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Menstrual Cycle and Exercise: A Complicated Relationship

Now, I am not a women nor can I relate to what women go through on a monthly basis (apart from roughly monthly when the shopping bill doubles to feed my girlfriends cravings), however what I can do, and will attempt to do below, is look at the research and try to make sense of it, give you my take, and hopefully some takeaway messages that can be put to practice, whether you're a man or a woman.


What is the Menstrual Cycle?

Your menstrual cycle is divided into two phases, the follicular phase, and the luteal phase. Your follicular phase begins during menses and runs until ovulation, your luteal phase runs from ovulation until menses. Throughout these two phases your body goes through an array of hormonal fluctuations, the two most prevalent being estrogen and progesterone.

These two hormones usually follow a very predictable cycle patterns throughout the menstrual cycle, with both being relatively low during menses, estrogen then begins to build during the follicular phase right up to its peak just before ovulation, estrogen then begins to wane and progesterone begins to build, peaking at mid luteal phase, followed by a wane of both hormones ready for menses and the subsequent start of a new cycle.

Now you may be questioning why all this information, is it relevant?

Yes, both those hormones have effects on the nervous and skeletal systems, with estrogen showing an excitatory effect, and progesterone having an inhibitory effect on neurotransmitters. Therefore, it could be interpreted that if estrogen has an excitatory effect then, surely, we should see greater athletic gains during its peak, from the end of menses to the start of ovulation, and a decrease in performance markers when progesterone is at its peak, somewhere between ovulation and menses, right?

Unfortunately it isn’t quite as simple as we thought, during a recent systematic review and meta-analysis looking at studies measuring variations in strength and fatigue markers during menstrual cycle, it was found that the data is inconclusive, and no consistent data seems to point to one particular cycle phase outperforming the other.


It isn’t however taking away from research that have found evidence that training in mid-late follicular phase shows greater gains in muscle strength and muscle diameter, while others show that endurance training is enhanced during the luteal phase. I am just saying that there are other factors that I believe need to be considered.

What are they?

One being that menstrual cycle can’t be identified as simply two phases, the hormonal fluctuations during each phase surely warrant a divide, while the variations in cycle lengths and levels of hormones secreted also need to be taken into consideration.

For example, how much level of testosterone is present, especially in studies where a performance difference was found, what is the estrogen to progesterone ratios, plus I guess sampling bias and sample sizes are also something to consider.

These amongst other implications need to be considered.

Most studies divide the cycle into the two aforementioned phases and simply compare one to other, or measure mid phase to another phase, early phase to end of the other phase, and so on, and this creates a jumble of information that is very hard to interpret and action in the real world.


The biggest issue to me is effects, or symptoms. Effects in menstrual cycles vary greatly in women, from symptoms to hormonal shifts, which increases discomfort and a perceived impaired performance. In addition, most of these symptoms and subsequent feelings go unnoticed and un-talked about with coaches/trainers, this can result in programs that do not take such issues into consideration, poor performance, de-motivation, and ultimately a lack of interest in the program itself.

In fact, a study in 2018 showed that a large proportion of athletes reported negative side effects during their menstrual cycle, over 70%. And the sad thing is a lot of these athletes do not talk to their coaches about these issues, why?

I guess it is a topic that is somewhat still seen as taboo but hello, it is simple human biology and we must take it seriously. The research is starting to catch on and more and more literature is beginning to trickle out on the subject. I personally would like to see more done on the psychological impact of menstrual cycle, how it impacts performance, and how those findings can be applied to a working program.


I guess what I am trying to say

Everyone is individual, talk to your trainer, if you have one, about this and together come out with a plan that suits you, and if he/she doesn’t want to consider this as an opportunity to further enhance your program then I suggest you seriously question your coach choice. If you don't have a coach then track your cycle for a few months, keep a mood diary alongside it, and use the findings to better direct your workouts.

I know I have probably babbled a fair bit but the key takeaways are:

- Track your cycle, if you do not already do so. Link those cycles to how you feel, really connect with how your body works.

- Talk to your coach/trainer, if you have one. If not then use your tracker to work out how to better periodise your own programme. Or talk to me and I can be your coach :-)

- When training, if it feels right to push more then do so, if not then take that opportunity to practice some regeneration/recovery. Use this to learn more about yourself, make that mind/body connection.

If your current program works for your, great, keep it up and do not change. Remember the phrase, if it isn’t broken don’t fix it.

Science is a wonderful thing however please do keep in mind that all these studies have deviations in their participants results, and does not mean that everyone fits the same model.


Until next time, ciao.

Any and all questions welcomed, feel free to email me for more info.


Wilson.

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