by Coach Sandi Nypaver
With no knowledge from athletes or coaches on how to eat and train for optimal athletic performance throughout the menstrual cycle, there are plenty of examples of women having amazing races at all stages of the menstrual cycle. Does knowing what the research on female athletes says even matter? Maybe we can ask all the women who fear getting their periods on race day or the women who have felt bloated and lethargic on the start line of a race just because of where their hormones were at? While I can’t dispute the fact that women have raced well at all stages of the menstrual cycle long before any research came out, I also think it’s a fact that there have been plenty of women who underperformed on race day because they didn’t have any information to guide them on what they could do to feel their best when hormones were high or they were on their period. Thanks to researchers focusing more on female athletes, we now know that women who train with their cycles may see more gains than those who don’t.
The research on athletic performance and female physiology is improving, but it’s still very much a growing concept that there should be research done just for female athletes. Moreover, what we thought we knew about female athletes and performance in regards to their cycles a few years ago might already be outdated. I was listening to a podcast with Dr. Stacy Sims, a human performance researcher who wrote the book “Roar” the other day and she mentioned that she’d like to rewrite a few chapters of the book due to new studies that have come out. With the understanding that information will continue to change on this topic, I created the image below to help summarize the information on what we know now.
While I suggest that all my athletes track their cycles by using an app like FitrWoman, I was motivated to create this image for a few reasons. The idea first came to mind when I heard that the US Women’s National Soccer team has signs in their locker room reminding them about how they should alter their training depending on if they were in the low or high hormone phase. I think all women’s locker rooms could benefit from that. Then a couple of weeks ago my sister did a talk on female body image and I took a few minutes to talk about how to train and eat with your cycle and wished there was a better way to summarize the information with a visual. Most importantly, I wanted an easier way for parents and coaches to present this information to their daughters and female athletes. It still may be too much to ask that all male coaches be comfortable talking about menstrual cycles, but I think handing something out like this image would be manageable.
Applying the Research
Now that we’re starting to get more information on how female athletes can optimize training based their cycles, I think there needs to be a growing discussion on how this information can actually be applied. I’m not going to pretend to know all the answers, but for the sake of getting more people to think about this, I’m going to share some thoughts on how the current information can be applied to female runners.
A good place for me to start is by saying that I don’t believe certain types of workouts have to be excluded just because the body isn’t as primed for that type of work in a certain phase. Even the researchers who have dedicated tons of time looking at the physiology of the female athletes have said that women should never feel like they can’t do something just because of the phase they’re in. After all, some of the research has shown us that there are things that can be done to optimize performance at any phase. With that said, it may be beneficial to put an emphasis on one workout over another depending on which phase a woman is in.
Let’s say Shalane F. just started phase one and her body is primed for high-intensity intervals. Her training plan calls for an interval session of 6 x 800m at 5k pace on Tuesday and then a 2 x 3-mile tempo at lactate threshold on Friday. If Shalane was in phase two I might consider making the interval session a little longer (this depends on a lot of things), but since recovery might not be as good due to the progesterone drop causing an inflammatory response, I’m going to stick with 6 reps. However, I could say something like “If you feel great and know you can run faster than the pace range I gave you, go for it!”. (I would never say that too close to a race.) After the run, Shalane should get in the usual healthy carbs and some protein (timing does matter for women), but she should also consume plenty of anti-inflammatory foods to help aid recovery and possibly reduce the intensity of cramps. In the following days, I’d make sure she’s recovered by Friday to do the tempo session and possibly give the option to move the tempo to Saturday if that will help her crush the workout. For the tempo, it might be helpful to say something like “You should start off at the easier end of the pace range and go from there.”
Then there’s Alex M. in phase two who is currently flying high and feels like she can handle anything. (Okay, Alex usually feels like that, but now she REALLy feels like that.) Since optimal adaptations can be made right now, especially with HIIT and strength training, she’s going to do a 10 x 1km workout at 10k pace. Similar to Shalane in phase one, I might give the okay to run a little faster only if she’s confident she can hit faster paces at the right effort. Even though there are no specific suggestions on food during this phase, Alex just did a big workout and needs to make sure she replaces all the calories and fluids she lost to recover and get the full benefit of the workout. After Alex does the run and gets in some calories, she might hit up the gym and do some heavy lifting like 3 to 4 sets of 6-8 reps of deadlifts. Since Alex trains smart and is already in good shape, she might not even feel sore the next day or two. However, easy days should still be kept easy.
Serena W. is doing okay, but she’s noticing she doesn’t feel quite as strong as she did a week ago. On her schedule is a fartlek of 8 x (2 minutes Fast, 1 minute Easy) and then an 8 mile uptempo that’s part of a 16-mile long run. In this case, I could tell Serena that the uptempo is the big workout of the week and the fartlek is just to get in some speed without creating a ton of stress in the body. Good form should be emphasized along with a proper warm-up that includes some mobility and activation exercises. (Serena is smart and does this before most runs throughout her cycle.) Serena also likes to strength train and doesn’t want to lose the strength gains she made in phases 1 & 2, but she knows to listen to her body. To maintain strength, I suggest either keeping the same weight or taking some weight off of her squat and deadlift and doing 2 to 3 sets of 8 to 12 reps. This is also a good time for Serena to do low weight or bodyweight exercises that focus on technique.
To help make the most out of Serena’s long run and make sure she can hold the effort of the uptempo, a couple of things have to be considered. Serena is plant-based and avoids a lot of processed foods, which means her diet is very low in sodium compared to the standard American diet. This is wonderful and part of the reason Serena feels good headed into her long run, but because there’s a decrease in plasma volume and sodium levels in this phase, she needs to make sure she stays hydrated throughout the run using a drink with sodium in it. She does this for other long runs but pays more attention to hydration here. Since her body shifted to using more fat for fuel, to hit the paces for uptempo she further practices race day fueling by taking in a few gels during the run. After the long run, I tell her to make sure she replaces the calories she lost and to attempt to be “lazy” and get more sleep than usual to help with recovery.
