On 19th September, I ran my first ever ultramarathon, a 50km, 1900m elevation gain jaunt in the Peak District, one of the UK’s National Parks. The race itself was different to any other I had done, not least because of social distancing measures put in place to ensure the competitors safety, and was superbly organised by Ultra X (the co-hosts of my other big adventure, the Tribe RFL).
I arrived in the Peaks on the Thursday afternoon, wanting to get a feel for the area and have the chance to explore a little – the issue with racing somewhere is that in the couple of days before the race you don’t want to do anything that might hinder your ability on the day, but then after the race you’re incapable of actually moving and doing anything fun. I’d always recommend arriving 3 days before a race if you want to be able to explore and get in a shakeout run!
Warmup hike around a gorgeous Mam Tor loop
We did just that – on Thursday we did a short walk, and on Friday a slightly longer one of about 12km, scouting out a small part of the course. Saturday was, of course, a total rest day (which I found myself very much needing after our walk the day before). It wasn’t a ‘carb-loading’ day per se, but the whole week previously had been filled with a slightly greater proportion of carbohydrates than usual to make sure muscle glycogen stores were as full as they could be.
On Saturday I set up camp with the runners completing the full 125km weekend, who were coming back from their first day (75km) as we set up my tent. The evening was spent eating our freeze-dried meals and snacks while listening to people recount their adventures from the day.
Nescafe coconut coffee (a godsend if you’re PB and don’t want to carry milk around with you).
The next morning started with a big breakfast and some snacks at around 8am, followed by taping of my irritated tibialis posterior, a little niggle I’ve been having on and off since January. Better to preempt injuries than have to stop mid race! Coffee x2 in (I tend to save caffeine for race days), three loo breaks (nervous wees are a thing) and a little jumping around at the start line, we were off. COVID restrictions means that we set off in waves, so I started alone, but shortly caught up with a friend from the Azores Run for Love (these events are small, so you often see the same faces pop up again and again, which is part of what makes them lovely!).
Simba and I running the old Mam Tor road down to checkpoint 1. Photo by Benedict Tufnell
Race kit (where I can’t find the exact kit I’ve put their newer versions, or left blank if there isn’t one):
The first 5km of the race were done at my usual long run pace, which may have been a bit fast but we made the most of the downhills and easier terrain to warm up quickly. We made it to the first checkpoint in less than 30 minutes, after which I took off my trousers and packed them away. I also took my in first nutrition around then.
Coca Cola (while I usually hate coke, it is one of THE BEST things to drink mid long run. I guess it’s the combo of sugar and caffeine that does it!).
I preempted one of the colder parts of the route by keeping on my warm weather gear for the first peak, as it was still early and cold and the wind was freezing up there! But after summiting the first peak, I took off my rain jacket and stored it away in my bag. This was the order of the day – run, drink, eat, strip a layer, repeat, until I was just wearing my shorts and a t-shirt (while I love to run in just a sports bra, for longer races I try to wear a t-shirt to avoid bag chafing and sun/wind burn). And that’s how I got round the race! Food, water and one foot in front of the other.
I finished the race in 6h49mins, which was over an hour quicker than I had anticipated! It also afforded me the place of 6th woman, which is better than I could ever have expected. I hope to do more soon – it really was SUCH a fun day. I don’t think I’ll ever get bored of the outdoors, and this was the perfect way to spend as much time in it as possible (and eat as much food as possible!). Watch this space for another race 😉 I’d love to hear if you have any plans for similar races coming up? What gear do you swear by? I’m always up for getting more recommendations! Comment down below!
One of the more roady parts of the race (15km in or so)
You can see my vlog of the race below – don’t forget to like and subscribe if you enjoyed!
Huge shoutout to Simba (middle) for running back from the end to collect me 3km from the end and force me to run the whole last segment. I wouldn’t have otherwise!Second massive shoutout to my dad and his girlfriend, Charlotte, who drove me to the Peaks, helped me set up camp and plied me with ginger parkin when necessary. I literally couldn’t have even got to the race without them!
This piece is part 2 to last week’s blog post on how periods affect training. If you haven’t already, give it a read!
When it goes wrong
A topic I have spent some time (though probably not enough) discussing on my Instagram page, as well as on here, is overtraining and RED-s, or Relative Energy Deficiency in Sport. The condition has spent more time in the limelight recently, with high profile cases coming to the fore, and more people on social media opening up about their experiences too. However, unfortunately the topic is still shrouded in mystery and shame, meaning that every year more people are affected. Even worse, it’s often assumed that losing your period is a normal, even healthy side effect of training, and isn’t anything to be concerned about. This is a myth that needs to change.
