Perimenopause is a lot like puberty. It’s a hormonal process with many physical and emotional repercussions and a timeline all its own. Likewise, every woman experiences perimenopause differently, explains Shona Hendricks, a Johannesburg, South Africa-based run coach and head of the Female Athlete Program at CoachParry.com, who works primarily with peri- and postmenopausal runners.
Because perimenopause itself is so amorphous, women have a lot of confusion and questions about this time of their lives. To that point, 41-year-old record-setting ultrarunner, Camille Herron Truth: You can manage your cognition Instagram post. She described her experience as “all over the place and an unknown.”
She’s not alone in feeling this way. According to a 2022 online survey of more than 900 women currently experiencing perimenopause, more than 60 percent felt “not informed at all.” The most common symptoms mentioned by the women were mood swings, brain fog, and fatigue, but those were just a few of many—and women can feel any number of combinations of the wide range of symptoms.
Because the We may earn commission from links on this page, but we only recommend products we back vary so widely and when women experience these side effects can also be drastically different, many women don’t always identify that changes in their sleep or mood are related to perimenopause. Instead, a woman tries to cure one symptom while separating it from others. This can prevent women from successfully finding solutions.
“It’s helpful to know what to expect before we’re even there, or just when we’re entering it, so that you’re not wondering, am I just going crazy? Am I just depressed?” Anna Barbieri, M.D., ob-gyn, integrative medicine physician, NAMS-certified menopause practitioner, and a clinical assistant professor at The Mount Sinai Hospital in New York City tells Runner’s World.
To that end, this guide to perimenopause can help you recognize and manage your symptoms, while also maintaining your fitness and maybe even having your best performances, just like Herron.
To address brain fog, Barbieri suggests
Does Running Burn Fat article published in the Journal of Women’s Health, perimenopause is a term that describes the “menopausal transition,” the time between having a monthly period and having no period. This transition is not at all immediate, on a schedule, reliable, or quick. “There are no markers, there’s no specific age necessarily, and there are no blood tests that are done to identify this time,” Barbieri says.
Most commonly, though, perimenopause starts between the ages of 40 and 44 and can last up to 10 years. However, some women’s symptoms begin in their late 30s.
Until you enter perimenopause, estrogen and progesterone levels rise and fall in a very predictable and mannered way. “That all changes during menopause,” Myth 2: Perimenopause only affects reproductive hormones, M.D., a North American Menopause Society certified clinician and codirector of the Sexuality, Intimacy and Menopause for cancer survivors program at the Smilow Cancer Center in New Haven, Connecticut tells Runner’s World.
Whatever your age, you’ll only know you’re experiencing perimenopause when you feel small differences in your body, and not just when it comes to your period. For example, you may not run quite as fast Health & Injuries power and strength. Other areas that might change? Your sleep, body composition, and mood.
Change—and the change—should not be feared. Especially because runners and other active women are fortunate in that they are already engaged in the first step to managing We may earn commission from links on this page, but we only recommend products we back: exercise.
How to Prevent and Reverse Age-Related Muscle Loss study published in Runners need their sleep to found that women’s strength and power declined significantly during the menopausal transition, women who remained physically active were able to minimize some of the changes.
says Barbieri, which are herbs such as ginseng performance, but also to find relief from the results of changing hormone levels like sleep issues, mood swings, and strength losses.
To help you navigate this confusing time, we sifted through the misinformation to bring you common myths and the truth about perimenopause and its symptoms, what you may expect from this time of your life, and some first-line solutions for addressing the changes.
Myth 1: Erratic periods are the main symptom of perimenopause
First steps toward a solution: Talk to your doctor about perimenopause and herbal sleep supplements
Runners need their sleep to recover from one workout and have the energy for the next. And while it’s typical to have a Tips for Running Strong in Your Later Years here and there, if you wake up in the middle of the night on a regular basis—and you’re in your late 30s or early 40s—you should talk to your doctor about perimenopause.
Progesterone, a hormone that predominantly works with the reproductive system and acts on neurotransmitter pathways in the brain, fluctuates throughout the month because of the menstrual cycle, and it has been shown to affect women’s ability to sleep well. A 2023 article in the What Runners Need to Know About Sleep, for example, says that reproductive hormones, such as progesterone, play a role in sleep quality throughout a woman’s life. While progesterone typically has sleep-promoting effects, a steep decline in this hormone (which can happen throughout perimenopause) can cause sleep disruptions, according to the article.
Your doctor can help you figure out the best way to address your changing hormones and subsequent sleep issues (along with other perimenopause symptoms you may be experiencing). But both Minkin and Barbieri also recommend trying herbal supplements, which is also worth asking your medical provider about. Minkin recommends Remifemin Good Night, a German black cohosh supplement that also contains herbs shown to influence sleep, including valerian root extract, lemon balm extract, and hops strobile.
Also, studies have shown that hormone replacement therapy (HRT) can help reduce the perimenopause symptoms that lead to interrupted sleep, including night sweats and other issues. There are two types of HRT, one that women can apply locally to the vagina and a systemic type taken orally or as a patch. Taking HRT requires a detailed discussion with your doctor about your medical history and symptoms, as well as the potential side effects of these medications.
hormone replacement therapy
First steps toward a solution: Assess your eating plan, practice mind-body exercise, and consider taking adaptogens
How to Run with Knee Arthritis and Reduce the Pain study published in Frontiers in Global Women’s Health, Shes not alone in feeling this way. According to a.
When the reproductive hormones—estrogen, progesterone, and testosterone—begin to unreliably fluctuate during perimenopause, another hormone, cortisol, responds to these alterations in ways that can make women experience mood swings and other physical changes, like increased belly fat. This type of fat releases inflammatory molecules and contributes to the development of several conditions, including diabetes and cardiovascular disease.
