Certain transitions in life can be challenging. During puberty, there are a lot of physical and hormonal changes that can be overwhelming and difficult to manage.
As inevitable as getting your first period and beginning menstruation is for girls, so too is the end of the chapter of menstruation marked by menopause that comes later in life.
Going through menopause is described to be a drawn-out transition involving a host of physical, emotional, and mental symptoms that vary from individual to individual but often include notable, uncomfortable sensations such as hot flashes, extreme fatigue, mood changes, and difficulty sleeping.
Given all of the symptoms that women experience through perimenopause and menopause, it’s no surprise that menopause can affect exercise performance. If you are approaching menopause, it can be really helpful to understand how menopause and running may affect your performance and what to expect with menopause workouts.
In this guide on menopause and running, we will discuss how the impact of menopause on running and exercise, what to expect with menopause and exercise in general, and tips for running through menopause.
We will cover:
- What Is Menopause?
- Symptoms of Menopause that Affect Running
- Can Running Alleviate the Symptoms of Menopause?
- 5 Tips for Menopause and Running
Let’s dive in!
The Honest Truth: How Menopause Actually Changes Running
The menopause-and-running narrative has shifted significantly in the last 5 years. The advice that worked in your 30s and 40s — same training, recover with sleep, eat normally — under-serves runners through peri-menopause and beyond. The physiological shifts are real, individual variation is enormous, and the training adaptations that work look different from the standard endurance prescription.
1. The oestrogen drop affects more than hot flashes
Oestrogen is anabolic for muscle and bone, regulates body temperature, and supports recovery. The peri-menopausal decline produces measurable losses in muscle mass, bone density, and recovery rate even at unchanged training loads1Stachenfeld NS. Hormonal changes during menopause and the impact on fluid regulation. Reproductive Sciences. 2014;21(5):555–561.. The performance and body-composition changes most peri-menopausal runners notice aren’t a training problem — they’re a hormonal-substrate problem that requires a different intervention than “more miles.”
2. Heavy strength training becomes non-negotiable
The single most-replicated intervention in the menopause-and-exercise literature: heavy resistance training (3–5 sets, 4–8 rep range, near-maximal loads) preserves muscle mass, bone density, and metabolic health more reliably than moderate resistance training plus aerobic work alone2Wright VJ, Schwartzman JD, Itinoche R, Wittstein J. The musculoskeletal syndrome of menopause. Climacteric. 2024;27(5):466–472.. The “go heavy or go home” advice that sounds out of place for endurance runners is actually the most-supported menopause-running prescription. Two heavy sessions a week, compound lifts, full recovery between sessions.
3. Protein intake bumps to ~1.6 g/kg/day
Pre-menopause, the standard endurance-runner protein recommendation is 1.2–1.4 g/kg/day. Through peri-menopause and post-menopause, the literature increasingly supports a bump to 1.6–1.8 g/kg/day to maintain muscle mass against the anabolic resistance that develops with declining oestrogen3Mauvais-Jarvis F, Bairey Merz N, Barnes PJ, et al. Sex and gender: modifiers of health, disease, and medicine. The Lancet. 2020;396(10250):565–582.. For a 65 kg runner, that’s ~105 g/day — distributed across 4–5 feeds. This is alongside the heavy strength training, not as a substitute.
4. Sleep architecture changes — and matters more
Hot flashes and night sweats fragment sleep architecture in 60–80% of peri-menopausal women, reducing deep-sleep time and recovery hormone secretion. The impact on training capacity is large but under-discussed: poor sleep capable runners regress as fast at 50 as decade-ago training would have predicted at 70. Sleep hygiene (cool bedroom, consistent timing, alcohol cut-off) becomes a performance variable, not a wellness suggestion. HRT consultation with a menopause-trained GP is genuinely worth the time for sleep recovery alone.
5. Thermoregulation during running
Hot flashes during runs are a real performance constraint, not just discomfort. Stachenfeld’s work shows menopausal runners reach the same body-core temperature at lower exertion levels and tolerate it less well. Practical adjustments: cool-down before runs not just after, more frequent water + electrolyte intake during runs, lighter clothing layers, mid-run cooling stops in summer. Treating heat tolerance as something that has to be re-managed isn’t weakness — it’s adapting to a different physiological reality.
