This one is for all my menstruating humans all around the world (but sing it like XTINA).
While it’s absolutely fascinating to non-menstruating humans that we bleed monthly, very little research has been done to date to benefit the exercising female (AFAB). We all know from chats with our girlfriends that our mood and physical capabilities eb and flow through our cycle and it can affect our motivation to get to pole classes, our pole-gress and even likelihood of sustaining injuries.
So now that there’s research on the menstrual cycle, what does it say?
Well, a recent systematic review by McNulty et al. 2020, found that the changes in hormones throughout your cycle may have ‘trivial’ effects on exercise performance. However, overall there is still insufficient good quality evidence available to formally make a guideline for exercise performance throughout the menstrual cycle. Ie. we need to know more!
But, with that said we can definitely take some pearls of wisdom from these studies and look at how we can individualise and optimise our training based on the hormonal changes that occur during our cycle.
Hormones in your Menstrual Cycle
Let’s first start by understanding the key different hormones that are circulating during our cycle.
Oestrogen (estrogen/estradiol), the primary sex hormone in women that is responsible for puberty, breast development, menstrual cycle, fertility, pregnancy, bone strength, cardiovascular and cognitive health. Its main functions in female organs include stimulating egg follicle growth in ovaries, formation of breast tissue, maintenance of vaginal wall thickness and lubrication and regulation of flow and thickness of uterine mucus secretions. Levels of oestrogen waver throughout menstruation and a woman’s lifespan and can also be affected by puberty, menopause, pregnancy, extreme dieting or weight gain, overtraining, strenuous exercise and some medical conditions.
Progesterone, produced in the ovaries, plays a crucial role in the menstrual cycle and supporting pregnancy. A rise in progesterone, thickens the lining of the uterus in preparation for a fertilised egg to implant in your uterine wall. During pregnancy, high levels of progesterone helps maintain the uterine lining to support the fertilised egg. Contrastingly, if there is no fertilised egg, the drop in progesterone forms the start of the menstrual cycle.
Follicle-stimulating hormone (FSH), produced in the pituitary gland, plays an important role in the development and function of the ovaries. The presence of FSH helps follicles (which hold the eggs) in the ovaries mature.
Luteinising hormone (LH), also produced in the pituitary gland, stimulates ovulation by triggering the release of the mature egg from the ovary.
During our cycle these hormones fluctuate and have an effect on our body and the way we function. It’s only natural that specialists and researchers have begun to wonder over the past short while if women should exercise in a way that is entirely different to our male counterparts.
Let’s take a look at this recent research now.
Exercising during your cycle
Let’s talk through a generalised textbook 28 day cycle. Whilst this is considered the standard length of a cycle, please note that cycles can vary in length from person to person with the normal considered to be between 21 to 35 days.
There are 4 phases of our menstrual cycle: menstrual phase, follicular phase, ovulation phase and luteal phase. We quite often refer to the first 14 days as the follicular phase and the last 14 days as the luteal phase. Let’s talk through what happens at each of these stages now and the effect on exercise.
Phase 1: Menstruation aka Bleeding time
This part of the cycle marks the beginning of the menstrual cycle. It generally lasts between 3-7 days, and as most of you know it is the time where the uterus lining is shedding. Hormonally, your oestrogen and progesterone levels are at its lowest, and as a result of this dip in hormones, you might also notice a dip in your energy levels.
Exercise & Recovery
Despite the dip in energy levels and period symptoms, gentle movement is encouraged to manage your mental health, pain and discomfort. Armour et al. (2019) found some evidence to support the use of exercise to treat period pain and menstrual cramps. Similarly, Tsai (2016) found that regular yoga practice can be beneficial in reducing PMS and period symptoms. While being “evidence-based” is important and VERY en-vogue, particularly when there is insufficient evidence and no guidelines available, the most important thing about training is actually listening to your body! So while there are studies out there that recommend exercising whilst on your period, if you are feeling below average with 1 or 150 period symptoms, listen to what your body needs. If it’s a cuppa tea and binge re-watching Friends that you need, you do you! You have every other day of the month to get your booty up and around the pole. But, if you really want to go and the cramps ain’t stopping you, then show up, you’ll feel fab for moving.
