How Much Slowdown Should I Expect In Perimenopause?

In my early and mid-twenties, I jogged several times a week — though whenever asked about my exercise routine, I prefaced any talk of my miles by lamenting how slow I was. Like so much of my youth, I didn’t truly appreciate what I had while I had it. Sure, I wasn’t fast compared to the other runners in the park, but that was the fastest runner that *I* would ever be.

I took a break from regular exercise (in addition to folding laundry, completing a thought, or even trying to look put together) while my kids were young, and when I went back to jogging, I was, unsurprisingly, even slower. Sure, my speed and endurance increased with practice, which was rewarding to see. But around age 42, I realized my average times were starting to dip.

This gradual slowdown with age is to be expected, and explains why runners compete in races by age category. A 2018 study using data from world records found about a 1% decline in the five-year period between ages 35-39, and a “linear decline” after that, meaning that every year, elite runners get a bit slower. This applies to us non-elites and to non-runners as well — age gradually slows us down. Our VO2 max, a measure of how efficiently the body uses oxygen, declines with age. At the same time, we are slowly losing muscle mass.

But for those of us with female reproductive organs, there’s another significant physical change that usually begins in our forties and impacts our bodies, mental health, and relationship to exercise: perimenopause.

The Perimenopause Effect

“By definition, your menopause is just one day,” Dr. Ariana Sholes-Douglas, an ob/gyn and author of The Menopause Myth: What Your Mother, Doctor and Friends Haven’t Shared About Life After 35, tells ScaryMommy, noting that perimenopause symptoms can begin long before that day. “You can technically not be menopausal until you're 48, 50, but you can have symptoms up to 10 years prior.”

She added that many women think their symptoms aren’t related to menopause because they’re still having their period, but symptoms often peak before the last menstrual cycle. In addition, symptoms may continue post-menopause, meaning the whole process can impact your well-being for an entire phase of life.

What kinds of symptoms are we talking about? A truly mind-boggling mix that proves there is almost no bodily function not impacted by sex hormones.

Sholes-Douglas says that perimenopause symptoms include everything from classics like hot flashes, insomnia, and irritability, to lesser-known issues like a burning sensation in the mouth or “frozen shoulder” — part of musculoskeletal syndrome which, Sholes Douglas explains, “includes the joint pain, the decrease in muscle mass, the decrease in bone density, and then a very specific symptom that tends to affect the shoulder joint.”

The main culprit behind all of these is fluctuations in estrogen levels, though other sex hormones like testosterone also play a role. “I explain it as kind of like a reverse puberty,” Sholes-Douglas says. “During puberty, we're having erratic hormones that are going up, and during perimenopause, we're having erratic hormone production that's going down.”

Sensing the Shift

Since perimenopausal symptoms vary drastically from one person to the next, it’s hard to predict how you might need to modify your exercise routine. Running coach Amanda Brooks underscores that each person’s body is impacted differently by perimenopause, saying, “Some people have a much bigger reaction to the shifting hormones, and some people just kind of flow through it.”

But she said it’s fairly common, regardless, for shifts in mood and energy to affect a person’s training. Sometimes, she points out, “people who've been consistent runners forever suddenly just feel unmotivated. They're kind of sad, they don't feel great, and so that shifts their desire to go run.”

Changes in mental health, even more subtle ones, can understandably impact a person’s motivation, according to Dr. Juliet McGrattan, a physician and running expert. “Things like losing your confidence, feeling more self-conscious,” can take their toll, she says, “especially if you're having other symptoms like gaining weight or an increase in your sweating.”

It can be difficult to connect the dots, especially if you’re still having your period. “These aren't necessarily the kind of things that people think, ‘Oh, well, that's the perimenopause,’” McGrattan says.

The joint pain and sleep issues that Sholes-Douglas mentioned can also make working out a challenge, as can injuries, which are another risk that increases with age.

What You Can Do

Whether or not you’re a runner, these changes can be frustrating. But by making some wise adjustments, you can continue to exercise — and even enjoy it. Here are our experts’ top tips.

