Case Study: Helping a Midlife Ultramarathon Runner Find Her Natural Fuelling Strategy & Thrive Through Perimenopause

Helen (name changed for confidentiality) came to me in her mid-40s at a time when her life felt full and almost too full. She was a passionate runner who regularly took on half marathons, marathons, and increasingly, ultramarathon events.

Running wasn’t just her sport; it was her identity, her stress relief, and her way of staying grounded. But as she moved through perimenopause, things began to shift.

Her energy wasn’t as stable as it used to be; she was experiencing new aches and niggles, recovery seemed slower, and her sleep had become unpredictable.

On top of her running volume, she also worked full-time and was raising a young family. She told me she felt like she was “running on fumes”  physically and emotionally and wanted to learn how to support her body better.

What she wanted most was to refine her fuelling strategy. She didn’t want to rely heavily on commercial gels or ultra-processed race foods.

She preferred a more natural approach but wasn’t sure what her body could tolerate during long efforts, especially as her hormones were changing.

She also wanted to support her perimenopause symptoms naturally and protect her long-term health so she could keep running for decades.

Step 1: Understanding Her Physiology & Her Lifestyle Demands

We began with a deep dive into her training schedule, her weekly load, her nutrition patterns and the physical and hormonal changes she had noticed.

Her training weeks were intense - long runs, back-to-back training days, hill sessions, speed work and strength training squeezed into a calendar already overflowing with work and family responsibilities.

It was immediately clear that her energy availability was swinging dramatically. Some days she ate too little for her training volume; other days she ate enough but lacked structure.

She also admitted that she often trained fasted or skipped recovery meals because she was rushing between commitments. Over time, this pattern was placing her at risk for low energy availability, poorer recovery, increased inflammation and mood changes, all of which are amplified during perimenopause.

Step 2: Finding Her Personal Fuelling Sweet Spot - Natural, Consistent & Gut-Friendly

We spent several sessions exploring what her body tolerated best during both training runs and race simulations. She had tried gels in the past but disliked the artificial sweetness and the blood sugar crashes that followed; she also experienced bloating from these. 

Instead, she tried:

• mashed dates and nut butter combinations

• salted medjool dates

• watermelon segments

• homemade rice cakes

• soft-boiled potatoes with sea salt

• natural fruit pouches

• diluted fruit juices with electrolytes

• maple syrup sachets for quick-release energy

Through trial, timing adjustments and load experimentation, we found a combination that delivered steady glucose, minimal gastrointestinal distress and predictable energy. 

We also refined her pre-run and post-run strategies, emphasising:

• carbohydrates before long efforts (especially important in perimenopause)

• a protein + carbohydrate meal within 45 minutes of finishing

• electrolytes tailored to her sweat rate

• antioxidant-rich foods after intense sessions

Step 3: Supporting Her Through Perimenopause Naturally

Perimenopause was making her running feel more unpredictable, from mood swings to temperature dysregulation to slower recovery. 

We also worked together on:

• Stabilising blood glucose

• Increasing magnesium and omega-3-rich foods

• Adjusting fibre to match her hormonal fluctuations

• Adding natural phytoestrogen foods

• Supporting sleep through nutrition timing

• Reducing inflammation through herbs and spices

• Ensuring adequate iron, B vitamins and protein intake

The aim was not to “fix” perimenopause, but to help her move through it with more resilience, more energy and more predictability in her performance.

Step 4: Prioritising Recovery - A Non-Negotiable for Midlife Endurance Athletes

One of the biggest breakthroughs came when she realised that her recovery needed to be treated as seriously as training now

We worked on:

• consistent post-run fuelling

• a weekly recovery day plan

• regular stretching and mobility sessions

• magnesium baths

• eating enough total calories to prevent hormonal disruption

• strategic rest around her menstrual cycle

She quickly noticed that her legs felt lighter, her mood steadier, and her sleep deeper. She even said her long runs “felt enjoyable again” instead of draining.

Step 5: The Results - Energy, Stable Performance & Confidence for the Future

Over the months we worked together, she rediscovered her rhythm. Her natural fuelling plan worked so well that she used it successfully in multiple races, including an ultramarathon she had previously struggled through.

Her recovery improved significantly, her energy stabilised, her mood was calmer, and she even noticed subtle but meaningful improvements in body composition.

Most importantly, she felt in control again, not pushed around by hormones, exhaustion or confusion about what to eat. She learned to understand her body’s signals and what they meant for her performance, her health and her perimenopause journey.

She now sees her running as something she can do sustainably, not something she will “age out of.”