Does Running Cause Imbalanced Hormones?

A couple of years ago I was in a doctor’s office getting blood test results when the nurse practitioner looked at me and said, “You’ll always battle imbalanced hormones as long as you’re running as much as you do. A human is not meant to run like that.”

I was miffed. Yet, another health professional who blamed a health issue on running. But was she right?

My experience with imbalanced hormones

In my twenties, I had low estrogen and missed my period for years. A fertility specialist pumped me full of hormones to try to rid my amenorrhea, stimulate my period, and balance my hormones, but it didn’t work. He told me I needed to stop running.  (Later, a focus on nutrition would help my period return.)

Flash forward about 5 years later after having both my kids and my estrogen was SKY HIGH. I learned this after my running performance tanked and my coach urged me to get a blood test. (Read more about this experience here.) 

The high estrogen had a domino effect on my other hormone levels (hormones are very interconnected). The very imbalanced hormones were corrected over time by supplements, which according to the nurse practitioner, I will have to continue taking as long as I was training for marathons. 

That’s because hormones play a major role in running and if you don’t fuel and recover well (which can be very difficult in a rigorous marathon training cycle), they can become imbalanced. 

In other words, yes, running can mess with your hormones.

To understand the role of hormones and how we can support balanced hormones when running through nutrition, I connected with Amy Stephens, a certified sports dietitian for elite runners. Fresh back from counseling her athletes at the Olympic Trials, Amy had some eye-opening revelations about how diet can help balance hormones in runners. 

The function of hormones in athletes 

The body has dozens of hormones which are chemical messengers that travel to tissues and organs to tell them what to do. Their mission is to keep your body in homeostasis where your body temperature, blood pressure, blood sugar levels, etc. are all stable.

The role of hormones, especially for female athletes, is critical for growth to match a training cycle, explains Amy.  

Hormones have many vital functions that include: 

•     muscle and bone growth;
•     recovery from workouts;
•     regulation of all body systems like heart rate, digestion, menstruation, and blood pressure;
•     controlling hunger;  
•     building up stored energy; 
•     and building and repairing muscles after a hard workout so you can get stronger for the next one.

A few important hormones are: 

•     Insulin
•     Testosterone
•     Estrogen
•     Ghrelin
•     Leptin
•      Growth hormone, and 
•     Thyroid Stimulating Hormone (TSH)

There are many more hormones that keep our body healthy, but these are the ones most impacted by low calories and can have the biggest impact on performance and health. 

Common hormone imbalances in female runners

Running can mess with hormones if recovery is not prioritized. That’s because running causes a stress response from the body and results in a cascading effect on your hormones. If it doesn’t have time to level out, the hormone imbalance becomes greater and greater.   

According to hormone health company Eve Wellness, which does at-home hormone tests, there are three main hormone imbalances seen in female runners:

Low progesterone

Progesterone helps us sleep, support a calm mood, and use fat for energy. Progesterone and cortisol are made from the same precursor hormone; pregnenolone. 

When you run intensely, your body prioritizes survival over reproduction and thus prioritizes cortisol, which helps it deal with stress.

Low estrogen

Estrogen is produced in our ovaries, fat cells, and adrenal glands. When a woman’s body fat level falls below 19%, she is at an increased risk of low estrogen and may even lose her period, also known as amenorrhea. 

Again, your body prioritizes survival over reproduction. Your body essentially believes it may not have the energy requirements to perform regular functions, thus it knows it cannot support a baby. 

Related: RED-S: The Health Danger Facing Female Runners

High androgen

Androgens are a group of hormones that include testosterone, DHEA, etiocholanolone, and androstenedione. Half of the androgens are made by the adrenal glands and the other half is made by our ovaries and fat cells. 

When our bodies become stressed, including during running, our adrenal glands increase the production of cortisol AND androgens. After a while, this can interfere with ovulation and our menstrual cycles.

The role of hormones in running

When you run, your hormones fluctuate to deal with the stress you’re putting on your body. 

Amy explains how: Stress from exercise predominantly uses the hormones cortisol and growth hormone. These hormones are released as a result of adrenaline during exercise which in turn release glucose into the bloodstream to supply energy and increase the heart rate so you can power through a tough workout.  

Once you stop exercising, the hormone levels begin to shift into repairing and restocking the energy used.  During the restocking process, your body is smart and will restock even more energy and make muscles stronger for the next session.  Thus, the most beneficial time to have food is within an hour or so after a workout.  

“Eating a snack will increase levels of insulin which is a hormone that signals the body to absorb and repair tissue.  Food immediately after a workout will maximize the restocking of nutrients,” she advises. 

How imbalanced hormones impact running performance

When a female runner doesn’t fuel before or immediately after a run, her body goes into low-power mode. 

“The resetting metabolic rate is down-regulated to conserve energy.  Since there is less energy available during the workout, less energy will be restocked after the workout is completed,” explains Amy. 

