How periods affect training

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).

Common Running Nutrition Mistakes

This is a guest blog post by Renee McGregor, a dietitian who I look up to for evidence-based information, especially in regards to running and nutrition. 

Renee is a leading Sports and Eating disorder specialist dietitian with 20 years of experience working in clinical and performance nutrition. She’s worked with athletes across the globe including supporting Olympic (London, 2012), Paralympic (Rio, 2016) and Commonwealth (Queensland, 2018) teams. She is regularly asked to work directly with high performing and professional athletes that have developed a dysfunctional relationship with food that is impacting their performance, health and career. On top of this Renee is the founder of Enspire clinic, a centre specialising in supporting individuals and athletes of all levels and ages, coaches and sports science teams to provide nutritional strategies to enhance sports performance and manage eating disorders. This is reflected in her work on social media too, priding herself on proving an educational hub for both the professional and everyday athlete. When not inspiring others with her incredible work, Renee can be found running the mountains and chasing the trails, most likely training for a crazy ultra-marathon!

burst

Everyone has an opinion about nutrition – why shouldn’t they? After all, we all need food to survive. However, there is a difference between anecdotal nutrition advice and actual nutritional science. On social media we are exposed to the former a lot more than the latter. What works for one person in a sample of n=1, may not work for another. Just the other day I was on a group chat where someone very boldly stated that their new vegan regime was the cause of their newly found energy and improved recovery. However, this was based on subjective information, which they had collected over a few weeks. Is this science? No – this is one individual’s personal experience with no information of what her diet had been like previously or even if any other aspect of her life had also changed which may have resulted in how she was feeling. Presently there is no evidence in the literature to suggest that a plant-based diet can improve an individual’s performance – such anecdotal evidence could cause more harm than good.

Nutritional science, and particularly sports specific nutrition, is actually quite complex. While many simply look at the impact of one particular nutrient or process on performance, this completely ignores the fact that the human body is run on an intricate system of endocrine, biochemical, immunological, physiological and psychological pathways that all work collectively.

Let’s take the keto diet as an example. This was a huge trend a few years ago and many still promote it with the idea that if we remove carbohydrate from our diet, then our body will use more fat for fuel and improve our performance but also our body composition. While on the surface this may seem to have some gravitas – take out carbohydrate and the body will have to find another fuel source to provide the body with energy – what has been completely ignored is the importance of carbohydrate intake on the hypothalamic pituitary axis, which is necessary to get adaptation from a training response. In addition, carbohydrate has a critical role in optimising immune function in those who are physically very active.

So, with this all in mind, here are some of the common mistakes often made…

 

Carbohydrates

Numerous studies have demonstrated that carbohydrate is the preferred fuel used by the body and is definitely the key to optimal performance. That said, many runners still have little understanding of how much they actually need in order to meet their requirements with many under fuelling.

As stated above, carbohydrate availability is particularly key for the hormonal cascade needed in order to see adaptation and thus progression. This means ensuring sufficient carbohydrate before, during if your runs are over 90 minutes and within 30 minutes of completing your session. While everyone’s physiology is slightly different, as a rule of thumb the requirements set are 5g/Kg BW of carbohydrate if you are running for 60 minutes a day, with this figure increasing for longer or multiple training sessions. In general, I do not encourage fasted sessions and the recommendations state that if you are going to include these, you should not do more than 2 a week and they should be no longer thank 60 minutes, at an effort of no more than 6/10. More than this and at higher efforts, potentially can result in chromic stress on your body leading to a depressed immune system, higher risk of injury and down regulation of your hormones, particularly your thyroid gland, oestrogen and testosterone, leading to further negative health consequences.

In practise, if you are training regularly, it is unlikely that you will ever have full glycogen stores and so it is essential to ensure that you consume carbohydrate at meals and snacks throughout the day. Aim to include nutrient dense carbohydrates such as oats, potatoes, whole grains, fruit and yoghurts at 3 meals (about a 1/3 of your plate) as well as including 2-3 smaller carbohydrate based snacks such as bananas, cereal bars, 2 slices malt loaf or 2-3 oatcakes with peanut butter.

One common observation I have seen is that many people view vegetables as carbohydrate, often displacing these for pasta, grains, bread and potatoes. While vegetables play a role within our diet and should be included, they are predominantly fibre which means they add bulk to the diet but not essential carbohydrate fuel.

 

Protein

There is a lot of hype around protein in the recovery phase, with many runners stressing about not getting enough to enhance recovery. Protein does play a role in the response to training and should be included in addition to carbohydrate, particularly immediately after. The general recommendations are that a recovery meal/snack/choice should provide 1.2g/Kg BW carbohydrate and 0.4g/Kg BW protein. So for someone who is 55Kg this would be 66g of carbohydrate and 22g protein and looks like a medium size baked potato with a small tin of tuna.

It is important to appreciate that the body will struggle to utilise more than 0.4g/Kg BW post training for muscle protein synthesis and adaptation. Any additional protein consumed will be used as fuel or stored as excess. Therefore, it is actually really important to spread your protein requirements out throughout the day. Aim for palm size portion of protein at 3 meals and then half this amount for snacks. This will ensure that your body always has an amino acid pool to draw from in order to repair and rebuild muscles, throughout the day, as well as preventing blood sugar fluctuations.

