Running Strong at Altitude: A Women's Guide to Racing Higher

More women are taking on high-elevation trail races every year. From the Alps to the Andes to the Drakensberg, these events offer wild beauty and deep challenge. Altitude influences how the body performs and recovers, but it should not hold you back from the big mountain goals that call you. With the right preparation, you can meet the altitude as an ally, not an obstacle.

Why Altitude Changes the Game

Above roughly 1500 metres, air pressure drops and every breath delivers less oxygen. The body compensates by increasing breathing rate and heart rate, which can make familiar paces feel harder. Sleep and appetite can also shift. Most trail races that count as altitude events sit between 1500 and 3000 metres, so the effects are noticeable but manageable with good planning.

Research and Female-Specific Insights

Research shows that seven to ten days at moderate altitude allows the body to adapt blood volume, oxygen transport and breathing efficiency (Millet et al., Frontiers in Physiology, 2022; Wehrlin et al., Sports Medicine, 2023).

For women, iron status and hormonal balance add extra layers:

• Women often begin with lower haemoglobin and ferritin, which limits oxygen delivery. A ferritin level of at least 40 ng/mL, and ideally 50 to 70 ng/mL, supports endurance and recovery at altitude.
• Altitude and long travel can disrupt sleep and menstrual rhythm. Tracking cycle symptoms and adjusting training load helps maintain stability.
• Energy availability matters. Under-fuelling amplifies fatigue and hormonal stress, especially in the luteal phase.

Preparing Without Overcomplicating It

1. Annual Iron Check: Every woman in our community is encouraged to have her iron levels checked at least once a year, ideally before a new training cycle begins. Think of it as part of your training toolkit, like new shoes or a plan refresh. When you know your numbers, you can fuel, train and recover with confidence.
2. Six to Ten Weeks Before Travel: Arrange a blood test for ferritin, iron, B12, folate and vitamin D. Emphasise iron-rich foods paired with vitamin C. Seek medical advice before supplementing.
3. One to Two Weeks Before Travel: Focus on sleep, hydration and consistent meals. Build a small sleep bank before you leave.
4. On Arrival: If possible, arrive seven to ten days before the race. Rest for the first few days, move gently, eat well and sleep early. If that window is not possible, arrive four to five days before and make travel part of your taper. Rest completely for the first day or two after landing.

If Early Arrival Is Not Possible

Sometimes life and budget do not allow the ideal. I have definitely travelled right before a race at altitude and simply made it work. When that is the case, focus on mitigation:

• Hydrate before, during and after travel. Include electrolytes every few hours.
• Move often on long flights to support circulation.
• Expose yourself to daylight on arrival to reset your body clock.
• Eat iron-rich meals and avoid skipping snacks. Appetite can drop at altitude.
• Keep the first 24 to 36 hours on the ground easy with walking and mobility.
• Expect your heart rate to run slightly higher early in the race and pace by effort rather than speed.

Training Smart at Altitude

• Run by perceived effort and maintain a conversational pace on climbs.
• Extend your warm-up to allow oxygen delivery to stabilise.
• Fuel early and consistently, aiming for 30 to 60 grams of carbohydrate per hour.
• Prioritise post-run recovery: protein within 30 minutes, stretching or yoga and plenty of rest.

Mindset and Adaptation

Many women cannot take ten extra days off work to adapt and that is completely fine. Your body is capable of performing well with the right attitude and small adjustments. Focus on what you can control: hydration, fueling, rest and pacing. Stay calm, be kind to yourself and let curiosity lead. The mountain rewards presence more than perfection.

Her Trails Takeaway