This hurts performance because, in this low power mode, the body will not dive as deep into the energy stores because it’s holding on to calories as a safety precaution and conserving energy. Energy that would have been used to supply muscles and repair tissues is not available. This deficit sets a runner up for injury which will most certainly impact performance.

Related: 6 Steps to Return to Running After Injury

How a hormone imbalance can cause a running injury

Hormones are created and will function properly if there’s adequate energy to fuel the body. When the exercise levels increase, such as in a training cycle, but the calories don’t increase, the body goes into low-power mode.  

“Similar to a cell phone in low-power mode, your body will prioritize exercise and use all available energy to supply muscles but conserve energy from other important functions like creating hormones.  As these hormone levels drop, over time many other important functions will be affected,” explains Amy. 

These functions include:

•     digesting food
•     building new bones
•     menstruation
•     energy production
•     tissue repair, and many more

“Typically, I’ll see an athlete cut back on calories and lose their period.  This is an indicator that the body doesn’t have enough calories to function properly, and low-power mode is likely to start affecting other vital areas of the body,” Amy said. 

Workouts might initially be unaffected or even improve, but as time goes on, the low-calorie levels interfere with bone remodeling, adds Amy. This can lead to bone injuries because when bones are stressed during a workout or run, the outer layer is remodeled by osteoclasts and osteoblasts. 

During a training block, our bones slowly build over time, as our training load increases. Low power mode prevents the remodeling process and our bones are more susceptible to injury. It can also interfere with muscle mass, connective tissue, and strength rebuilding, and gains.

That is because—you guessed it—this process is regulated by estrogen and thyroid hormones. “So, if there’s insufficient estrogen available, remodeling might occur at a slower rate and the new bone is not as strong as the initial structure,” explained Amy.  

Even five days of low-calorie intake can interfere with new bone formation and soft tissue remodeling.

Related: Marathon Fueling 101: What Runner’s Should Eat

How to balance hormones in female runners

The most important way to balance hormones in female runners is to EAT. This means female runners SHOULD NOT: cut carbs, run depleted-state runs, do fasted runs, do intermittent fasting, or delay refueling. 

Here is why:

•     Not eating carbs before a run robs your body of the signal for insulin to store energy and increase muscle growth and repair. 

•     Running on empty causes your blood sugar and insulin levels to drop which hurts performance and halts the repair process. 

•     Not eating every three-to-four hours (intermittent fasting) delays your body’s signal to keep restocking energy.  

•     Not refueling after a workout misses the opportunity to restock the energy used and increase stores for the next workout.

Foods to eat to balance hormones in female runners

Amy says complex carbs and fruits are the best foods to restore hormone levels.  

Eating carbohydrates stimulate the pancreas to release insulin and the body reacts to insulin by storing energy. This kickstarts the repair process and signals to the body that there is adequate food to make more hormones.  

Fats provide adequate calories so the body can use the carbohydrates for energy restoration. Fats are also a key nutrient for hormone restoration because hormones are made from fatty acid molecules.  

Some foods to eat for balanced hormones include:

•     Potatoes
•     Beans
•     Lentils
•     Brown rice
•     Oatmeal
•     Fruits such as bananas, apples, pears, berries, and pineapples
•     Fats such as avocados, nuts, seeds, and olive oil

Here is how to help maintain balanced hormones in runners:

Eat a carb-dense snack of 200-300 calories about two hours before your run.

It can take about two hours for the body to digest and release carbs into the bloodstream. At that time, insulin levels increase to help keep the blood sugar stable. The presence of insulin in the bloodstream signals the body to store energy and increase muscle growth and repair.  

Eat every three-to-four hours.

This signals the body to keep restocking energy.  Calories are essential and ideally distributed evenly throughout the day so your body has a chance to stock every ounce of nutrition.

Eat carbs and protein within 30-minutes after running. 

This is when your muscles are primed and able to better absorb glucose. Doing so will maximize glycogen stores and rebuild muscle so you recover faster for your next run or workout.

Eat a full meal 2 to 3 hours after your run. 

If you had a hard or long run, you want to have a balanced meal with carbs, protein, and fat. This continues to be an optimal time for your muscles to rebuild and replenish glycogen stores. 

Related: 3 Proven Ways to Refuel after a Long Run + 2 Yummy Recipes

Consider getting your hormone levels tested regularly. 

I don’t think I would have ever known I had imbalanced hormones had I not been tested. My imbalanced hormones put me at risk for health dangers such as breast cancer in addition to poor running performance. I would have accepted that feeling fatigued and cranky most of the time was my new norm as a mother runner of two. 

Thus, I urge all women to get regular blood panels. You can do this through your regular primary care doctor, OB-gyn, or a company like Eve Wellness. 

If you would like additional help chasing your running goals, check out our Coaching Services.