 

Sugar

With so much negativity around sugar, it is hardly surprising that many runners are equally concerned about their intake. While I would never advocate a high sugar diet, there are definitely times during training and competing, where sugar is the only option. During endurance events, such as a half or full marathon, the body will need an easily digestible source of carbohydrate to keep stores topped up so that running pace can be maintained beyond 60-90 minutes. Gels, jelly babies, sports drinks are all suitable options and they all contain sugar. So in this case, sugar actually enables and potentially enhances your performance.

 

5 Nutrition Staples:

  • Don’t be drawn to the latest fad – many runners will try almost anything to improve their performance. Focus on training and getting the building blocks of your diet correct first – this is going to have more impact than whether you are gluten free or not.
  • After a very hard training session and especially when you will be training again within 12 hours, taking on something like flavoured milk is an ideal choice to start recovery as quickly as possible. The combination of added sugar to the natural milk sugar causes insulin to increase in the blood. Contrary to what you might think, this is actually really important. Only when our insulin levels are raised, can we draw carbohydrates and protein into the muscles to start the recovery process.
  • Always practise your race day nutrition – the worst mistake you can make is to use what is available on race day without previously having tried it –this could have real negative effects on your performance.
  • Work out what is right for you – just because your training partner swears by a bowl of porridge every morning, this does not necessarily mean this is the right fuel choice for you.
  • You don’t have to eat less on your rest day – for most this will fall between two training days so it is the perfect opportunity to recover and then refuel. By being consistent with your nutrition, you will also allow for consistency with your training which allows for progression.

 

Screen Shot 2018-02-02 at 10.58.17

 

If you enjoyed this blog post, go and check out Renee on Instagram and share this post!

Overtraining

Fitness undoubtedly has a myriad of benefits, from the mood-boosting to the life-improving. However, it is possible to have too much of a good thing, and over-training is an issue that can affect even amateur athletes in pursuit of their next PB or particular aesthetic goals.

When I first started training I felt invincible. Increasing my sessions per week left me exhausted but happy and no matter how much I trained, I always had the desire for more. However, long story short, recurring injuries and losing my period aged 17 left me questioning whether I really was helping my body, or whether my intense training regime was actually causing more harm than good.

It wasn’t until later that I discovered RED-S, or Relative Energy Deficiency in sport, previously known as Female Athlete Triad, which is now known to affect both men and women. If not enough food is consumed to cover the energy demands of your workouts, and the rest thereafter, chronic energy deficiency can occur – you basically run out of fuel in your body, and your body does what it can to make it up. This may mean fuelling from fat, muscle, brain and even the heart.

It is possible to be overtraining without all the symptoms of RED-S, and this can lead to a range of problems.

First, it’s important to bear in mind that overtraining is possible by:

a) Doing too much exercise (for your current level of fitness) or

b) not having enough recovery between workouts or

c) chronically underfuelling

It is possible to accidentally overtrain if you increase your training load without increasing food intake, decrease your rest times and/or reduce food intake.

Symptoms:

Decrease in training ‘gains’

We all want to make progress when we workout, but overtraining could hinder exactly that. Overtraining can lead to an increase in recovery times and decrease in performance, meaning that training sessions don’t provide the benefits that they should, so little to no improvement is seen.

Increased risk of injury

While most of us suffer from aches, pains and niggles at some point during a training regime, having recurring issues could be a sign of something more serious. When fatigue accumulates from lack of recovery, small injuries don’t have the chance to heal, and form can suffer, leaving the athlete at a greater chance of acute injuries, too. In addition, lack of food can lead to decreased bone density, especially in women, linked to fractures and osteoporosis, especially in athletes who don’t do weight-bearing exercises.

Insomnia/agitation/low mood

A good intake of food and sufficient rest are both important for our endocrine (hormone) system. When the body is under stress however, the overproduction of cortisol and disruption of other hormones can make it harder to wind down and fall asleep. This in turn can lead to low mood and agitation and, of course, less progress in training.

Recurrent illness

Training puts the body under a lot of stress, which when paired with rest can make it stronger. However, without sufficient food or rest, the body does not have enough energy to warn of viruses and other infections, making illnesses and infections more likely and more frequent.

Loss of period

When women train too hard, hormones can become unbalanced. Paired with a lack of energy availability, the body does not have the energy to support itself, let alone another life. Therefore many athletes lose their periods – whilst this is seen as ‘common’ and perhaps even ‘normal’ within the running community, it could be symptomatic of bigger issues and should never be ignored.

Often, overtraining is the result of a lack of education or an overabundance of enthusiasm for a particular sport. In these cases, recognising and resolving the problem can be quite simple. Eating more, ensuring rest days are adhered to and taking a step back from frequent intense sessions can resolve the above issues relatively quickly.

For some people however, the issues are more psychologically rooted, and may require professional help to deal with.  The paradox with RED-s and over overtraining, is that the result is reduced performance, exactly the opposite of what the athlete is aiming for. If you believe you might be suffering from overtraining, seek help from a health professional – not only will your training suffer if you don’t, but you could be putting your lifelong health at serious risk.

If you are unsure if you are suffering from overtraining, it is possible to measure bone density and hormone levels to ensure everything is in check. First, however, try reducing training intensity and/or increasing food consumption to see if any of the issues resolve themselves. A new PB is not worth the damage done from overtraining.

I hope this helps! I would love to hear your thoughts on the subject 🙂 Come and find me on Instagram and YouTube for more fitness and food content!