Marathon Runners

Menopause and Training

BY Carrie McCusker

Female athletes often achieve stunning performances well through middle age. Here's what you need to know to be one of them.

In 2019, 40 years after her record-setting 2:35:15 at the Boston Marathon, Joan Benoit Samuelson took on the course with a new goal of finishing within 40 minutes of that original, historic day. She succeeded, with plenty of time to spare, in 3:05:18. She was 61.

Samuelson, who earned a gold medal at the first running of the women’s Olympic marathon in 1984, also holds the 55-59 marathon age group record; 2:50:29 which she set in 2013. The longevity and dedication Samuelson brings to running are awe-inspiring, and allow fresh perspective when contemplating the effects of age on performance.

Lack of Data

While every human’s hormonal balance changes throughout the lifespan, understanding the shift particular to female athletes is often hampered due to a lack of research data. A Sports Medicine article published July 2020 reviewed available historical data related to female hormones and sport performance, noting that “general guidelines on exercise performance across the MC (menstrual cycle) cannot be formed; rather, it is recommended that a personalized approach should be taken based on each individual’s response to exercise performance across the MC.”

The takeaway here: a lack of definitive data means science can’t offer much specific advice on using the MC and hormonal shifts as a guide for peak performance. While female athletes wait for more peer-reviewed studies to emerge, there are some solid approaches to coping with physical and mental changes throughout the lifespan that come from other research or experience. Women over 40 regularly execute incredible endurance performances, demonstrating that while age may change your body, that does not mean abandoning your goals. 

Erin Dawson-Chalat MD offered some perspective about the aging female athlete. Dr. Chalat, an OB-GYN based in Maine, didn’t take up competitive running until her forties. At age 52 she ran 3:01:52 at the Chicago Marathon, dominating her age group and has since gone on to numerous finishes under 3:10. Dr. Chalat eats a predominantly plant-based diet, and despite a schedule that requires regular all-nighters, she manages to find enough rest and recovery to allow for long-term goal achievement. 

In her experience both working with menopausal women and being one, Dr. Chalat has found that three key topics emerge again and again, specifically: changes to body sleep patterns and body composition; changes to hormonal patterns and period symptoms; and the influence of thoughts or belief systems on performance and mental well-being.

Body Composition, Sleep and Hydration

Two of the most common complaints during the menopausal transition phase are weight gain and disrupted sleep due to shifts in metabolic processes and hormones. Many female athletes are attuned to body composition and the importance of sleep for performance, so this phase can be particularly frustrating.

Body Composition

A 2016 review of masters athletes suggested slower muscle repair after exercise indicates they “may benefit from higher doses of postexercise dietary protein, with particular attention directed to the leucine content of the postexercise bolus.”

While leucine is found highest in animal products, it can also be obtained through soy, nuts and seeds, beans and lentils. In fact, an interesting 2018 study of 754 females over the age of 45 discovered a link between a vegan diet and less-bothersome menopausal symptoms—so don’t feel like you need to get all your protein from meat! Add low-rep, high-weight strength training to that increased protein intake, and you may alleviate some of the body composition changes that seem inevitable with age.


Sleep should also continue to be a focus for anyone seeking peak performance for mind and body. Try to keep sleep and wake times relatively constant, and don’t hesitate to use the power nap as a tool. Studies have found even 5-10 minutes of sleep in the afternoon can refresh the mind and body so you have the energy for that evening workout. If you have difficulty sleeping, avoid caffeine and sugar, and don’t eat right before bed. Keep your bedroom cool and dark, and try chilling out with a book instead of a screen. 


Finally, hydrate. According to  Dr. Stacy Sims in her book Roar, older women tend to have a higher core temperature than younger women and the hormonal flux can make it harder for them to perform in the heat. She even goes so far as to say that “precooling and hydrating are non-negotiable.”

As you age, it’s more important than ever to go into training and racing fully hydrated and prepared to hydrate throughout. Start the day with hydration and understand that your needs will be higher in the heat. If you are taking on long-distance training and racing, you may even want to consider taking (or re-taking) a sweat test to help pinpoint your sodium and fluid needs. 


Hormonal fluctuations occur in all humans and can vary vastly from one individual to another. They also work in patterns, meaning one hormone may signal the release or retention of another—which makes it difficult to equate the release of specific hormones to specific physical effects. Unfortunately with aging, those hormonal patterns become even more erratic, which means that a once-predictable period might begin to become heavier or more scarce, or that you might experience new related symptoms.

It is essential to remember that your performance during your period, even an unpredictable one, is not necessarily diminished. Dr. Chalat points out, “there seems to be a lot of individual variability in how much hormones fluctuate throughout the female cycle and whether those changes influence an athlete’s VO2 max at all.” Of course, that doesn’t mean it’s not inconvenient; one hallmark among aging females is a longer period with heavier bleeding—which is obviously less than ideal during any endurance event.

Dr. Chalat suggests one simple, safe solution: try an IUD (intrauterine device). Developed for birth control, the small amount of progestin released by certain IUDs can also help reduce both the length and severity of the period, leading some doctors to prescribe them during perimenopause. It should, however, be noted that an IUD will not alleviate other menopause-related symptoms such as hot flashes or mood changes.

The Power of Thought

The power of thought is of massive importance. Masters athletes are often disciplined, organized people who manage busy lives and training. While it is essential to accept that your reproductive hormones, over which you have very little control, may not stay predictable, you can choose how you deal with it.

A person’s belief in their capacity to achieve and be successful is called self-efficacy. (Bandura 1977). Basically, if you feel like you will be effective and are competent, you are more likely to take risks and have a positive outcome. In the case of the tidal nature of female hormones, head into the waves ready.

Dr. Chalat concurs, “If you think you will perform poorly in the luteal phase of your cycle, this very well may contribute to poor performance.” While this advice applies to almost any area of performance, it helps to apply it specifically to your physical changes during the menopause transition. Recognizing that changes happen and taking steps to work within your new framework can help you stay on track and even make athletic pursuits more rewarding. 

Age doesn’t have to be a barrier to continued enjoyment and success in endurance sport participation. There are so many strong aging female athletes out there reminding us all that it’s possible to manage change and maximize potential throughout your entire athletic career. As an athlete, you already know how to tap the benefits of proper diet, sleep, hydration and exercise for peak human performance. Roll with the changes while keeping a positive outlook, and you’ll continue to be your best, most powerful self. Carrie McCusker is a level 2 TrainingPeaks coach and a lifelong athlete who enjoys bringing individual attention to every level of athlete. You can find her on Strava and Instagram or check out her coach profile at TrainingPeaks.

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About Carrie McCusker

Carrie McCusker is a level 2 TrainingPeaks coach and a lifelong athlete who enjoys bringing individual attention to every level of athlete. You can find her on Strava and Instagram or check out her coach profile at TrainingPeaks.

Visit Carrie McCusker's Coach Profile

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