[This is a guest post by Beatriz Fernandes. Beatriz received her BS in Exercise Science, MS in Management and is currently participating in the Athletic Lab Internship Program. Beatriz has experience coaching at a variety of levels in the US and over in Europe and holds certifications with US Soccer.]

As I briefly explained in my previous blog posts (part 1, part 2), women not only have a different anatomy, but also a unique physiology. The hormonal changes that control the menstrual cycle and the ovaries? ability to produce an egg might also, consequently, affect the ability of the muscles, mind, and even mood to perform and recover depending on the hormonal phase the athlete will be in. Considering these recent findings, researchers and sports scientists have suggested putting all research data side-by-side and proposed matching the Menstrual Cycle Phase with a training priority considering the hormonal levels and their impact in training performance.

In order to combine all of this information, first and foremost, the athlete would need to track her period for at least three months. This would not only allow the athlete to know when the first day of the menstrual cycle would be, but also, predict all the other phases that, as mentioned on the previous post, will behave differently between them.

This tracking can be done through direct methods such as blood, urine, saliva, ultrasounds, and endometrial biopsies. Indirect methods like marking the days on the calendar and adding symptoms when relevant, which begin before the period, are less invasive and cheaper. Phone apps like FitrWoman or Clue are also useful tools that can be used as an indirect method. For athletes who use hormonal contraceptives, basal temperature tests can be helpful; however, the use of contraceptives (beyond contraception itself) are not recommended by researchers and sports scientists as they may give a false indication of menstrual health. (Sims, 2016; Pitchers & Elliot-Sale, 2019).

Period Tracking and the Training Road Map:

Once the athlete’s menstrual cycle calendar is designed, which is important to continue tracking in case some cycles differ from what is expected, the athlete and coach will be able to identify the regular symptoms in each phase. Although textbooks say that a 28 day cycle is the most common, a menstrual cycle can vary from 21-40 days cycle (Sims, 2016). This means that the athlete with a 21 day cycle follicular phase will be completely different in length than the athlete with 35 day cycle. This is important to mention because of the estrogen and progesterone hormonal imbalance throughout the phases: the same training plan will not have the same results in these two athletes due to their unique physiology that allows them to be at the “top of their game” in different moments.

Many strength and conditioning plans are based on a four-week cycle and the stages of stress purposed by the General Adaptation Syndrome (GAS). Usually, during the first and second weeks, the body is exposed to a new stress and overload. During the third week, the body creates resistance in order to reach the threshold of desired adaptation , and on the fourth and final week, exhaustion to that stimulus appears. This final week is usually used for testing and recovery, preparing the athlete for the next training cycle.

A 28 day menstrual cycle would fit almost perfectly into this model. Here is why:

If the athlete tracks her cycle and knows exactly when and for how long the phases will last, the MC can then be used as a natural ergogenic aid (Sims, 2016). According to some studies, in the Follicular Phase “low hormone” the training focus is recommended to be on strength/power training (low repetitions and high weights) and high intensity endurance training; however, during the Luteal Phase “high hormone” the recommendation is on less cardiovascular intensive work, functionality, technique, and endurance maintenance (Sims, 2016, Pitchers & Elliot-Sale, 2019).

When matching these recommendations with GAS, the Follicular Phase would ideally match the overload/resistance of the first three weeks and the Luteal Phase would match the deload / maintenance of the fourth week.

Although the research is not consistent on showing significant effect of the cyclical hormonal variations on maximal strength, it is agreed upon sports scientists that the Follicular Phase (first part of MC, pre ovulation) is associated with an increase in endurance, strength-endurance, muscle growth, insulin, and pain tolerance when compared to Luteal Phase, which is the second part of MC, post ovulation. (Pitchers & Elliot-Sale, 2019; Sung et al. (2014).

But, there is a catch. What if the athlete does not have a 28 day cycle?

For example, if the athlete has a 21 day cycle, the Luteal Phase – when deload/lower intensity training should happen the training plan will fall on the resistance stage of GAS, and the Follicular phase when the athlete could be training hard – the training plan will fall on the deload week of GAS.

