Initially Published On TrainingPeaks Coach Blog linked here
When I talk about women-specific training, I often see puzzled looks on people’s faces. Many people shy away from these conversations. Talking about female physiology and how it affects our training may be the missing piece to a possible breakthrough performance for some female athletes. I was one of them.
As often happens, facing adversity and going through some rough times in my personal life caused something unexpected and exciting. Trying to survive and noticing my mental and physical health declining, I started checking in with my body more often, listening to what it was telling me. That’s when I started tracking my menstrual cycle and noticing the definite patterns that would repeat every month like a clock. My energy levels, my concentration, my ability to nail hard workouts, my motivation, my food cravings and even my low back pain — I could predict when it would happen in the next cycle.
This initial curiosity prompted me to do a lot more research and education on the topic of female physiology, and finally, I became an experiment of one — applying my knowledge to my unique female body. Little did I know when I started this journey that it would eventually lead me to have the best year in my athletic career, placing first in my Age Group in Ironman and Ironman 70.3 events. Something I was never able to come even close to with my previous training. Needless to say, the topic of the menstrual cycle and hormonal fluctuations never came up with any of my coaches, and it’s time to change this for other female athletes.
Menstrual Cycle as a Health Indicator
The American College of Obstetricians and Gynecologists (ACOG) defines the menstrual cycle as a complex process orchestrated by interactions between many of the body’s tissues, cells and hormones. It reflects a woman’s overall health status and can be thought of as a “fifth vital sign,” along with blood pressure, body temperature, heart rate and respiratory rate. Pause for a second and think about that — it reflects a woman’s overall health. Should we not, as coaches, be concerned about our clients’ overall health? We ask questions about blood pressure, diabetes, previous surgeries, etc., but rarely does the topic of the menstrual cycle come up in a conversation or as a question on an athlete’s intake form.
For a woman, who may already be in sync with her body and know her hormonal state throughout the cycle, sharing that information with a coach so that appropriate programming could be applied to reflect the different cycle phases, may be all that is needed for this athlete to take it to the next level. To feel and perform her best. And some women may have little idea of what’s happening throughout their cycle and would benefit from some guidance. It is a personal topic, and a few female athletes may not be comfortable sharing this information. However, if they understand how this information is being used and its benefits to their training, they will often want to use the power of female hormones to their training advantage.
Cycle Tracking Tools
Cycle tracking is the greatest act of self-care a woman can have. It is a free monthly wellness check that every female has until she reaches perimenopause. With very little time investment, women can get massive rewards in their training and overall well-being.
There are multiple ways to track a cycle: as simple as pen and paper and as complex as monthly subscription services. There are dozens of apps that allow women to track their cycle and symptoms: Wild AI, Fitr Woman, Clue and Natural Cycles, just to name a few. Garmin and TrainingPeaks allow cycle tracking through their interfaces as well.
I am a big fan of Wild AI because it has a coach account where a coach can see their athletes’ menstrual cycle phase and training recommendations for that given phase based on each person’s check-ins. Coaches do not see details, only the overall readiness score.
With a glance at the WildAI app dashboard, coaches can see where a particular female athlete’s strengths and weaknesses are based on their physiology.
Equipped with this kind of information, coaches can adjust the workouts accordingly. Early on in this process, frequent check-ins with an athlete are essential for the program’s success. After a few cycles, the process becomes easier and more predictable for both an athlete and a coach.
After doing this for myself and my athletes for quite some time, I have this information in my head — what would be the best training approach for a given athlete at a given time in her cycle? It is a time investment at the beginning, but it will pay huge dividends overall. Also, it demonstrates how invested a coach is in their athlete’s success while creating a more trusting relationship between the two.
It may be difficult for some coaches, especially male coaches, to have this kind of conversation with their female athletes. With so much training programming nowadays being online, the use of the TrainingPeaks calendar as a communication tool could be super useful. I use comments heavily, and it works great for both parties. Once an athlete indicates she started her menstrual cycle, I can chart the phases, and once I have those phases laid out on the calendar, I can plug in specific workouts to match the training load and intensity for that individual athlete.
Menstrual Cycle Phases
So, what does a regular cycle look like, and what are the common patterns that exist that coaches could pay attention to and optimize their athletes’ training? There are a few models that exist today, the simplest one containing two phases: follicular and luteal and more complex models containing as many as seven phases. I prefer the five-phase model that I will describe below.
The length of the menstrual cycle is the number of days between the first day of menstrual bleeding of one cycle to the onset of menses of the following cycle. The average duration is 28 days, but most cycles fall in the 25-30 range.
Early Follicular Phase
The Early Follicular Phase begins at the start of a period when the uterine wall begins to shed its lining. This phase lasts two to eight days, with the average duration being four to six days. This phase is characterized by the increase in the secretion of a hormone called follicle stimulation hormone (FSH) that is responsible for the formation of follicles containing maturing eggs in ovaries.
This phase is very individual, with some women experiencing menstrual cramps due to uterus contractions trying to expel its lining while others do not experience severe cramping and can continue their training as normal. The sex hormone levels are low during this phase, therefore also having minimal impact on carbohydrate availability and other physiological functions.
Studies suggest that high-intensity training could be beneficial at this time and can promote lean muscle mass gain and strength development if a woman is not affected by menstrual symptoms such as severe cramping.
