Hogarth Women's Health Focus: Training and The Menstrual Cycle
Now, before we start, let’s address the elephant in the room. I am a man writing about periods. At the risk of mansplaining a topic I have no personal experience of, I would just like to admit that my wife made me do it.
How did it come to this? I was in bed, on my phone, chuckling at memes. Meanwhile my wife was beside me reading Period Power by Maisie Hill. The mood in our bed would best be described as mixed.
The lack of conversation about this issue is a sign of the patriarchal society we live in, and it is damning that something which affects half the population is stigmatised and shied away from. This blog aims to address the social, scientific and sporting aspects regarding the menstrual cycle.
It is imperative that men, as well as women, learn about the subject and encourage an openness about something that will impact not just women’s daily life but training too. At The Hogarth we always aim to create an environment not just focussed on training programmes but overall wellbeing. They complement each other too, so more than a choice, we have a duty to do so.
The menstrual cycle is still a cultural taboo. As a trainer at the start of a session we would ask how the member is. Whilst injuries, niggles, or energy would be brought up only a minority of my female clients would mention how they felt in relation to their cycle. Maybe it’s having a weird trainer like me that freaks them out but we should want to smash down the barriers that are holding back the conversation, should women wish to do so.
Whilst women are obviously more informed than men, both sexes have plenty to learn when it comes to sports physiology and periods. According to Dr Emma Ross, co-head of physiology at the English Institute of Sport more than 70% of women have not received education about their menstrual cycle and exercise.
ATHLETES AND MENSTRUATION
Back in 2015 when tennis player Heather Watson lost at the Australian Open, she put the result down to “girl things” and it was seen as a ground-breaking moment. She won plaudits for daring to speak out about it. The fact she felt unable to use the word period demonstrated where we were as a society. Sadly, I’m not sure enough has changed since then.
In 2019 Chelsea Women became the first UK professional football club to take the menstrual cycle into account for their player’s programmes following a lead from the US National Women’s Team, which embraced the area within their team on the way to winning the World Cup. The Chelsea manager Emma Hayes said “It is fair to say, I am a female coach in an industry where women have always been treated like small men. The application of anything from rehab to strength and conditioning to tactical all come from the basis of what men do.”
One of the tools the Chelsea players use is tracking their cycles with an app. This can help give you feedback, advice and a reference point to what is going on and what to expect, providing with better strategies throughout. An app can help you spot patterns so you can pre-empt and prepare. Of course, many women also use contraceptive pills to regulate their cycles.
Overall, studies have been inconclusive. One study approximated 75% of athletes experience negative side effects during their periods. These include cramps, back pain, headaches, and bloating. Other research also indicates fluctuations in strength, metabolism, inflammation, body temperature, fluid balance and injury risk that are associated with hormonal fluctuations throughout the cycle. However, the way in which the menstrual cycle affects females and their performance is highly individual and numerous studies indicate no differences across the cycle. If you were hoping for easy answers, sorry to disappoint you!
THE MENSTRUAL CYCLE BROKEN DOWN
To try and understand what women can go through let’s take it back to a reminder of what the purpose of the menstrual cycle entails. The body is being prepared for the possibility of pregnancy through a series of changes. An egg is released from the ovary and the uterus lining thickens during the second half, the luteal phase. If the egg is not fertilised before the end of the cycle this lining is shed through the vagina during a period.
Hormones are key throughout. Oestrogen is on the rise during the first half, the follicular stage, spiking just before ovulation then dipping before a little comeback before premenstrual syndrome (PMS) hits. Progesterone is quiet during the follicular stage but after ovulation it steps up helping thicken the lining of the uterus to prepare for a fertilized egg. There is a little cameo from testosterone as it pops up around ovulation. Two other hormones peak at ovulation, luteinizing and follicle stimulating hormones (LH+FSH) which help to release the ovum (the egg pre fertilization).
THE FOUR SEASONS – HOW THEY CAN AFFECT YOUR EXERCISE
During the four stages of the menstrual cycle women will go through a variety of moods, emotions, waves of energy and tiredness. Hormones are bouncing all over the shop. Fitting in an appropriate training regime around all those factors is complicated. This blog can give you the tools to get more control over understanding your cycle and its machinations and its effect on your and exercise and wellness. As trainers we are often there to push you to do more and, let’s be honest, our answer to any problem is more exercise. However, the type of activity and the intensity at different points of the cycle may need to vary.
Every woman will have her own story to tell about her cycle so it’s vital to listen to everyone as individuals. The whole subject is splendidly discussed in Hill’s bloody brilliant book. She descriptively uses the four seasons to illustrate the four stages of the cycle.
WINTER - THE PERIOD
The thickened lining of the uterus is shed as the egg has not been fertilised and it is a fluid containing blood shed through the vagina. It can last between 3-8 days but usually it’s about 5 days. The body can feel heavy and uncooperative during this phase. Bad cramps can affect one as they did with Watson. On the flipside Paula Radcliffe ran a marathon world record despite these cramps in the last third of the race in 2002. Which shows how hard to predict the impacts are.