A different, but similar mismatch would occur if the length of the cycle was 35 days in which the Follicular phase would last around four weeks and the Luteal Phase would be hitting a second cycle of GAS, exposing the athlete to a new stressor when her physiology is compromised. Some studies even say that stressors, characterized by situations which create a demand for performance or require adjustments to new demands, increase the risk of a long cycle (Harlow SD, 1991).

Often, the traditional training plan might not be a perfect fit.

Even if the athlete has a 28 days cycle, if neither the athlete nor the coach is aware of the athlete’s menstrual cycle calendar and the training plan is implemented around the athlete’s ovulation day, the whole training plan could become very unproductive. If that situation happens, the stage of resistance to the desired adaptation will fall on the late luteal phase, phase which the female athlete simply cannot physiologically perform at her best, and in this case, even falsely accused of lack of fitness.


This table, adapted from Hamilton, 2012 and retrieved from Kaizen Health, visually combines all we have been exploring up until now.

If you notice Hamilton used a 31-day cycle training approach and takes into considerations the psychological changes that also occur (poor reaction times and mood, for example). Although this table shows the application of theoretical research, athletes and coaches need to be mindful that this is not a one-size-fits-all type of model. This was a real setting created by Hamilton after tracking a women’s rugby team which did not include hormonal contraceptive users nor athletes with menstrual dysfunction.

Based on the ideas mentioned above, the Menstrual Cycle can be used as a roadmap for performance and recovery. It can also be used to make adjustments to training plans. This roadmap will be different for every female athlete even on a team setting. Professional athletes, for example, must perform no matter what day of the cycle games and competitions fall and it will be important for them to know and understand their weaknesses on those days.
Knowledge will bring athletes a mindful control instead of the uncontrolled anxiety some MC bring.

Summarizing the main points:

  • The menstrual cycle has a life cycle that can and should be tracked
  • Each phase of the cycle has a main need, main change, and main impact on sports performance that if properly addressed it can enhance athletes’ performance
  • Tracking and open communication will bring tremendous benefits for the athlete’s health and performance
  • Strength training programs for women can be tailored to each athlete’s menstrual cycle and coaches should take hormonal fluctuations into account
  • Creating and implementing a training plan around the menstrual cycle can be challenging and taxing for the coach, but it will potentiate and optimize their female athlete’s performance
  • It’s not a taboo subject for male or female staff. It affects performance and can enhance performance and once we accept that, that’s where we’ve made great strides. Phill Neville, UK’s Soccer National Women Coach

References:

  • Hamilton, D. The impact of Monitoring Strategies on a Team Sport Through an Olympiad: Physical Development, Taper and Recovery. Proceedings of the 8th UKSCA Annual Conference. Royal Holloway University, Egham, London. 2012
  • Harlow SD, Matanoski GM. The association between weight, physical activity, and stress and variation in the length of the menstrual cycle. Am J Epidemiol. 1991 Jan;133(1):38-49.
  • Pitchers, G. & Elliot-Sale, K. 2019, Considerations for coaches training female athletes retrieved from Issue 55/December 2019, Professional Strength and Conditioning, UKSA.
  • Selye H. (1950). Stress and the general adaptation syndrome. British medical journal, 1(4667), 1383 1392.
  • Sims, S. 2016, ROAR: How to Match Your Food and Fitness to Your Unique Female Physiology for Optimum Performance, Great Health, and a Strong, Lean Body for Life. 1st Edition, Rodale Books (2016)
  • Sung, Eunsook et al. 2014. Effects of follicular versus luteal phase-based strength training in young women. SpringerPlus vol. 3 668. 11 Nov. 2014
  • General Information retrieved from:
    • https://www.fitrwoman.com/publications
    • https://mennohenselmans.com/menstrual-cycle-periodization/
    • Table retrieved from: https://kaizen-health.uk/resources/blogs/influence-menstrual-cycle-strength-training-timing/
    • GAS graph retrieved from: Kang, Yune. (2011). Journal of the Korean Medical Association.
  • Phone Apps mentioned:
    • https://www.fitrwoman.com/
    • https://helloclue.com/