The Mid-Follicular Phase begins when the menstrual bleeding stops and the body starts preparing an egg and the uterus for possible implantation of a fertilized egg. This is when the estrogen levels start rising, and they continue to rise all the way until ovulation when the egg is released. This phase’s duration varies in length between women and even from cycle to cycle for the same woman.
This phase can last anywhere between 10 to 20 days. Estrogen increase contributes to increased muscle strength and quicker recovery rates, so high-intensity and strength training should be a priority during this phase. However, there is also research indicating that this phase carries a higher injury risk due to estrogen’s effect on connective tissue laxity (ACL injuries in female athletes occur two to eight times more often than in male athletes) so emphasis on a proper and longer warmup may be needed.
The ovulatory Phase begins when an ovary releases the dominant follicle into the fallopian tube, where it has the potential to be fertilized. The egg can survive for 12-24 hours past ovulation. Some women can feel when an egg is released. Tracking cycles is also a good indicator of when ovulation occurs, as most women will start a new cycle 14 days later. Finally, taking the basal temperature in the morning before getting out of bed is another way to detect ovulation, as the basal temperature will be 1/2 to 1 degree higher in the second half of the cycle.
Similarly to the Mid-Follicular phase, high levels of estrogen continue to contribute to increased muscle strength as well as faster recovery times from exercise-induced fatigue. This is my favorite time to assign benchmark testing to my female clients. HIIT and VO2Max sessions seem easy, and motivation is usually high around this time. If a race happens to coincide with this phase, it would be a great time to chase that PR!
The mid-Luteal Phase begins after ovulation, when the corpus luteum (the sac that contained the egg) starts secreting estrogen and progesterone, preparing the uterine wall for possible implantation. Mid-luteal phase is believed to be around 10 days, with slight variations between women, but it is not nearly as variable as the follicular phase. After ovulation, core body temperature, energy expenditure and resting heart rate increase while blood plasma volume is reduced, all affecting women’s ability to train.
Progesterone dominates during this phase, and it is a catabolic hormone that can impact the recovery rate and reduce performance at higher intensities. Therefore, lower intensity but longer duration aerobic-type workouts are recommended during this phase.
Late Luteal Phase
The late Luteal Phase begins when the estrogen and progesterone levels start dropping, preparing a woman’s body for the next cycle. This drop can often cause physical and mental symptoms such as anxiety, mood swings, decrease in performance and energy levels. This phase lasts for about four to six days.
It’s also the time when women need to focus on themselves, practice self-care and be kind and patient with themselves. This is the week that I like to use as a recovery week in the training cycle and include an extra rest day or focus on low-intensity training such as swim drills or pedaling drills on a bike trainer, especially if a woman is experiencing menstrual symptoms. Again, TrainingPeaks has a way of recording these details and is a great tool that both athletes and coaches should utilize in their communication.
Menstrual Cycle Disorders
As it was mentioned earlier, having a regular menstrual cycle is an indicator of a healthy hormonal balance in a female body. The absence of the menstrual cycle or an irregular cycle may indicate a serious condition that should be investigated immediately. It is scary that sometimes women, coaches and even doctors ignore or do not pay enough attention to this problem, and women pay serious consequences at the expense of their health later in life. LEA and RED-S are especially relevant in the younger female athlete population. Girls and women should be educated and regularly checked for symptoms.
Individualized Training Approach for Women
Women’s bodies are amazing and complex, and no two bodies are the same. The complexity of female physiology is partially to blame for the lack of research and studies done on female athletes, and I am very happy to see that it is starting to change. More research papers are being published to counter the longstanding research biases.
I believe that if women listen to what their bodies are telling them, coaches are educated on the topic of female physiology and apply that knowledge and individual approach to their female athletes’ training, they may just find the missing piece of the puzzle to a happier, healthier life and consistent athletic achievement!
- Chidi-Ogbolu N, Baar K. (2019, Jan.) Effect of Estrogen on Musculoskeletal Performance and Injury Risk. Front Physiol. 2019 Jan. 15;9:1834. doi: 10.3389/fphys.2018.01834. PMID: 30697162; PMCID: PMC6341375 https://pubmed.ncbi.nlm.nih.gov/30697162/
- F. Miro, L.J. Aspinall (2005, Jan.) The onset of the initial rise in follicle-stimulating hormone during the human menstrual cycle, Human Reproduction, Volume 20, Issue 1 https://doi.org/10.1093/humrep/deh551
- Reed BG, Carr BR (Updated 2018, Aug.) The Normal Menstrual Cycle and the Control of Ovulation. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. https://www.ncbi.nlm.nih.gov/books/NBK279054/
- Stacy T Sims, Alison K. Heather (2018, July) Myths and Methodologies: Reducing scientific design ambiguity in studies comparing sexes and/or menstrual cycle phases https://doi.org/10.1113/EP086797
- Sung E, Han A, Hinrichs T, Vorgerd M, Manchado C, Platen P. (2014, Nov.) Effects of follicular versus luteal phase-based strength training in young women. Springerplus. 11;3:668. doi: 10.1186/2193-1801-3-668. PMID: 25485203; PMCID: PMC4236309 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236309/
- Zhang S, Osumi H, Uchizawa A, Hamada H, Park I, Suzuki Y, Tanaka Y, Ishihara A, Yajima K, Seol J, Satoh M, Omi N, Tokuyama K. (2020, Jan.) Changes in sleeping energy metabolism and thermoregulation during menstrual cycle. Physiol Rep.e14353. doi: 10.14814/phy2.14353. PMID: 31981319; PMCID: PMC6981303 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6981303/