If you’ve ever pushed through a training block feeling utterly wiped out, picked up a niggling injury that seemed to come from nowhere, or noticed that your body responds completely differently from one week to the next – you’re not imagining it. And you’re definitely not alone.

For decades, the advice women received about exercise and training was largely based on research carried out on men. The programmes, the recovery guidance, the injury prevention strategies – most of it was built around a body that doesn’t experience the same monthly hormonal fluctuations, the same perimenopausal transition, or the same post-menopausal shift in bone density and muscle mass that women navigate across their lifetimes.

The good news? That’s changing. In 2026, one of the most talked-about shifts in the UK wellness world is the move towards female-first fitness – training that actually takes your biology into account rather than working against it. And as a therapist who works with women at all stages of life, this feels like a very long time coming.

Your Hormones Are Doing a Lot of Heavy Lifting

Let’s start with the basics. Throughout your menstrual cycle, your oestrogen and progesterone levels rise and fall in a fairly predictable pattern – and those fluctuations have a direct effect on how your body feels, how it recovers, and how injury-prone it may be at any given time.

Research has shown that oestrogen levels affect ligament laxity – essentially, how loose or flexible your ligaments are. This is particularly relevant around the knee. Studies suggest that women are two to four times more likely to sustain an anterior cruciate ligament (ACL) injury than men, and while there are multiple contributing factors (including anatomy and biomechanics), hormonal fluctuations are increasingly recognised as part of that picture.

It’s worth noting that the science here is still evolving – some studies show a clear link between certain phases of the menstrual cycle and increased injury risk, while others suggest the relationship is more complex and individual. What we can say with confidence is that your hormonal cycle influences your body in ways that matter for training – and that understanding this is far more useful than ignoring it.

Practically speaking, this might mean you feel stronger and more energised in the first half of your cycle (the follicular phase), and notice more fatigue, aches, or a dip in performance in the days before your period arrives. Neither of these experiences is a sign that something is wrong. Your body is simply doing what it’s designed to do – and your training plan can reflect that.

The Perimenopause and Menopause Piece

For women approaching or going through perimenopause and menopause – which typically begins in the mid-to-late 40s and can last several years – the hormonal picture becomes even more significant.

As oestrogen levels decline, the effects on the musculoskeletal system can be quite pronounced. Oestrogen is a powerful anti-inflammatory hormone that plays a key role in maintaining both bone density and muscle mass. When levels drop, the impact can include:

Joint pain and stiffness – Low oestrogen increases the rate of joint inflammation, which can cause swelling, pain and reduced range of movement. Many women are surprised to find that joint discomfort is a recognised symptom of perimenopause, not just something that comes with getting older.

Muscle loss – Women can experience a rapid decrease in muscle mass and strength during this transition, which leaves the body more prone to muscle injury and slower to recover from training.

Reduced bone density – Bone density peaks around age 30 and gradually declines thereafter, with a more rapid decrease during perimenopause and menopause. Research suggests women can lose between 15 and 25% of their bone density in the first ten years after menopause – significantly increasing the risk of stress fractures, particularly for women doing high-impact activities like running.

Frozen shoulder – This one catches a lot of women off guard. Frozen shoulder disproportionately affects women aged 40 to 60, and is now increasingly recognised as a musculoskeletal symptom of perimenopause, linked to inflammation of the shoulder joint lining. If you’ve been quietly suffering with a stiff or painful shoulder, it’s absolutely worth getting properly assessed.

None of this is meant to be alarming. These are normal biological changes – but they do mean that the way you train, recover, and look after your body may need to adapt. And the sooner you understand what’s happening, the better placed you are to stay strong, active, and injury-free.

Why “Pushing Through” Isn’t Always the Answer

Here’s the thing about being an active woman in your 30s, 40s or 50s – most of the time, you’re already brilliant at just getting on with it. You fit training around work, family, life. You push through the tired days. You tell yourself the ache will settle down.

And often it does. But sometimes it doesn’t – and that’s when things start to unravel.

When the body is navigating hormonal changes, the margin between “working hard” and “overloading” narrows. Tendons and ligaments that are more lax, joints that are more inflamed, and muscles that are losing mass more quickly than they’re being rebuilt – these aren’t things that respond well to more volume and more intensity without the right support in place.

The women who tend to do best are the ones who treat recovery as part of their programme – not something bolted on as an afterthought, but a genuine and deliberate part of how they train. That means prioritising sleep, managing load sensibly across the training week, and – crucially – seeking professional support when something isn’t settling.