","author":"US Census Bur"},{"issue":"1","key":"pone.0335738.ref008","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.maturitas.2014.09.009","article-title":"Physical activity and menopause-related quality of life - a population-based cross-sectional study","volume":"80","author":"K Mansikkam\u00e4ki","year":"2015","journal-title":"Maturitas"},{"issue":"3","key":"pone.0335738.ref009","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1002\/jcsm.12547","article-title":"Muscle and bone mass in middle-aged women: role of menopausal status and physical activity","volume":"11","author":"S Sipil\u00e4","year":"2020","journal-title":"J Cachexia Sarcopenia Muscle"},{"issue":"6","key":"pone.0335738.ref010","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1016\/j.jada.2008.03.015","article-title":"Physical activity is associated with risk factors for chronic disease across adult women\u2019s life cycle","volume":"108","author":"K Woolf","year":"2008","journal-title":"J Am Diet Assoc"},{"key":"pone.0335738.ref011","doi-asserted-by":"crossref","first-page":"107924","DOI":"10.1016\/j.maturitas.2024.107924","article-title":"Exercise for peri- and postmenopausal women: Recommendations from synergistic alliances of women\u2019s medicine and health psychology for the promotion of an active lifestyle","volume":"185","author":"D Godoy-Izquierdo","year":"2024","journal-title":"Maturitas"},{"issue":"7","key":"pone.0335738.ref012","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1249\/MSS.0b013e318213fefb","article-title":"American College of Sports Medicine position stand. 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