Training Around Your Menstrual Cycle

How do I manage my training around my menstrual cycle?

Within the field of exercise science, research has traditionally been conducted on men. In the history of medical research, it wasn’t until the 1990’s that it became mandated to include women in clinical trials. The result of this is that the research around women and their optimal training regime is in its relative infancy.

Another compounding problem with this research is that when designing studies, there have been exclusions of women who suffer from “menstrual dysfunction or disorders”. These include what we now know are very common symptoms for the majority of women, such as premenstrual symptoms, painful cramps, irregular periods and heavy bleeding. A study from 2022 of 1086 athletes from 57 sports, found that these symptoms affected up to 78% of female participants.

While many women do experience what is described as a “perceived” change in performance throughout their cycle, it is important to understand what the evidence says about formulating a training plan around your menstrual cycle, as well as the how this affects women who are taking a hormonal contraceptive.

The Natural Menstrual Cycle

While the average menstrual cycle is 28 days, it is important to remember that this can vary significantly from one woman to the next. It can also vary from one cycle to the next for any particular woman.

During the follicular phase (the first part of the cycle), oestrogen is on the rise. Some studies suggest that strength training during the follicular phase results in greater muscle strength than training during the luteal phase (second part of the cycle). This is possibly due to the fact that oestrogen helps us to build muscle. As we get closer to ovulation, in the middle of the cycle, we also experience an increase in Testosterone. Both oestrogen and testosterone can have a positive effect on mood, energy and strength and is when women may feel they can train harder.

It is important to keep in mind that this hormonal peak can also correspond with loosening of the ligaments, so attention to correct form is important to prevent injury. During the luteal phase there is an increase in progesterone and oestrogen begins to decline. This is when women may experience their energy tapering off.

With the decline in oestrogen and progesterone at the end of the cycle, close to menstruation, premenstrual symptoms can develop which include bloating, fatigue and mood changes. This can have a negative impact on performance and women may feel they are unable to train as hard as they could earlier in the cycle. This might be a good time to de-load and focus more on recovery. There is some evidence to suggest that muscle strength and performance are trivially reduced during menstruation.

Hormonal contraceptives

Hormonal contraceptives can be either a combined pill, which includes a combination of oestrogen and progestogen (similar to naturally produced progesterone) or a progestogen only pill. There are also many other forms of hormonal contraceptives that include but are not limited to long-acting reversible contraceptives such as Intra-uterine devices (IUD’s).

Many women will use contraceptives to prevent pregnancy, however they are also commonly used by many women, including athletes, to gain control over the menstrual cycle and help to manage symptoms. While using hormonal contraceptives, the hormone profile will not be the same as a natural cycle. Side effects are still reported though and can be variable, depending upon the contraceptive in use. Most of the pills prescribed will consist of “active” pills that contain hormones and then “inactive” pills at the end of the cycle, sometimes referred to as sugar pills. Taking the inactive pills at the end of the cycle results in a bleed.

When measuring women’s performance, while using hormonal contraceptives, researchers have looked at measures of performance including: aerobic fitness, muscle strength, mental sharpness, balance and sleep quality. Some studies have suggested that while side effects do occur that negatively impact performance, they do not appear to occur during the use of the active pills, but rather during the use of the inactive pills.It was also noted that while the risk of ligament injury appears to be higher around ovulation in a natural cycle, this risk appears to be minimised in athletes who use hormonal contraceptives. It is speculated that the decline in a woman’s performance across her cycle is not so much related to the hormonal changes and is possibly indirectly related to symptoms that are experienced such as PMS, lack of sleep and pain.

What does this all mean for me?

It is obvious that there is still a lot of work to be done in this area and the current recommendations appear to be that there is no evidence to suggest that a training program needs to be designed around an individual’s menstrual cycle. While many women do report being able to train differently at different phases of their cycle, at this point in time the evidence doesn’t suggest that specific programming is always required.

The actual reality of a women’s experience can be very different to this. Many women will take time off training during menstruation for a number of reasons. Each woman knows her body better than anybody else and should be encouraged to listen to her body and pay attention to what feels right for her at any given time. A good trainer will listen to their client and work with them to optimise their results and minimise any potential injury.

If you feel that you are experiencing menstrual cycle complications that are significantly impacting your quality of life and ability to undertake activities, it is best to discuss this with your doctor to develop a suitable management plan. At TML Coaching, it is important that you feel comfortable to discuss any concerns you may have in this area so we can fully support you to be your healthiest version of yourself!

Further reading:

• Perceived impact of the menstrual cycle and hormonal contraceptives on physical exercise and performance in 1086 athletes from 57 sports: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9468598
• The impact of menstrual cycle phase on athletes performance: A narrative review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916245/
• Endozone: https://www.endozone.com.au/

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