As progesterone and estrogen start to decline for Tatyana M., all types of training become equally beneficial. She does okay with her 10 x 1-minute hill repeat session, but she feels like she’s not recovering from it as fast as she normally would. I slightly lower her mileage and also give her an extra easy run before her next key workout. To reduce PMS symptoms as much as possible, Tatyana starts putting an extra emphasis on eating foods rich in magnesium, zinc, omega 3’s and other anti-inflammatory foods. For part of her lunch, she might have a plate of leafy greens with walnuts, chickpeas, and berries with a large sweet potato mixed in. (In that sentence, the keyword is “part” as Tatyana knows to eat more if she’s not fully satisfied in order to become the best athlete she can be.) To further aid recovery, Tatyana will have a small glass of tart cherry juice later in the day to help promote quality of sleep.
As you might expect I could have many different scenarios with different suggestions, but I hope this is enough to get more people to start thinking about how training might be adjusted depending on what phase a woman is in. As always, keep in mind that each woman is unique and will be differently affected by her menstrual cycle. Some women may not feel the need to consider their menstrual cycle in regards to training and food choices and that can be okay.
None of the above suggestions are going to make a significant impact if a woman is anemic, not fueling properly, not getting enough sleep, etc. Even skipping breakfast every day can put a woman in a low energy state, even if she gets in enough calories later in the day. Additionally, there are still plenty of females who don’t get their periods from under fueling which will eventually lead to underperforming or an injury. It’s important the entire running community promotes a healthy body image for athletes. A good place to start is looking at The Female Runner’s Body curriculum: https://wanderlustcounseling.com/resources.
There are two other things worth noting for women, coaches, and parents. One is that it can be normal to skip a period every now and then. For girls just getting their period, their cycle will take time to follow a predictable schedule. The other thing to note is that more severe cycle related symptoms are not normal and seeking out the right advice is highly advised. Helpful advice could come from a doctor who specializes in female hormones and understands how food and lifestyle can impact hormones.
If you are a coach reading this, I wanted to include a section of the form I have new athletes fill out before I start coaching them. Feel free to use the questions for your own female athletes.
Additional Questions for Women:
(As always, you never have to answer a question that makes you feel uncomfortable.)
-Do you regularly get your period?
-Are you perimenopause, going through menopause, or postmenopause?
-Do you track your cycle either using an app or writing it down?
-Have you considered your cycle when making decisions about your training?
-Are you comfortable talking about your menstrual cycle?
Perhaps the most important takeaway from all of this is that we can use all of this information to empower women to become the best athletes that they possibly can be. Admittedly, I hated my period and my changing hormones for a long time and I know I’m not alone with that thinking. Tapping into the information now available on female athletes is a wonderful way to start changing that way of thinking and to begin to actually appreciate the entire menstrual cycle. Male athletes don’t get such useful feedback from their bodies. The female body is incredible and it’s time to start celebrating that!
The Female Runner’s Body: https://wanderlustcounseling.com/resources
How tracking their periods helped USA women’s soccer team win the World Cup: https://www.goodmorningamerica.com/wellness/story/uswnt-period-tracking-win-world-cup-64709450
Enhanced Athletic Recovery without Undermining Adaptation: https://nutritionfacts.org/video/enhanced-athletic-recovery-without-undermining-adaptation/
Benefits of Ginger for Menstrual Cramps: https://nutritionfacts.org/video/benefits-of-ginger-for-menstrual-cramps/
Dietary Treatments for Painful Menstrual Periods: https://nutritionfacts.org/video/dietary-treatment-for-painful-menstrual-periods/
Effect of omega-3 fatty acids on intensity of primary dysmenorrhea: https://www.ncbi.nlm.nih.gov/pubmed/22261128
Evaluating the effect of magnesium and magnesium plus vitamin B6 supplement on the severity of premenstrual syndrome: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3208934/
Zinc treatment prevents dysmenorrhea: https://www.ncbi.nlm.nih.gov/pubmed/17289285
Effects on power, strength and lean body mass of menstrual/oral contraceptive cycle based resistance training: http://umu.diva-portal.org/smash/record.jsf?pid=diva2%3A881205&dswid=-2353
Frequency Variations of Strength Training Sessions Triggered by the Phases of the Menstrual Cycle: https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-2007-973052
Within‐day energy deficiency and reproductive function in female endurance athletes: https://onlinelibrary.wiley.com/doi/abs/10.1111/sms.13030
Menstrual cycle and basal metabolic rate in women: http://umu.diva-portal.org/smash/record.jsf?pid=diva2%3A881205&dswid=-2353
Effects of follicular versus luteal phase-based strength training in young women: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236309/
The Effect of the Menstrual Cycle on Exercise Metabolism: https://link.springer.com/article/10.2165/11317090-000000000-00000
Changes in muscle strength, relaxation rate and fatigability during the human menstrual cycle: https://physoc.onlinelibrary.wiley.com/doi/pdf/10.1113/jphysiol.1996.sp021381
Effect of the Different Phases of the Menstrual Cycle and Oral Contraceptives on Athletic Performance: https://link.springer.com/article/10.2165/00007256-199316060-00005
How to Use Your Menstrual Cycle to Become a Better Runner: https://www.active.com/running/articles/how-to-use-your-menstrual-cycle-to-become-a-better-runner?page=3
Running for Women by Jason Karp and Carolyn Smith