Frequently Asked Questions
Should I take HRT for running performance?
HRT is a medical decision with a competent menopause-trained GP, not a performance decision. That said, recent literature suggests HRT can support sleep, mood, and bone density in ways that benefit training capacity. The 2002 WHI scare that put many GPs off HRT is now largely re-evaluated; the modern body of evidence favours individualised HRT for many women through peri-menopause. Get the medical assessment first; the running benefits follow if HRT is right for you.
Why am I gaining weight at the same training load?
Three things change simultaneously in peri-menopause: muscle mass declines (lower BMR), insulin sensitivity drops (more carb storage as fat), and sleep fragmentation alters hunger hormones (ghrelin/leptin imbalance). The training stays the same; the metabolic context shifts. Strength training, protein intake bump, and sleep prioritisation all push back against this — sometimes successfully, sometimes only partially.
Are PRs still possible after menopause?
Distance-event PRs are absolutely possible — many female runners hit lifetime marathon and ultra PRs in their 50s with the right training adjustments. Sprint-event PRs are harder because top-end neuromuscular power declines faster than aerobic capacity. The age-grade calculator (see age-grade calculator) is a more honest measure than absolute time for tracking improvement post-menopause.
Is fasting good or bad for menopausal runners?
Generally, the evidence leans against extended fasting for peri-menopausal women specifically. The combination of declining oestrogen + low energy availability accelerates bone loss and muscle loss. The pre-menopausal evidence base for intermittent fasting doesn’t cleanly transfer. Eating regularly through the day with adequate protein at each feed is the safer approach for most peri/post-menopausal runners.
When should I see a doctor?
Cycle changes, hot flashes, sleep disruption, mood changes, and joint pain that meaningfully affect training are all reasons to see a menopause-trained GP. The British Menopause Society and the Australasian Menopause Society both maintain registries of menopause-trained doctors. Don’t wait until your training is significantly compromised — earlier intervention prevents much of the running-relevant decline.
What Is Menopause?
Menopause refers to the eventual cessation of the menstrual period. It typically occurs between the ages of 45 and 55, with plenty of variation, and some women will enter perimenopause—the precursor to menopause—as early as 40 or even younger if there are hormonal issues.
The reason that menopause occurs is that all biological females are born with a finite number of eggs (nearly 2 million!), termed oocytes, in their ovaries.
During puberty, the hormonal profile of a girl changes such that ovarian follicles develop. Each month (or roughly 27-32 days), one of the eggs will mature within a follicle, becoming an ovum that is then released during ovulation.
The ovum travels down the fallopian tubes. If it is fertilized by sperm, the ovum and sperm will fuse into a zygote and become implanted into the uterus to begin a new life. If the ovum is not fertilized by sperm, it will eventually be shed along with the uterine lining during a menstrual period.
Not all of the eggs the biological female is originally born with will eventually mature into an ovum, and an even smaller number eventually reach ovulation. This number is said to be around 400, meaning that in the average woman’s lifetime, she may experience around 400 periods, depending on whether she has children or not.
If you have an average of 12 periods a year, this works out to 33 years of menstruation. According to the National Health Service (NHS) in the UK, The average starting age for the first period is 12, and the data indicates that this is similar in the United States.
Therefore, menopause can be expected around the age of 55. However, in the several years leading up to the last period, the number of viable eggs remaining is significantly less (around 1,000 versus the initial 2 million), and periods become infrequent.
This is known as perimenopause and is associated with the beginnings of the symptoms characteristic of menopause. During perimenopause, estrogen levels often fluctuate, and this stage may last from several months to several years.
Menopause is marked by the absence of a period for one year if the woman is over the age of 50 or two years if she is younger than 50 years old.
After menopause, there is actually a third phase, termed post-menopause, in which symptoms of menopause may still persist for several years, depending on the individual.
How Does Menopause Affect Running
Although menopause is a normal process of healthy aging, it is still associated with side effects that can not only alter how you feel in your daily life but during your running and menopause workouts as well.
Here are some ways in which running and menopause interact in challenging ways:
#1: Fatigue
One of the seemingly unavoidable side effects of menopause is unexplained fatigue, which can make exercising during menopause physically difficult and motivationally unappealing.