Exercise is a stressor to the body. For the most-part, it is a good stressor, leading to adaptive changes to make us faster, stronger, fitter. There comes a point, however, where the demands of a particular sport go beyond the recovery that is given, and beyond what the body can handle. There are many ways that this can happen, and the outcome is a cascade of physiological responses with serious, even life-changing, consequences. RED-s refers to a state where there is insufficient energy intake for the amount of training being undertaken, leading to reduced bone density, low energy availability and, among other things, hypothalamic amenorrhoea, or stopped periods. In the general population, around 2% – 5% of women are affected. Within athletes, the prevalence is much higher, at 3.4% to 44%.
Somewhat problematically for diagnosis and recovery, there are many stories of athletes having their best seasons right before their body starts to shut down. This is because the effects of RED-s take time to come into play, and can be caused by the most innocuous-seeming deficiency in calories over a long period of time. However, this is an important issue as it is increasingly common even among for-fun athletes, even those of a ‘healthy’ BMI, and RED-s is quietly sidelining more and more people.
Periods are important. They show that your hormones are functioning as they should – it is impossible to function optimally as a human and athlete without the hormones your body needs.
RED-s, a condition that encompasses a number of symptoms, including menstrual irregularity
Why do people lose their periods?
Secondary amenorrhea is when you have experienced regular periods before, but then stop menstruating for 3 months or longer after that point. Functional hypothalamic amenorrhea (FHA) is a type of secondary amenorrhea, caused by low energy intake, weight loss, stress or a combination of these factors. Note: you do NOT have to be underweight and be training loads and have a really low calorie intake for this to happen. All of these make it more likely, but FHA can happen to anyone. It is also important to rule out other causes of amenorrhea, in case it is caused by some other factor.
Losing your period as a side-effect of training should never be seen as acceptable. The idea that it’s a sign that you’re working hard is both harmful and wrong – you can train much better if you have a healthy cycle.
Evolutionarily speaking, FHA in times of stress may have been adaptive. If you can’t support your own body and health, there’s no way you could support another life (i.e. a baby), so it doesn’t make sense to ovulate, as this is energy consuming. The downregulation of the body’s natural functions protects the brain and vital organs. However, there’s no questioning that it is a red flag that something is up, and in this day and age we are lucky to have the knowledge to protect ourselves against such outcomes.
What happens when you lose your period?
FHA results from changes in the hormone GnRH, which in turn reduces luteinising hormone (LH) and eventually oestrogen availability. This has a number of negative consequences affecting the whole body, including bone density, cardiovascular health and mental health. The longer it continues, the greater the effects. Conditions such as osteoporosis, previously associated with post-menopausal women, also become more likely, due to the reduction in oestrogen’s protective effects on bone density. This in turn increases risk of injury such as fractures. Research suggests that athletes with menstrual irregularities are also likely to experience more injuriesandrecover slower from those injuries.
This is a question I get asked a lot, and I am reluctant to give prescriptive answers, as I am not a medical professional. Generally speaking, reducing stress on the body and increasing energy availability are good places to start. Often the causes of FHA are not entirely physical, and seeking professional mental health help can assist too.
These are some of the factors most important to optimising physical health:
Ensure you are allowing for adequate rest between training sessions.
Reduce the number of very intense sessions per week, and space them out.
Make sure you are eating enough carbohydrates, fats and proteins.
Avoid fasted training sessions.
Get enough sleep – it is vital to recovery!
Eat within 30 minutes of a training session.
Reduce stress in other areas of your life where possible.
If you are unable to get your period back by yourself, after reducing exercise intensity and improving recovery, it is recommended to seek professional help as soon as possible. A specialist sports dietician should be able to help if you’re concerned or not sure if you need pointing in the right direction.
Conclusions
With the increase in uptake of sports, and higher stakes especially in competitive sports, it is unlikely that conditions such as FHA and RED-s are going away any time soon, especially among young women. While we place pressure on men and women both to perform and look a certain way, regardless of actual health, it is vital to continue to educate athletes and coaches on the consequences of not treating our bodies well and with respect.
Unless you’re actively trying to get pregnant, it can be easy to push issues such as FHA to the back of your mind, especially if the perceived immediate benefits are greater the perceived long-term risks. Ironically, if your primary concern is performance rather than long-term health, it will be difficult to become healthy and thus perform optimally. I’m hoping that by talking about it more and improving public awareness, we can start to encourage people to seek help when they need it, and hopefully reduce stigma while we’re at it!
If you’d like to learn more about this topic, these podcasts were particularly helpful for me:
If you found this blog post helpful, please do share with anyone who might find it useful or share and tag me on Instagram! Many thanks to specialist Renee Mcgregor for talking me thorough these complex issues too. If you enjoy my posts regularly, please consider contributing so I can keep this page up and running (no pun intended).
