Hormone Therapy for a Female Marathon Runner with Early Perimenopause in Salisbury, MD
A woman in her mid-30s — an avid runner training to qualify for the Boston Marathon — came to Remedy Longevity & Cellular Medicine in Salisbury, MD to optimize her health and recovery. Comprehensive labs revealed the early stages of perimenopause and testosterone levels that could be optimized. After about a year on bioidentical testosterone and progesterone, with her plan guided by InBody body-composition and PNOĒ metabolic (VO2 max) testing, she reports stronger recovery around workouts, steadier energy, and sharper focus both in training and at work.
At a Glance
- Who
- Woman in her mid-30s; avid runner and school teacher training to qualify for the Boston Marathon
- What they came in with
- Early-stage perimenopause with testosterone levels identified for optimization on comprehensive labs
- What their care involved
- Bioidentical testosterone and progesterone; ongoing InBody body-composition analysis and PNOĒ metabolic breath testing (VO2 max, fuel utilization)
- How long it took
- About one year of care
- Where they are now
- Improved recovery before, during, and after workouts; better daily energy; stronger mental focus and patience at work — including a promotion
The Full Story, in Our Clinician's Words
I have a patient who's in her mid-30s who is an avid runner and athlete. She was looking to accelerate her performance and improve her recovery actively. She's trying to qualify for the Boston Marathon as a runner. She's also a school teacher — lots of little kids, very busy job. She came into the practice about a year ago looking to optimize her overall health, see what she could do to protect her cellular function and improve her recovery.
We started by doing comprehensive labs on this patient. We found that she was in some of the earlier stages of perimenopause. Her testosterone levels were also something that could be optimized. We did start her on a regimen of bioidentical testosterone and progesterone. This over the past year has helped to improve her recovery before, during, and after workouts. She feels as though her energy has improved in the school setting. She is also able to meet the demands of the day with full energy and zest and passion for her job.
Throughout her time here at Remedy, we have deployed various different diagnostics and biometric tracking modalities for her care, including the InBody body composition assessment tool that we have here. We have also had this patient on the PNOĒ, which is metabolic breath analysis, where we're capturing VO2 max. We're looking at how efficiently her body is able to switch back between utilizing fats versus carbohydrates for fuel. Using this data, using some of the other information that we see from her blood work, we have crafted a very detailed plan for her that is propelling this patient into the next level of success and performance.
The exciting thing is that it's not just about her performance as an athlete. It's also about her performance in the workplace as a teacher. She's been able to lock down a promotion. She feels that her energy, her motivation, her mental focus is stronger. Her patience has improved. And she's seeing this on a daily basis with added success in the workplace.
This case study describes one patient's experience and results at Remedy Longevity & Cellular Medicine. Every patient is different, and individual results vary. This content is for education only and is not medical advice — please consult a qualified clinician about your own health.
Questions About This Case Study
Can perimenopause really start in your mid-30s?
Yes. Hormonal shifts can begin years before menopause itself, and early perimenopause is often missed because symptoms like slower recovery, fatigue, or mood changes get attributed to stress or training load. Comprehensive lab work is how it was identified for this patient.
How does hormone optimization support athletic performance and recovery?
When labs show levels that are genuinely suboptimal, physician-supervised bioidentical hormone therapy can support recovery, energy, and body composition. At Remedy, every plan is built from comprehensive lab work and tracked over time — this patient's plan also used InBody body-composition and PNOĒ VO2 max testing to guide training and nutrition.
What testing was used to guide this patient's plan?
Comprehensive blood work, InBody body-composition analysis, and PNOĒ metabolic breath testing, which measures VO2 max and how efficiently the body switches between fats and carbohydrates for fuel. Together these let the care team adjust her protocol based on data rather than guesswork.