#2: Irregular or Heavy Bleeding
Periods often become unpredictable and may even be unduly heavy before they stop, which can be difficult to manage while running.
#3: Urinary Incontinence
Due to the decrease in estrogen associated with menopause, stress incontinence (urinary leakage) may worsen or set in.
Running can increase stress incontinence and make it harder to control urine retention. Some women find they need to wear a pad and have to make frequent stops during menopause running workouts.
#4: Breast Pain
Running during menopause can be uncomfortable if you have increased breast pain and tenderness. Even with a good sports bra, the bouncing can be painful, and some women note extreme nipple sensitivity, which can make wearing a sports bra challenging.
#5: Achiness
Muscle and joint pains are common, which can be exacerbated by running, or you might get unduly sore after menopause workouts that you previously could do with ease.
#6: Weight Gain
The changing hormonal profile is often associated with weight gain, which can make running harder since the weight gain is fat mass, not lean body mass.
#7: Hot Flashes
Hot flashes make it hard to control our temperature during exercise and may disrupt sleep, leading to more fatigue.
#8: Headaches
Headaches can make it unappealing to exert yourself and exercise during menopause.
#9: Emotional Changes
Anxiety, a decrease in competitive drive, and depression associated with menopause can certainly interfere with your motivation to run during menopause.
#9: Clumsiness
There is often a decrease in coordination or issues with balance, focus, clumsiness, and preciseness with movements, which can increase the risk of falls and injuries.
Can Running Alleviate the Symptoms of Menopause?
The good news is that while running during menopause can be more challenging and often less appealing, exercise has been shown to reduce the symptoms of menopause.
Furthermore, exercise and running during and after menopause can help prevent common age-associated decreases in physical health and fitness associated with menopause, such as a decrease in muscle mass and strength and a decrease in bone density, which can lead to osteoporosis and increased risk in bone fractures.
Additionally, running during menopause can be a way to help prevent weight gain that is often associated with the transition.
According to the Mayo Clinic, getting regular physical activity before, during, and after menopause is crucial for maintaining optimal health and easing the transition through this life stage. In addition, exercise during and after menopause can also help reduce the risk of certain cancers and can help boost your mood and combat depression.
5 Tips for Menopause and Running
Here are some tips for running safely through menopause and beyond:
#1: Incorporate Strength Training
Strength training 2-3 times per week with total-body workouts can help attenuate the losses in muscle mass and strength and can keep your tendons healthier as well, the integrity of which can diminish due to the decrease in estrogen during menopause.
These benefits of strength training can help support your running and reduce the risk of injuries and can keep joints healthy.
#2: Incorporate More Cross-Training Workouts
One of the primary benefits of running before, during, and after menopause is that it is a high-impact activity, so it helps build bone density.
However, if you are suffering from bone mineral loss or already have osteoporosis, swapping out some of your running workouts for low-impact cross-training workouts can help prevent the risk of stress fractures.
Consider the elliptical, cycling, swimming, or incline walking once or twice a week.
#3: Focus On Recovery
You may find that when you are running during menopause, you are more sore, tired, and slow to recover after your workouts. Focus on incorporating recovery modalities into your daily running routine. Examples include foam rolling, stretching, icing, and getting more sleep.
It can also be helpful to quantify your state of recovery and your body’s physiological readiness to run.
Some of the higher-end GPS running watches, such as the Garmin Forerunner 955 and the WHOOP 4.0 monitor your body’s heart rate variability and other biomarkers of recovery and actually give you actionable information about your readiness to push your body during your next workout.
Getting one of these devices can be extremely helpful in guiding your training without overdoing it.
#4: Get a Running Buddy
If you find that your motivation to run is waning, look for a running body or exercise companion to accompany you on your workouts. This can help increase accountability and can make the workout more enjoyable.
#5: Stay Positive
Running through menopause and beyond is not easy, so give yourself some grace and a big pat on the back for doing your best to get through it.
Looking to take our advice and add some cross-training to your weekly fitness schedule? Check out our cross-training guides to choose some activities you will truly enjoy!
Low-Impact Cardio Workouts To Try
Alternatives to Running: 16 Fun Cardio Ideas To Replace Running
References
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