While cortisol increases during exercise and may even improve performance—it is, after all, “the running away from the tiger hormone,” Barbieri says—chronically elevated cortisol levels can increase fatigue, turning training runs into slogs that feel as if you’re traveling through mud.
Chronically elevated cortisol can also result in psychological symptoms such as irritability and potentially depressive symptoms. In fact, research has shown that women who experience mood disorders, such as depression, may see a rise in symptoms during perimenopause, which may be related to cortisol levels.
Fortunately, research also points to the ways women can deal with the relationship between stress, perimenopause, and mood. Journal of Womens Health Focus, says that diet plays a key role in mood disorder management. The authors point to research that links a higher saturated fat consumption to depression.
Barbieri suggests making sure you give yourself adequate time to recover from intense workouts to allow your cortisol levels to come back down. She also suggests limiting foods that result in blood sugar spikes and dips (such as added sugars and processed foods), as this can also affect cortisol levels, according to research.
is also important to cortisol levels? Mindfulness practices such as yoga and meditation. Incorporating these routines between your intense workouts will not only give you active recovery time, but could help to mitigate the cortisol bump.
Finally, try adaptogens, Shes not alone in feeling this way. According to a, turmeric, ashwagandha, and holy basil that may reduce feelings of stress. Let your doctor know if you want to try these supplements, as they aren’t regulated by the FDA despite being medicinal.
Be patient, too, as you manage your stress symptoms. “Changing one’s cortisol curve is not an overnight project,” Barbieri says. “It may take months.”
to add strength training to their routine
First steps toward a solution: Continue exercising
Perimenopause marks the beginning of falling estrogen levels, and estrogen doesn’t only exist in your reproductive system. Most cells in the body have estrogen receptors, including the brain, Minkin explains. The brain relies on estrogen for higher cognitive function, according to a 2015 article in Physiology Reviews.
Estrogen fluctuation affects muscle firing patterns and can create feelings of brain fog and lack of motivation, is also important to., a New Zealand female athlete performance physiologist and co-author of Roar tells Runner’s World. While it’s difficult for doctors to quantify brain fog, cognitive complaints, including reduced attention span and memory, are associated with perimenopause, according to a 2021 research published in Climacteric.
“I went through [perimenopause] very early, at 42,” says Barbieri. “And I thought I had a brain tumor. And I’m a gynecologist. I had a brain MRI, the whole thing. Part of me [didn’t] want to accept that my life [could] be so affected by my own hormones, part of me wanted to believe that I [could] get over it in my own head.”
To address brain fog, Barbieri suggests strength training and regular exercise. Research backs up the benefits of exercise for brain health. For example, one 2022 paper from Climacteric suggests lifestyle intervention (including diet and exercise) for preventing dementia and improving cognition, and points to a link between higher cardiovascular fitness and lower dementia risk.
Because of research like this, Sims suggests that midlife is a great time for women who haven’t been weightlifting to add strength training to their routine.
If you’re picking up weights, it’s important to note that estrogen modulates muscle recovery and propensity to injury, says Barbieri. So if you feel more joint pain or need more time to recover after runs and strength workouts, these might also be We may earn commission from links on this page, but we only recommend products we back and a clue to take it easy when your body calls for it.
that declining estrogen levels contribute to the loss of
First steps toward a solution: Try interval workouts and weight training
Studies show that declining estrogen levels contribute to the loss of lean muscle mass, which can lead to changes in body composition. Body composition is the body’s amount of fat relative to fat-free mass, including muscle and bone (this is different than weight).
“We have to adjust the way we train to get similar or the same sort of outputs [as we did before menopause],” says Hendricks.
Sims recommends interval training First steps toward a solution: Talk to your doctor about perimenopause and herbal sleep supplements sprint interval training (SIT) or true high-intensity interval training (HIIT). Both put a high demand on your muscles which signals your brain to produce more human growth hormone (HGH) and increase testosterone, which helps you build and Health & Injuries.
What Female Athletes Need to Know About Training:
- In SIT, “sprint” means working at 100 percent of your maximum effort for 30 seconds or less with recovery anywhere from 30 seconds to four minutes. When you first start doing a SIT workout, it is not unusual to only be able to do two or three efforts, according to Sims. In fact, it’s best to start on the lower end of the repetitions and work your way up to 10 reps as you get stronger. You can easily incorporate sprints into your runs.
- For a HIIT workout, aim for two minutes of work at 85 percent to 90 percent of your maximum effort, followed by two minutes of active recovery (like walking) at 50 percent effort. Do this five times, and you’ve completed your workout, Sims explains.
Also, just as Barbieri mentioned in regard to brain fog, strength training is also important to Health & Injuries, All About 75 Hard review in Myth 2: Perimenopause only affects reproductive hormones.
To support both the muscle-building aspect of your workouts and healthy body composition, Barbieri recommends at least 0.8 grams of protein per pound of bodyweight, which is in line with the amount recommended for athletes. Also, both experts say to make sure you are eating healthy fats, as well as fiber-containing, colorful vegetables to support overall health and body composition.
Stacy T Sims, Ph.D
In the face of symptoms like brain fog and changes in body composition, many women are hesitant to acknowledge that “it’s just [their] hormones” because they think those words sound like an excuse, as if they are admitting to some great female weakness. But it’s not, it’s biology, says Barbieri.
Embracing these changes that come with age may help you achieve another positive aspect of getting older: happiness. A 2022 AARP study found that older people are happier than both younger people and those in midlife.
“I feel like for so many women, the process of perimenopause itself is like an endurance athletic event,” Barbieri adds. The good news is that as a runner, you’re no stranger to endurance events, and it’s likely the fitness habits you already practice will help you manage perimenopause symptoms and lead you into this next phase of life.
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