Menopause and Running: What You Need to Know

You sweat buckets. Your running tights seem extra snug. You toss and turn at night. During the day, you’re exhausted and irritated.

The signs and symptoms of menopause can read like an athlete’s nightmare. There’s no doubt about it—the shifts in hormones that occur as you exit your reproductive years can have serious effects on your running, says exercise physiologist and nutrition scientist Stacy Sims, Ph.D.

The upside—besides moving up an age group or two? All women experience these changes, but maintaining your mileage puts you ahead of the pack in terms of coping with them, Sims notes. What’s more, with a few modifications to your routine, you can continue running strong long into post-menopause. Here are the answers to your burning questions about hot flashes, stomach fat, and more.

First things first: What, exactly, is happening to my body?

Beginning about age 40, your baby-making years wind down and your ovaries produce smaller amounts of the hormones estrogen and progesterone. Since these chemical messengers control your menstrual cycle, you’ll often start to bleed irregularly and eventually stop having periods—what most women think of when they hear the word “menopause.”

However, these hormones have effects on more than just your reproductive system. Estrogen strengthens bones and plays a key role in vasodilation, or the way your blood vessels expand and constrict based on what’s going on inside and outside your body, Sims says. As a result, your blood pressure and temperature perception shift in ways that may affect your running (more on that in a sec). And lower estrogen levels also trigger your body to store fat instead of build muscle—not exactly ideal for your 5K times.

So. Very. Hot. Why—and how am I supposed to run through this?

Menopause heats things up in more ways than one. First, your body’s natural air-conditioning system works less efficiently, Sims says. Normally, your blood vessels expand as you warm up, sending blood closer to your skin for cooling; lower estrogen levels blunt this response, trapping more heat inside your core. This—along with changes to your brain’s thermostat, the hypothalamus—likely contributes to hot flashes, which strike about three-fourths of menopausal women.

Score one for runners: Some research suggests women who exercise regularly have fewer hot flashes in the first place. Plus, you probably feel less peeved by them than your nonrunning girlfriends. “Runners are used to feeling heated; they’re used to that feeling of sweating and don’t shy away from it,” says Susan Reed, menopause expert at the University of Washington, US.

Rest assured that training through a hot flash poses no danger, Sims says. A dose of the amino acid beta-alanine, which helps open up blood vessels, before a run can help ward them off; so can slurping down a slushie or ice-cold water to cool you down from the inside. If it’s hot out, consider wearing a bandana soaked in cool water or a scarf prepacked with ice or cooling beads.

A good night’s sleep also plays a crucial role in recovery from tough training sessions. But in a cruel twist, menopause sometimes robs you of rest right when your body starts to need more of it. Nearly two-thirds of menopausal women report some symptoms of insomnia, according to the National Sleep Foundation.

Lower levels of estrogen and progesterone decrease production of the hormone melatonin, which helps you drift off to dreamland in part by dropping your core temperature, Sims says. Your body then tries to cool you down by pumping out perspiration. However, the changes to your temperature-regulating system make you prone to overshoot. The result: a cycle of sweating profusely, then waking up chilled and sticky.

Again, runners have an advantage here, since regular physical activity improves sleep overall. Try to stick to morning runs if you can, as evening exercise elevates your core temperature too close to bedtime. To increase your odds of getting up for that a.m. run, drink a cold glass of melatonin-boosting tart cherry juice 30 minutes before bed, Sims advises. Also try keeping your bedroom cool, using moisture-wicking sheets or firing up a bed fan.

I sometimes feel woozy postrun. What gives?

Back to those blood vessels again. Just as they take longer to expand during exercise, they also don’t shrink down as quickly afterward. This causes a blood pressure drop that can leave you feeling light-headed when you stop moving, or even just when you stand up after sitting down, Sims says.

Cooling yourself down with an icy drink or a cold towel can speed along this constriction to steady your blood pressure, Sims says. So can compression gear, which keeps blood moving instead of pooling in your legs.

