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Camille Herron is one of the best ultramarathoners in the world. A multi-world record holder, the trained scientist was the first person to win both the storied 55-mile Comrades Marathon in South Africa (2017) and the 153-mile Spartathlon in Greece (2023). Last year, she set the all-time American, 48-hour distance record, clocking 270 miles for the third-best performance ever in the world.

In March, Herron set a new women’s six-day world distance record at Further, Lululemon’s groundbreaking women’s-only ultramarathoning event in La Quinta, California (read more about Further here). Over those six days, she ran 560.33 miles—220 laps on a 2.56-mile course—shattering her previous personal best of 270 miles. And the 42-year-old has been in perimenopause for the past two years.

Part of a generation of professional athletes competing at a high level well into their 40s, Herron is outspoken about the impact of perimenopause—the gradual transition phase before the cessation of a person’s menstrual cycle—on her performance and well-being.

“I had no idea perimenopause existed until two years ago,” admits Herron, who has a master’s degree in health and exercise science and started experiencing symptoms such as extreme fatigue and irregular menstrual cycles when she turned 40.

Meaning “around menopause,” perimenopause refers to the hormonal changes leading up to the end of menstruation and reproduction capabilities. While the timeline varies by individual, perimenopause often starts in the late 30s or early 40s and lasts for several years until menopause, which is defined as when a person has not had a menstrual cycle for 12 consecutive months. During this transition period, dramatically fluctuating estrogen levels cause symptoms such as irregular menstrual cycles, hot flashes, night sweats, mood swings, sleep disturbances, and changes in menstrual flow.

Herron went public about her symptoms last year in an Instagram post, where she talked about how “there isn’t a blueprint of when and what someone will experience and knowing what the right solution(s) are.”

“I feel like women have held in this struggle all these years, and holding it in was making me struggle even more and impacting my mental health,” Herron says. “Just talking about it eased that burden.”

But in addition to feeling isolated and experiencing sudden changes in her body, she also feared a decline in performance.

“I want to help normal women know more about perimenopause and how to cope with it, but also how to manage it as an athlete,” she explains. “And even though I’m going through these hormonal changes, when I feel great, I feel really great.”

“Even though I’m going through these hormonal changes, when I feel great, I feel really great.”

How Camille Herron has adjusted her training for perimenopause

Herron credits her medical team and sports dietician for helping her develop strategies to dial in her training to minimize symptoms and maximize performance.

For her, one of the first signs of perimenopause was a high iron level, which was causing Herron fatigue, joint pain, and muscle weakness.

“Your period helps regulate your iron, but when you go through perimenopause, you’re not having your period as often, so it becomes harder to manage,” explains Herron. She also quit taking her oral contraceptive—a move she says also helped alleviate her symptoms—and started following the Root Cause protocol, an anti-inflammatory diet.

In addition to these lifestyle changes, she also cut back on running volume and distance.

In the weeks leading up to Further, she kept her mi