Despite working in the realm of ‘women’s health’ for many years of my life, I recently realised that this wasn’t something I’d ever written, vlogged or even talked about much on my social media. As something that affects so many of us, I thought it would be a good idea to rectify this, and hopefully shine some light on how menstrual cycles can affect training, what it means to lose your period and how we can take care of our bodies the best we can, while achieving the fitness goals we set out to achieve.
To give a little background, I worked at the Royal College of Obstetricians and Gynaecologists as a press officer and social media manager for over a year after I left university. I then went on to run the social media accounts for Freda, a sustainable period products brand that helps reduce period poverty here in the UK with every purchase. So, I know a thing or two about periods and the taboos that surround them, but for some reason have never spoken about it openly. Many thanks to Renee Mcgregor, a sports dietician specialising in overtraining and athlete health, for her help talking me through the complexities of the human body. Give her a follow, and check out her ebook for more information on this topic.
Do periods affect training?
Historically, scientific research on women has been limited, thanks in no small part to the fact that periods are considered a ‘confounding factor’ when it comes to medical trials. In addition, the difficulty of finding a large enough cohort of people whose cycles match up adds an extra layer of complexity in organising scientific trials, limiting the number that have been carried out. However, more recently there have been several studies that show that changing hormones can affect both how we feel, as well as our performance. For years, scientists and coaches have worked on the assumption that biological females are essentially the same as males, just with different reproductive organs, but when it comes to training and the effect of hormones, we see that this isn’t true.
Anyone who has periods will know how moods, energy and motivation vary throughout their cycle, although you might not know why this is. FitrWoman, an app designed to assist training planning around the menstrual cycle, explains how training can be affected by fluctuating hormones throughout the four-phase cycle. It is important to remember that while the average length of a cycle is 28 days, for someone else it may be more or less – what is important is knowing what is normal for you.
“Starting with periods (phase 1), this is when women can experience a high amount of symptoms (e.g. back pain, cramps, fatigue) which can impact how you are feeling and therefore may impact exercise training/performance. Anecdotally, lots of the sportswomen we come across also cite that heavy bleeding has either caused them to change the way their train or miss training altogether, so this is definitely something key that we want to address. Things like moon cups can be game changers for some, and really heavy bleeders may want to be referred to a gynaecologist.
“After menstruation, levels of the sex hormones oestrogen start to increase (in Phase 2), and this can often be a good time to progress in training and just crack on. There is a little evidence to suggest that you can actually capitalise on strength training a bit more in this phase, likely due to the effect that oestrogen has on muscle anabolism/muscle protein synthesis.
“Oestrogen levels rise to a peak just before ovulation, and then progesterone levels start to increase (in Phase 3). Both of these hormones travel in the circulation and therefore can affect many physiological systems, not just the reproductive system. Progesterone often causes a small increase (by about 0.3-0.5 degrees C) in core body temperature and may cause an elevated heart rate, both which may affect exercise in the heat. Phase 3 can also be when sleep disturbances occur, and so without the right strategies in place, this can affect training.
“Towards the end of Phase 3, and in Phase 4, pre-menstrual symptoms are likely to occur, and this is where a lot of our work with our Female Athlete Programme is focused on. Whilst there is little evidence that exercise performance is affected by menstrual cycle phase, this is with a slight caveat of: ‘given that symptoms are managed’. Research has found that many active women say their menstrual cycle has negatively impacted their performance, and it is often during this phase. The sharp drop in oestrogen and progesterone concentrations could result in delayed recovery, increased cravings, increased fatigue, pain, mood swings and poor motivation through a multitude of mechanisms. However, it’s not all doom and gloom! It’s just about learning what your individual menstrual cycle means for you and being savvy about how to manage any symptoms you experience”.
Esther Goldsmith, sports scientist at FitrWoman
How hormones fluctuate during a standard 28 day cycle
All this to say: where you are in your cycle really can affect how you feel during training, but provided it’s not too hot, and provided you are able to manage symptoms, there’s little reason why your overall performance would be affected by your cycle. Having said that, it is important to note that if you are struggling, it might be worth switching round your routine in order to capitalise on days that you feel stronger. Tracking your cycle might help explain days where effort felt higher, or days you really aced training. I generally think that if I can workout on a day where I feel very ‘meh’, I can workout any day, and it’ll feel so much easier! It is important not to beat yourself up for a ‘bad’ training session – every session serves a purpose – and while your cycle may not be an excuse for a bad session, it may well be a reason.
Should you exercise on your period?