Give it to me straight: Are my fastest days behind me?

In part, that depends on your starting point, says Kathleen Weber, director of women’s sports medicine at Midwest Orthopaedics at Rush in Ameroca. Declines in estrogen and testosterone decrease your ability to build and maintain muscle. Your percentage of fast-twitch fibres, which help you sprint to the finish line, also declines, Sims says. So, long-term runners probably won’t touch their best times from high school cross country.

On the flip side, if you never reached your maximum potential at a younger age, you probably still have room for improvement through menopause and beyond. “For individuals who have taken running up later in life, they actually are becoming more efficient runners and they’re getting better,” Weber says.

Regardless of your past, a few training tweaks can ensure your speediest future. If you don’t strength-train already, add two to three sessions per week to maintain muscle mass and reduce your risk of osteoporosis, since the pull of strong muscles on your skeleton increases your bone density, Weber says. Sims advises including moves like plyometrics and hill reps—these train the connections between your muscles and brain to increase your power, or the ability to recruit strength quickly. Even if you’re a marathon runner rather than a sprinter, these short, sharp, high-intensity sessions can build the power you need to cross the finish line strong, she says.

What about injuries? Am I more likely to get hurt now?

Little research has explored injury risk linked to menopause, Sims says. Changes to levels of collagen could affect the elasticity of your ligaments and tendons. And because estrogen receptors exist all over your body, many women report achy joints, bones, and muscles when levels of this hormone decline, Reed says.

Fortunately, the same strength- and power-building moves that improve your performance also help keep you off the sidelines. Strong muscles keep your form intact and better absorb the impact of running, protecting your bones and connective tissue, Weber says.

I eat well but I’m still gaining weight. Do I need to change my diet?

Running alone offsets some of the famous middle-age spread. But the same high-carb diet that fueled your training before might not work as well as you near menopause, Sims says. Lower estrogen levels leave you more sensitive to carbohydrates, meaning you might need fewer gels, sports drinks, or chews to make it through your long runs.

Throughout the day, cut back on bread, pasta, and other simple carbs and focus on whole grains, fruits, vegetables, and high-quality proteins, Sims says. Sources like dairy, whey powder, and lean meats contain high levels of leucine, an amino acid essential to building muscle. Including protein with leucine in your pre-run meal means you’ll have the raw materials for recovery in your bloodstream the minute you stop sweating. Don’t dally with your postrun snack—and aim for another 25 grams of protein within 30 minutes after finishing, she advises.

So if low hormone levels cause all these issues, can’t I just replace them?

Synthetic estrogen and progesterone can minimize some of the symptoms of menopause, relieving hot flashes and night sweats while protecting against bone loss. But these benefits come at a cost. Hormone replacement therapy may slightly up your odds of breast cancer, heart attack, and stroke, among other problems.

An individual discussion with your doctor can help you decide whether the perks outweigh the downsides in your case, Weber says. Make sure he or she knows you’re a runner, and also if you’ve had stress fractures or irregular periods due to running, which place you at greater risk for osteoporosis. However, other methods besides hormone therapy can fight bone loss—including getting enough calcium and vitamin D, Weber says.

Coping with all these changes has left me a bit blue. Normal—or not?

Many women experience bouts of sadness during menopause. Running, like other forms of physical activity, is a proven mood-booster. But sometimes that alone isn’t enough to combat the chemical changes in your brain, especially if you have a history of postpartum or other types of depression.

If your runner’s high doesn’t lift you out of the dumps, talk to your doctor, Reed advises. Medications and therapy, such as problem-solving or cognitive behavioral therapy, can ease you through the transition.

Take heart, too, in the fact that many menopausal struggles are temporary. “People tend to be most symptomatic around the two years before the final menstrual period and up to three years after,” Reed says. “After that, people find they get a new rhythm and a new balance. Be accepting of the new you—and celebrate it.”

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