Start Strength Training

When it comes to the natural loss of muscle mass that happens as we age, there is a great deal of individual variation, much of which is based on genetics, McGrattan shares. But one environmental factor we can control is exercise, and the way to gain muscle mass, as well as boost other measures of health like bone density, is to do strength training.

McGrattan pointed out that the World Health Organization recommends two sessions of “muscle strengthening activities at moderate or greater intensity,” in addition to 150 or more minutes of cardiovascular exercise per week for adults.

“There isn't actual guidance on how long [strength training sessions] should be, but I would say aiming for about 30 minutes,” McGrattan advises, adding, “if that is not possible for you, then break it up and do 10 minutes every day or however it's going to fit into your life.”

If you’re a runner looking to increase your speed, you’ll probably want to aim to “lift heavy,” Brooks says. When you’re new to strength training, though, exercises that use your own body weight — planks, push-ups, squats, lunges — are a great place to start. “And they work as part of your warm-up prior to a run, too,” Brooks says.

If you have the resources to hire a trainer, perimenopause is a great time to do so. They can tailor a strength training workout for your needs, help you prevent injury, and boost motivation.

Oh, you can also set aside any worries about weightlifting turning you into the Hulk. “Women are often afraid of looking too muscly, being too bulky,” McGrattan says. “That's really not going to happen unless you start lifting very heavy and you're really increasing your protein.”

Make Adjustments to Your Routine

As you age, “Your recovery processes slow down a little bit,” McGrattan explains. So you may need more rest than you used to.

Don’t shrug off the importance of preparation, either. Warming up is something “a lot of us get away with skipping in our 20s,” Brooks observes, but as we age, we need it more to prevent injury. “It gets the heart ready, it gets your joints lubricated, it gets your muscles to stop feeling so stiff, so that when you start [exercising], nothing's going to pull.”

Like strength training, incorporating cross-training can help prevent injury, according to Brooks, who adds that folks should be open to adjusting based on their mood and energy levels.

McGrattan advises “doing things when you feel good and then dialing back and just having a bit of self-compassion when it's not such a good day,” reassuring, “It’s the hormones, it’s not you, and it won’t be like this forever.”

Fuel Up and Hydrate

Brooks underscores that it’s important to make sure we’re feeding ourselves adequately, being mindful that we may not feel thirst or hunger the same way that we did when we were younger. You want to make sure you’re getting enough protein when you’re working on building muscle. Foods like eggs, chicken, tofu, black beans, salmon, cottage cheese, and Greek yogurt are all good sources. For those of us in the 40-50 age range, the recommendation is 1-1.2 grams of daily protein per kilogram of body weight.

You may have noticed that there are a lot of dietary supplements marketed at the perimenopausal crowd. Spoiler alert: There’s no scientific evidence to support their effectiveness.

“There are a lot of people trying to make money out of women in menopause, and I think we're really vulnerable because we want quick fixes,” McGrattan cautions. In terms of supplements, she suggests most of us could use an extra boost of vitamin D, and vegetarians/vegans may also need B12. Women who are training hard and/or having heavy periods may need iron supplementation. Your primary care doctor can check your levels of all of these.

Find a Knowledgeable Doctor, and Advocate for Yourself

Hormone replacement therapy can help alleviate the symptoms of peri- and post-menopause, but you’ll need to find a doctor who is trained in this particular area of women’s health. Not all are. Shoales-Douglas recommends menopause.org as a resource for folks looking for a provider.

“I think the number one thing is being informed and then being intentional about having a provider that is an expert in that space,” she says.

Play the Long Game

Your fitness goals will need to change as you age. Chasing a personal record may take a back seat to ensuring that you stay active and pain-free.

Shifting from a “performance perspective” to a “health and longevity perspective” can help motivate you to make changes, Brooks says. For example, knowing the value of strength training, you might be more willing to head to the gym instead of going on a run.

As McGrattan reminds us, “It's not primarily about how you look and feel now, it's about your long-term health.”