What we can anticipate is that it can be a tough winter and exercise can boost your endorphins. You may do some restorative exercise to ease the symptoms. If you feel you want to push hard that is fine too. Exercising with a friend, a partner or a trainer will also make you feel better. Although I’d let my wife speak for herself when she has all three in one.
Don’t be harsh on yourself, spring is around the corner! The pains are often caused by pesky inflammation so try and eat anti-inflammatory foods such as fish, green leafy vegetables or berries to alleviate the aching.
SPRING - PRE-OVULATION
This will take you up to around day 14, the mid-point of your cycle. Now here you will start to feel good as your body wants you to get in the mood. The follicular stage here sees the ovary producing 5-20 follicles which house immature eggs. Usually only one of those matures into an egg whilst the others die. At this point the lining of the uterus is thickening in preparation for pregnancy. Women will be buzzing, feeling extra keen to push harder and are likely to be more sociable. Some studies have indicated a link to injuries as joints relax with the oestrogen boost so just be aware of any individual history of potential risks to joints.
When it comes to nutrition, it’s time to load up. Eat a healthy and balanced diet to support the increase in training intensity. Complex carbs, lean protein and good fats are all on the menu.
SUMMER - OVULATION
It’s peak time baby! Say hello to your best self. Confidence should be soaring as you feel productive and playful. Embrace this in your training. Testosterone arrives on the scene too which can lead to you posting some personal bests. Seize that moment as you will encounter a sharp drop after ovulation as oestrogen plummets. Feel free to lower the training intensity during this reversal. Through the summer get some good protein in to help recovery and try and avoid cravings by eating complex carbs. Yes, ovulation is all about those seeds and nuts.
AUTUMN - PREMENSTRUAL
Lasting approximately the last 3-4 days of the cycle, here is where I’m gonna regret getting involved in this, isn’t it? Hello minefield. Like leaves dropping so will the mood. Negative emotion, such as anger, sadness or frustration are heightened. They may just be highlighting how you really feel about something in your life. If you were looking to turn this into a positive, channel this focus into your training and get it done.
A whirlwind is going on throughout. Appetite is flying at this point as blood sugar is low. There will be a light resurgence in oestrogen before it drops again just to mess with you some more. Don’t be hard on yourself. Take it out on your trainer! Sweating out excess oestrogen can help with aerobic exercise. High intensity interval training can improve insulin sensitivity. Managing regular bowel movements should help regulate hormones so drink plenty of water. Sleep can be affected too so avoid alcohol, which will only make it worse. Try to allow the body the recovery it needs.
If it all starts to feel a bit much, step back, embrace the power of a deep breath and get back to low pressure holistic exercises.
LOOKING AHEAD
Dina Asher-Smith, the great British sprinter and current Olympian has been vocal in normalising the discussion around her training during her period. She has repeatedly highlighted the need for a supportive, understanding environment which can be unpredictable.
Asher-Smith emphasized that every athlete is different, some brush off their periods and some are concerned it will affect their performance. In her experience she has noticed that:
“Every major injury I’ve ever had has been on my period,” she says, “which is absolutely crazy. It’s for a number of reasons. The hormone levels in your body change. Your ligaments change. Your lower back’s sore, which means it pulls on your hamstrings more, and for a sprinter our hamstrings are our bread and butter. It’s not only your moves that are different. You make decisions that normally you just would not make. Sometimes I get insomnia on my period. So, instead of a consistent 10-hour sleep, suddenly it’s five hours, it’s four hours. If it’s a particularly bad period? That changed sleep can last for days.” “Every major injury I have had has been while I’m on my period.”
We can learn from her approach to training during her period. It can be a lesson whether you are an Olympian or a Hogarth member!
Dina Asher-Smith shared her training tips during her period with The Telegraph:
- Let your coach or therapist know that you’re on your period.
- She tends to suffer a sore back and ensures that her physiotherapist doesn’t do intense work if she’s already in pain.
- Communication is key. Usually coaches and trainers will know what to do to help, but they can only help if they know what’s going on.
- Don’t lift heavy if you’re already sore adjust your weights accordingly during your period.
- Listen to your own body and adapt training accordingly.
- Remember that it’s not a big deal, half the world deals with the same thing every month.
WHERE NEXT?
As already mentioned, one of the frustrations into menstruation and exercise is that studies haven’t been able to come to concrete conclusions. If you add to that various menstrual dysfunction conditions like amenorrhea (can happen with overtraining and undereating), relative energy deficiency in sport (menstrual dysfunction is a symptom of it) or endometriosis (affects 1 in 10 women and can be very disruptive), it can all be overwhelming.
When in need step back and refer to some of the strategies above using exercise to support and to thrive through it. I told you it’s always our answer! The evolving research to come may change our perceptions on this complex subject. All we can do is take what we know now and offer sensible advice and support for women. The power of the trainers here is listening and adapting. It is the hallmark of the good ones. We look forward to hearing from you!
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