Every woman I coach has had to deal their menstrual cycle kicking them in the backside at least once during their training. Some come on their period the day of their goal race (which is as much fun as it sounds, dealing with cramps, tenderness, and the sensation of bleeding everywhere). Others must deal with a tidal wave of hormonal changes that hit them “at a certain age.” Welcome to the peri/menopause.
I’ve had countless conversations with women who say the menopause – and the perimenopause – has hit them hard. Feeling teary and emotional mid-run; hot flushes and spiking heart rates; weight gain and feeling like a potato; and crucially, an unexplained dip in performance. Not by seconds but minutes. Running, once a source of pride in our bodies to do anything, becomes another mirror for looking at what they can’t.
The problem, yet again, is that the research doesn’t help the reality.
The research on menopause and running
As is the general trend with sports science literature into women, this topic is under-researched. [1] Where there is work, the link between menopause appears to be two-fold:
- Menopausal symptoms impact running performance
- Menopause comes alongside natural aging, which we know impacts running performance
A 2026 review of 29 studies into female masters’ endurance runners[2] concluded that while there was consistent age-related decline in running performance, ‘no studies considered the impact of menopause symptoms on exercise performance, despite their known negative effects’. Indeed, a lot of the declines, such as Vo2 max, were attenuated by training volume. The review did however hypothesise that as oestrogen has a cardioprotective effect, its loss could impact cardio functions (e.g. aerobic capacity). But as ever, we need more research.
An older study[3] that did review the direct link between menopausal status and declining performance found that the menopause “did not effect cardiorespiratory fitness when age and training were accounted for.” Of course that’s not to say it had no effect, just that causal links remain unproven.
Yet we know that women *do* experience such impacts. Another study[4] of 187 female masters’ athletes (including runners) found that the symptoms perceived to most negatively affect training and performance were:
- joint and muscular discomfort (experienced by 63% of the study)
- weight gain (67%)
- sleep problems (88%)
- physical and mental exhaustion (83%).
The other puzzling question is the role of hormone replacement therapy (HRT). If we assume it is the oestrogen loss that impacts performance, then surely HRT is the answer? You guessed it, the research is again limited. One review found that combining HRT and aerobic physical training can improve systolic blood pressure (linked to Vo2 max and other runner related benefits) more than training alone, but this only had 7 eligible studies and even then there were caveats. HRT doesn’t quite seem the performance enhancing drug it might be.
So what gives? Because while the literature doesn’t conclude that menopause (in itself) drives decline in running performance, in reality the two feel linked.
The reality of menopause and running
“The menopause is kicking me in the backside”
“It’s like starting again”
“I don’t know who I am anymore”
It seems patronising to dismiss decline in running performance as due to the symptoms of menopause, or just because of natural aging. To do so fundamentally misses the gap in performance women are suffering. We’re not talking a gradual drop in PB times, or taking the extra rest day. We’re talking about a fundamental change in the runner – 5 km times dropping by a third; an inability to complete long runs; changing pace boundaries where easy pace is now tempo (etc.)
So what can we do?
We can take certain elements from the science and apply them to practice. Starting with the runner’s main love = carbs. Menopause can influence the body’s use of fat and carbs during exercise, meaning that your previous diet may need reassessing. One relatively accepted principle is that post-menopause, women need more protein. For female endurance athletes, aim for around 1.2g of protein/ kg bodyweight per day, spread out across the day.[5]
Another common thread is the importance of strength training on retaining muscle mass. One review suggests that a 60-min session, three times a week, can improve aerobic fitness and muscles strength. [6]
We can also take the absence of literature as a blessing.
As a menopausal woman, you don’t necessarily need to do fewer intervals, have more rest days, or shorter long runs. You are not done yet. What you do need to do is modify your training approach based on how you feel. Heart rate can be a useful tool to gauge effort on any given day. The Rate of Perceived Exertion (RPE) scale is also helpful.
Give yourself slightly longer to train for key races, adding another block in to factor in more off weeks. Get creative with your training patterns – switch to more regular cut back weeks, or a 10 day training cycle, to match your symptoms. Capitalise on feeling good, switching quality days around to match your energy levels, not your schedule.
Yes, at times it is going to feel like running through treacle. But there is nothing in the literature to say that the menopause will stop you seeing benefits from your training. Expectations might need to adjust, as they all do when we age, but with the right tools and adjustments – you can kick the menopause in the backside.
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[1] “Invisible Sportswomen”: The Sex Data Gap in Sport and Exercise Science Research in: Women in Sport and Physical Activity Journal Volume 29 Issue 2 (2021)
[2] Effects of Aging on Determinants of Endurance Performance in Women Masters Athletes: A Scoping Review – PMC
[3] Effect of age and menopausal status on cardiorespiratory fitness in masters women runners – PubMed
[4] Frequency and perceived influence of menopausal symptoms on training and performance in female endurance athletes | PLOS One
[5] The role of dietary protein and vitamin D in maintaining musculoskeletal health in postmenopausal women: a consensus statement from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) – PubMed Note – active adults should be at the upper end of this baseline.
[6] Resistance training effects on healthy postmenopausal women: a systematic review with meta-analysis – PubMed