EXERCISE CONSIDERATIONS DURING A MENSTRUATION CYCLE

Awareness of the potential changes that occur during a menstruation cycle is important for performance and injury risk. With considerations to the female population and sporting participation, it is imperative there is an awareness of the impact exercise can have during this period. 

Firstly, the menstruation cycle consists of 4 different phases and that contribute differently to fitness and performance. 

  1. The Menstrual phase - elimination of the thickened lining of the uterus.
  2. Follicular phase - time between the first day of the period and ovulation.
  3. Ovulation Phase - release of the mature egg from the surface of the ovary.
  4. Luteal Phase - preparation for possible pregnancy (1).

Recovery

Our ability to recover from exercise is a vital component in how we perform during exercise and future exercise sessions. Creatine Kinase that aids muscle cell function, energy production and interleukin 6 (a pro-inflammatory), has been shown to be higher during the follicular phase when compared to the luteal phase during the post exercise period. Therefore, hormone changes can affect recovery at different stages of a menstruation cycle (2,3,4). 

Performance

During the stages of the menstruation cycle, hormones are changing that can affect how a female performs. Endurance performance seems to be negatively effected during the luteal phase but muscular strength potentially increases (5). An increase of estrogen within the luteal phase could be the cause of strength and power benefits, however, the opposite effect seems to occur when compared to endurance performance during the luteal phase (5,6). The effect throughout the different phases is apparent and individual differences may occur, but a decrease in aerobic capacity seems to remain consistent during the luteal phase (7).

Injury Risk 

Injury rates are higher during a menstruation cycle and the luteal phase could be the most problematic phase. Ligaments such as the Anterior Cruciate Ligament (ACL) become more lax (slack), therefore increasing the chance of an injury occurring (8). The possibility of ACL injuries occurring with females is higher than men and increase even further during the menstruation cycle (8,9). A potential further increase during the menstruation cycle should highlighted when planning training and an increased awareness when training or performing.

Summary & Suggestions 

It can be confidently said that throughout different phases of the menstruation cycle factors relating to exercise are affected. Exercise, intensity and volume considerations should be based on factors such as readiness to train and recovery status. The incorporation of a deload period (reduced load & volume) could prove beneficial in managing your workouts through the menstruation cycle. 

Keep exercises simple! If during the luteal phase ligaments become more lax and there is a lack of inherent neuromuscular control (9),  considerations should be taken when planning training or workouts as there is an increased chance of injury during lateral, multi-directional, landing and decelerating (stopping quickly) exercises.

Individual variances may occur throughout the menstruation cycle but the awareness and considerations towards programming for effectiveness and safety regarding the above suggestions should be reflected upon for future reference. 

Resources

  1. https://www.sciencedirect.com/topics/medicine-and-dentistry/menstrual-cycle
  2. https://www.ncbi.nlm.nih.gov/pubmed/31179123
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4176007/
  4. https://journals.plos.org/ploscompbiol/article?id=10.1371/journal.pcbi.1002130
  5. https://physoc.onlinelibrary.wiley.com/doi/pdf/10.1113/jphysiol.1996.sp021381
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5348024/
  7. https://www.ncbi.nlm.nih.gov/pubmed/8303141
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3581006/
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4805849/
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