By Callum Hodgson
After years of neglecting research of all kinds on females, including the menstrual cycle and athletic performance, the scientific community is rapidly playing catch up to better understand the effects of the cycle and its interaction with sporting performance. A once taboo topic with outdated and confusing notions such as exercise is too “stressful” for females during a period and that they should rest in this time to maintain fertility are now disregarded. This old rhetoric has left many athletes, adolescents and parents with questions about this topic. Within this blog we will cut through the nonsense and describe the implications the menstrual cycle may have on performance and offer some practical advice as to how best you can manage yourself through it! If management is needed at all!
The Menstrual Cycle:
Menstruation or a period usually occurs 9 to 10 times per year with one full cycle lasting anywhere from 21 to 35 days, often the cycle is cited as lasting 28 days however it is in fact highly variable from person to person. The onset of this cycle occurs on average at the age of 12, but again is variable and can occur as young as 8. Around the onset of the cycle it is normal for periods to be more irregular as parts of the brain that regulate this process have not fully formed. The entire cycle is mediated by several hormones that fluctuate throughout the month, two important ones are oestrogen (OE) and progesterone (PR). The fluctuations of these hormones has been reported to be ONE of the POSSIBLE reasons why mood, performance and other symptoms experienced during a cycle occur. However we will discuss this in more detail in the following sections! Again these symptoms and experiences can vary from person to person. Have you noticed the theme yet?
Hormones Throughout the Menstrual Cycle:
There are four key phases in which OE and PR fluctuate across a cycle, these are early (days 1-7) and late (days 7-14) follicular. As well as early (days 14-19) and late (days 19-28) luteal. I am using a 28 day cycle for ease, however I will reiterate here the individual nature of the cycle.
A common theory for performance enhancement or decrements during the cycle is the fluctuation of OE and PR. The theory for this is that OE is deemed a “neuroexcitatory” hormone that encourages the muscles to contract with more force and that PR is the exact opposite so therefore has the opposite effect.
According to this theory there should therefore be distinct phases in which females should be physically more ready to perform. This insinuates worse performance during the early follicular when OE is low, better performance in the late follicular stage when OE is high and PR is low. And again worse performance when PR is high during the luteal phase counteracting the positive effects of the high OE. Does the majority of research actually reflect this though, and is this actually practical?
The Evidence:
To cut a long story short, not really! Some research has found a reduction in some measures of performance in the late luteal and early follicular phase where OE starts to drop and the period starts, compared to the late follicular phase where bleeding stops and OE rises again. However the differences are so small and trivial that for all purposes it is practically insignificant. Whereas the vast majority of current evidence suggests that there is no link between phases of the cycle and physical performance. It is also important to realise that the interplay of hormones throughout the cycle are complicated and may have different effects on multiple aspects of performance and health. It is also important to realise the quality of much of this research is still pretty low and solid conclusions should definitely not be drawn from them until higher quality studies are undertaken.
With this being said a high proportion of females suggest that during their period or just before their period (late luteal or early follicular) they perceive their performance may be affected negatively by symptoms. Whereas some others report no interference and feel as though exercise and performing is beneficial. This is made obvious through some females being able to set world records whilst on their period! Yet a large proportion of athletes, (67 %) in one study, perceiving their performance was negatively affected.
Practical Suggestions for Training Around the Menstrual Cycle:
Clearly this suggests the need for a very individualised approach towards the menstrual cycle and sports performance or exercise. The first step in being able to minimise the effects of possible negative symptoms is having an open conversation with a trusted S&C coach, sports coach or parent about how you feel you may be being affected. These conversations should be normalised as it is another variable that may affect some athletes’ readiness. It should be viewed the same as questions around sleep, nutrition and training loads. Once this dialog has started here are some practical tips on how you can approach dealing with possible symptoms:
- Begin to track your cycle and symptoms across the four key phases and begin to notice any common trends in symptoms across these phases. This can be done the old fashioned way as part of a journal or on apps, I would recommend Fitrwomen!
- Once you have tracked these over a period of a few months and are seeing common trends at certain phases, have a conversation about training with your coach during that time.
- This doesn’t mean a cessation of training but possibly a reduction of intensity and volume around this time. For a gym based session this could look like offering a range of intensities to hit such as 70 – 80 % instead of one definitive load.
- Ensure nutrition and sleep is prioritised the entire month but particularly when symptoms are prevalent. This could be as simple as scheduling a twenty minute nap around this time or extending your sleep which can help reduce inflammation associated with hormone fluctuations. For good sleep habits see HERE.
- There is not enough evidence to suggest specific supplementation to help menstrual symptoms however a well balanced diet throughout the month is vital to maximise recovery and performance, see HERE for recommendations. Good sleep and nutrition is imperative especially when match days are non – negotiable.
- Some gentle aerobic exercise or yoga has been shown to help reduce symptoms. This could mean taking a short walk or performing a 15 minute yoga when symptoms are bad. Search Yoga for Cramps and PMS for a routine.
Menstrual Cycle Dysfunction:
It is also important to mention that a regular menstrual cycle is an important indicator of your health. Any sudden fluctuations from your normal cycle with symptoms such as:
- Cycles lasting more than 40 days or less than 21 days
- Missing or having no period
- Having very heavy or very painful bleeding
Should be investigated further by a medical professional. These symptoms may be as a result of overtraining and under-fueling and can lead to increased risks of injuries as well as a host of other health problems.
Some studies suggest that up to 20 % of females suffer from menstrual cycle abnormalities. Sports with stigma attached to weight such as combat sports, ballet or gymnastics are at a higher risk. This highlights the importance of sufficient nutrition and recovery to ensure the risk of these issues are minimised, and that you should never sacrifice your menstrual health for sports performance!
Key Takeaways:
The overarching theme is that each female athlete’s experience of a cycle is individual and as such the approach to training and performing should be matched. We have seen that there is not enough evidence to suggest only training or tailoring specifically to certain phases where OE may be high and PR low for every athlete. And that there is no clear link to a decrease in physical performance at any point in the cycle. If we only ever trained when OE is high ultimately we may miss out on enhancing performance be it on pitch or in the gym. This doesn’t mean however that an athlete’s training shouldn’t be tailored to them depending on their individual perceptions and symptoms.
We instead suggest that with careful monitoring of symptoms throughout the cycle that training potentially be altered to lower intensity aerobic type training on a case by case basis if you find that your energy levels and mood decrease and painful symptoms increase. This is likely to be around the late luteal phase or early follicular phase for most females which is pre and circa the period. Ultimately there is no magic wand or pill to eliminate negative symptoms. But consistent good habits such as great sleep, nutrition and recovery along with some light aerobic exercise or yoga will help manage potential negative symptoms of a period.
Finally it is important to note that this information only covers athletes not on forms of hormonal contraceptives and specifically focuses around performance. For more information on how hormonal contraceptives may affect performance and other important aspects of women’s health and the menstrual cycle please read this ARTICLE or contact us through our website here or our instagram page @move_4_sport.