We are all unique, and as with so many health-focussed topics, the answer to this depends on personal preference and how you feel, as mentioned above. For many people, exercising during their period alleviates symptoms such as cramps and low moods, meaning that training is a great way to manage these things. For others, however, training can feel impossible, or at least immensely unpleasant. Dr Vanessa Mackay, spokesperson for the Royal College of Obstetricians and Gynaecologists, recommends attempting light exercise during your period.
“Women may not feel like exercising during a painful period, but keeping active can help relieve period pain and discomfort. Woman are encouraged to try low impact exercises such as swimming, walking or cycling.
“Exercise can also help to regulate menstruation. If women are stressed, their menstrual cycle can become longer or shorter, their periods may stop altogether, or they might become more painful. Regular exercise, such as running, swimming and yoga, can help women to relax.
“If women experience severe period pain, or their normal pattern of periods change, they should speak to their GP.”
What’s important to note is that while it may assumed to be ‘normal’, being bedbound during your period is not something you should just ‘have to live with’, and if you are experiencing extreme discomfort and pain, you should visit a gynaecologist or doctor. Sadly, understanding around these issues is still pretty poor – it takes on average 7.5 years for someone to be diagnosed with endometriosis, for example – but if you feel something is wrong, please insist on seeing your doctor and getting a diagnosis. Similarly, if your normal pattern changes, e.g. you experience very heavy bleeding suddenly or lots of pain, speak to your GP, or even better a gynaecologist or endocrinologist. You should not have to suffer in silence.
Fuelling also may need to change around your cycle, especially in endurance sports. As hormones fluctuate, the need for protein and carbohydrates varies, as well as micronutrients, such as iron. Iron is especially important during and after your period, as iron is lost when you bleed. During phase 1 and 2 (the first half of your cycle), more carbohydrates are required, as the body is burning more fat. This is especially important in endurance training, and long fasted sessions should be avoided, as they place unnecessary stress on the body. During the second half of the cycle (phases 3 and 4), progesterone levels are higher, as is the BMR (basal metabolic rate), meaning that cravings are higher, but also that the body really does need more food. Energy expenditure can increase by 2-11% during this half. Here you should consume more healthy fats and have a regular intake of protein. A general rule of thumb is to make sure you’re getting in enough carbohydrates, have a regular intake of protein and listen to your body – it may be telling you exactly what you need!
For what it’s worth, I do not consciously change my exercise routine around my period. However, I do experience very low energy at certain times of the month (not every month – I’m still trying to figure out when, exactly) and often change around my routine to allow for extra food and rest on these days. I would never head out for a long run on a day when I feel exhausted to the point of needing a midday nap, and might instead take a walk or fit in a stretching session (both of which are useful parts of training, just less intense). Having said that, I also find a short (5-8k) run helps with PMS symptoms more than anything else, including painkillers! They’re definitely not my best runs, but for cramps and low mood, nothing beats an easy run for me.
TL;DR
Your hormones may affect perceived effort in training depending at the point you are in your cycle, especially in endurance training and in the heat.
Every woman is different: while some may feel no change, others may experience severe symptoms that affect how they are able to train each month. If you feel unable to complete normal tasks, consider visiting an endocrinologist or gynaecologist.
Low intensity exercise may help reduce pre-menstrual symptoms and regular exercise is recommended to keep the body healthy.
Your hormones can be capitalised upon to make the most out of your training – it’s not all bad news! Some parts of the cycle may be better for muscle growth, and training when you don’t feel your best can make other training sessions and races feel that much easier.
Be kind to your body! Don’t beat yourself up about a bad training session. Ensure you are getting enough rest days and taking on enough fuel and you’ll be back on track in no time.
Don’t forget that carbs are a necessary part of training, and especially required in the first half of your cycle. Make sure you have a good intake of protein and healthy fats.
Periods and hormones are healthy. It is impossible to be optimal if these hormones are out of whack e.g. if you lose your period due to overtraining. More on this later!
I hope this helps you and answers some of your questions about training at different parts of the cycle. Many thanks to Fitr Women for explaining the different phases and how these may affect training. If you are not sure how your cycle affects you, it may be worth tracking it with an app or on your calendar. While it may not be an ‘excuse’, it can often be reassuring to know why a particular session felt so hard, and know the days you will be able to make the most out of your training.
What I’ve learned from this research is that everyone is unique, and what works for one person may not work for another. However, it does seem to be the case that when everything is functioning well, the menstrual cycle can be beneficial for capitalising on training and optimising performance. It’s sad to see so many women experiencing debilitating symptoms every month and assuming this is normal. I hope this encourages more people to know what they are capable of, and others to seek help if they feel something is off.
If you’d like to learn more about this topic, these podcasts were particularly helpful for me:
If you found this blog post useful, please do share with anyone who might find it useful. If you enjoy my posts regularly, please consider contributing so I can keep this page up and running (no pun intended).
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