Running During Perimenopause: How to Adapt Your Training and Keep Going

Running in Perimenopause: The Same Sport, a Different Body

If you have been running for years and suddenly find that your body is responding differently, you are not alone and you are not imagining it. Perimenopause changes how your body handles training load, recovery, and even terrain. What worked in your 30s might leave you overtrained, injured, or utterly depleted in your 40s and 50s.

The hormonal changes of perimenopause, primarily declining estrogen and progesterone, affect everything from tendon elasticity to bone density to cardiovascular recovery. This does not mean you need to stop running. For many women, running remains a deeply valuable part of life: for mental health, for community, for the simple satisfaction of it. But it does mean that how you run needs to evolve.

How Perimenopause Changes Your Running Body

Estrogen has anti-inflammatory properties and plays a role in maintaining collagen and elastin in tendons and ligaments. As levels drop, tendons can become stiffer and more prone to overuse injury. Achilles tendinopathy, plantar fasciitis, and knee issues all become more common in perimenopausal runners. This is not inevitable, but it is a real pattern worth knowing about.

Bone density decreases with falling estrogen, raising the risk of stress fractures. If you run high mileage on hard surfaces and have low bone density, your risk increases. A baseline DEXA scan is worth considering if you are in your mid-40s or later and have not had one.

Muscle recovery takes longer. The muscle protein synthesis response to exercise declines somewhat as estrogen falls. What used to recover in 48 hours may now take 72. Ignoring this and training through persistent soreness is one of the fastest paths to burnout or injury during perimenopause.

Sweating and thermoregulation also change. Perimenopausal women often overheat more easily during runs. Starting at a lower effort level and building up more gradually during a session helps the body regulate temperature better.

Adapting Your Training Load

The biggest shift most perimenopausal runners need to make is building more recovery into their training. If you have been running five or six days a week, dropping to four or five with deliberate easy days between hard efforts is a sensible adjustment. Easy days should be genuinely easy, not a slow version of your usual pace that still leaves you tired.

Mileage increases should be conservative. The old ten percent rule (never increase weekly mileage by more than ten percent) was always a good guideline and becomes more important during perimenopause. Your tissues need time to adapt to load, and that adaptation time lengthens as hormonal support decreases.

Incorporating strength training alongside running is one of the most effective changes you can make. Strengthening the hips, glutes, and core reduces injury risk, supports proper running mechanics, and helps preserve the muscle mass that estrogen decline otherwise accelerates.

Fueling and Hydration: Getting It Right

Underfueling is a common problem among women runners in perimenopause, and it compounds the challenges of hormonal change. Low energy availability suppresses estrogen production, speeds bone loss, and impairs recovery. If you are running significant mileage and eating very little, your body is under more stress than the training alone would suggest.

Protein intake is especially important. Aim for at least 1.2 to 1.6 grams per kilogram of body weight per day. Getting 20 to 30 grams of protein within a couple of hours after your run helps muscle repair and recovery.

Hydration needs are higher in perimenopause because hot flashes and night sweats increase fluid loss. Starting runs well hydrated, carrying water on runs longer than 45 minutes, and replacing fluids promptly after running all matter more now than they may have in your 30s.

Pelvic Floor and Joint Considerations

Running is a high-impact activity, and the pelvic floor absorbs significant force with every stride. Declining estrogen contributes to pelvic floor tissue changes, and for women who have had pregnancies, existing weakness can become more symptomatic during perimenopause. Leaking urine during runs, a sense of heaviness, or pelvic pressure during or after running are signs worth taking seriously.

A pelvic floor physiotherapist can assess your specific situation and create a targeted exercise plan. Many women are surprised to find that their symptoms improve significantly with the right intervention, and that they can keep running without limitations.

For joint pain, particularly in the knees and hips, adding more cushioning to your footwear and running on softer surfaces when possible can reduce impact. Replacing running shoes that have passed their mileage limit (usually around 400 to 500 miles) is a simple and often overlooked intervention.

The Mental Health Case for Keeping Running

Running is one of the most effective natural interventions for mood, anxiety, and depression. During perimenopause, when hormonal fluctuations can destabilize mood significantly, the mental health benefits of running are arguably more important than they have ever been.

Consistent moderate aerobic exercise like running reduces cortisol reactivity, supports serotonin production, and improves sleep quality. Women who run regularly through perimenopause often describe it as an anchor: something that stays consistent even when everything else feels unpredictable.

If you find that your running is suffering due to perimenopause symptoms, adjusting the relationship rather than abandoning it entirely is usually the better path. Running slower is still running. Running shorter is still running. Running with more walk breaks is still running.

Signs You Need to Scale Back vs. Signs You Can Push Forward

Knowing when to rest and when to train is always nuanced, and perimenopause adds another layer. Signs that you need genuine rest include persistent fatigue that does not improve after a rest day, sharp or escalating pain in a joint or tendon, poor sleep that gets worse after runs, and a strong sense of dread about training rather than just normal tiredness.

Signs that you can push forward include normal post-run muscle soreness that resolves within 48 to 72 hours, stable energy levels through the training week, consistent sleep, and a sense of accomplishment or mood lift after runs. Tracking your training alongside your symptoms helps you see these patterns over time. Apps like PeriPlan let you log workouts and energy levels so you can notice when training is helping versus when it is adding stress your body cannot absorb right now.