E.J. Bradley
Published August 24, 2026 10:10AM
Lately, women have been inundated with information about our cycles, hormone levels, aging, and how it all affects our athletic—and yes, running—performance. It’s refreshing that women’s health is (finally!) getting some attention, but all this new information can make it feel like our hormonal fluctuations are working against our training and race times
Many of us have invested in fitness trackers that promise to monitor our cycles. They constantly spit data at us, sometimes urging us to “take it easy” because our luteal phase is in full swing. Yet it can still be hard to pinpoint why we’re crushing workouts one week—regardless of where we are in our cycle—while the next week feels like we’re fighting for our lives
And now, a new remedy for runners: hormone replacement therapy (HRT). Instagram ads for online hormone-optimization specialists, billboards for in-person clinics—all promising to enhance athletic performance. It’s both tempting and confusing to consider. (And is it even safe?)
We spoke with three endocrinologists to break down how hormones affect running performance in the first place, whether HRT is a legitimate way to improve it, and what to know before trying it
How Hormones Impact Athletic Performance
For women, there are two main hormones at play in running performance
“Both estrogen and progesterone have effects on athletic performance—though the differences in performance are small,” Dr. Gillian Goddard, MD, board-certified endocrinologist and author of The Hormone Loopat Park Avenue Endocrinology, tells Outside Run
Estrogen and progesterone rise and fall throughout the menstrual cycle, and those shifts can affect everything from energy levels and recovery to body temperature and how hard a workout feels
“Some women feel strongest around the middle of their cycle, when estrogen is higher,” says Dr. Fady Hannah-Shmouni, MD, FRCPC, endocrinologist and geneticist, professor at the University of British Columbia, and medical director at Eli Health. “Others notice that the week before their period they’re running hotter, feel more fatigued, or recover a little more slowly.”
Goddard adds that women may feel the biggest difference in performance (as measured by peak VO2, the maximum amount of oxygen the body uses during intense exercise) between the early follicular phase (during your period) and the late follicular phase, when estrogen is rising leading up to ovulation
That said, every woman’s body is different, and there’s a lot of individual variation to account for
“Science doesn’t support the idea that every woman performs better or worse at the same point in her cycle,” adds Hannah-Shmouni. “Instead of trying to force your training to match a calendar, it’s more useful to understand your own patterns and adjust when needed.”
When Should Hormone Testing Be Done?
Short answer: women don’t need to wait until perimenopause or menopause to get their hormones tested. According to the National Institutes of Health, perimenopause typically begins between ages 45 and 55, and the average age of menopause in the United States is 52
Speaking with an endocrinologist well before then is smart, especially if you’re dealing with common hormone-related concerns, notes Dr. Priya Jaisinghani, MD, an endocrinologist and obesity medicine specialist at NYU Langone Health
These concerns can include irregular or absent periods, hair loss, excessive hair growth, acne, heavy periods, menstrual cycle changes, weight gain, weight loss, premenstrual symptoms, bone fractures (including stress fractures), and, of course, symptoms of perimenopause or menopause
“Many women may be experiencing [these] symptoms and not realize they can be linked to hormones or hormonal transitions,” adds Jaisinghani
Is HRT Legit?
HRT is nothing “new,” per se. In fact, hormonal treatments for women have been around since the early 1900s. And it can help many women experiencing hormonal symptoms
But many of the HRT options popping up today are tied specifically to telehealth, with companies and health clinics suddenly surfacing with claims of HRT success for athletic performance
“Be cautious of programs that overpromise quick fixes or simple solutions for ‘optimization,’ or that market HRT as a performance enhancer rather than a medical treatment,” Jaisinghani says
She adds that HRT can be highly effective, but that it’s ultimately not a universal solution for fatigue, performance, or longevity
There’s some data suggesting HRT could support athletic outcomes for women
“Hormone therapy can help maintain muscle mass, but data regarding aerobic fitness is mixed,” adds Goddard
On the other hand, when women experiencing hormonal symptoms like restless nights and fatigue begin taking HRT, they may notice relief that benefits their running
“If taking hormone therapy improves your sleep and helps you feel better overall, that may lead to better athletic performance,” Goddard says
The main takeaway with HRT is that it won’t provide instant results, and outcomes may differ from person to person
“You should be skeptical of practitioners and companies offering hormone therapy specifically to improve athletic performance,” Goddard adds—and, perhaps more importantly, she cautions against testosterone claims
“There are also people advocating that women should take large doses of testosterone to improve muscle mass and athletic performance,” she explains. “Raising testosterone levels above the typical female range to improve athletic performance isn’t supported by high-quality data, and it can cause side effects like voice changes and enlargement of the clitoris, some of which aren’t reversible.”
How to Find a Safe HRT Provider
When sussing out a legitimate provider, Jaisinghani suggests making sure you’re talking to a board-certified endocrinologist or gynecologist. Some telehealth platforms and HRT clinics use nurse practitioners with other specialties to assess patients—that’s not to say they can’t do a good job, but it’s worth knowing who you’re talking to and what their knowledge limitations might be
Jaisinghani says to look for a doctor who is experienced and comfortable evaluating your symptoms, discussing risks and benefits, and providing ongoing monitoring throughout your treatment—not just selling you a product
Ultimately, HRT should be used to treat disease or hormone deficiency, rather than to chase marginal performance gains unsupported by evidence
“At the end of the day, the biggest performance enhancers are still the basics—consistent training, enough calories, quality sleep, and good recovery. Healthy hormones are usually the result of those habits,” Hannah-Shmouni says
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