Note:
Amenorrhea, the absence of menstruation, can be a result of increased energy expenditure and low energy availability. This means there is a difference between the energy consumed (eg. food) and the energy you use (eg. exercise). These changes can occur for a variety of reasons including dietary restrictions, exercise, stress or even a combination of all. Like other health markers such as blood pressure and heart rate, the presence or lack of period can allow health professionals to have a glimpse of your bodily functions and overall health. Keep an eye out for our future blog that will discuss amenorrhea, exercise and female athlete triad syndrome.
Phase 2: Follicular Phase
As mentioned earlier, this is the first half of your cycle (days 1-14) and can be split up into early and late follicular phases.
Early Follicular Phase
Your early follicular phase is basically day 1-5 of your period, which is marked by the low levels of oestrogen and progesterone. During this period the pituitary gland also releases follicle stimulating hormone (FSH) which helps the follicles mature.
Exercise & Recovery
The early follicular phase overlaps with your period, so like I said earlier, if you’re feeling shabby and need a bit more TLC, then give your body what it needs. But, if you’re feeling fab, get up the pole and do what brings you joy.
Late Follicular Phase
The late follicular phase is where it’s at! This phase usually occurs day 6-12 of your cycle and is marked by a slow rise in oestrogen and progesterone.
Exercise & Recovery
There is some evidence that the increase in oestrogen can have a positive effect on mood, increase energy levels and therefore can improve motivation to exercise. A study by Enns & Tiidus (2010) suggests that the rise in oestrogen can improve your body’s protective function against muscle soreness, which means recovery from training may be quicker and adaptation to exercise can be enhanced. It is suggested that resistance training during this phase can improve strength gains in the next phase too. In pole terms, this means if you train new hard tricks, you recover quickly and you’re more likely to hit PBs/new tricks in this phase!
Prado et al. (2021) found that women had higher levels of motivation before and after exercise, in the follicular phase compared to the luteal phase. You might find that you’re feeling more energetic and motivated, so definitely use this period to write down some goals and plan out your training schedules. Think about how you are going to achieve these goals, and use these first 2 weeks to chip away at it. Remember, while it’s great to know that you can be ticking some serious pole goals here, it’s super important to not overtrain. The rise in oestrogen in this phase also puts you at greater risk of injury towards the late follicular phase (around day 12) as it can result in increased tendon laxity (Chidi-Ogbolu & Baar, 2019). So remember to schedule in a rest day or two, and avoid adding too many training sessions or classes at once.
So in summary, exercise to your heart's content (Jokes, the physio says add in some rest days and do it progressively please).
POV: You are hella motivated, feeling beefy and filled with energy
Progressively increase your training days per week during this phase to optimise your muscle growth and strength. It is only a two week period, but you might notice by the time you are ovulating, you’ve hit some cool new tricks and PBs!
Schedule in some rest days
Ovulation (Day 14)
Around day 14 of your cycle, our body ovulates and the release of a mature egg from the ovary occurs. This happens as luteinizing hormone (LH) is released in response to the rise in oestrogen levels and the egg follicle reaching a certain size. During this stage, you are still riding on the highs of your oestrogen peak, so you will feel quite strong and high in energy still. As a result of the varied lengths of follicular phases, exact time of ovulation is very difficult to predict. However, a well-established marker used to determine which phase you are in your menstrual cycle including ovulation, is body temperature charting (Marshall, 1963). It is suggested that your body temperature rises by 0.3-0.5°C at ovulation, remains this high throughout the next phase and drops again when you menstruate. So, wondering if you’re ovulating? One sign is a slight rise in body temperature.
Exercise & Recovery
Remember, while you are at greater risk of injury during this phase, you may also continue to feel strong and high in energy. Which means, you will WANT to continue levelling up and being the beefcake that you are. So, I am definitely not saying ‘don’t train’, but perhaps take into consideration you have a slightly higher risk of injury during this time of the month, so ensure you’re warming up thoroughly and be careful to not overload or overtrain here.
Luteal Phase (Day 15-28)
Once the egg has been released, progesterone levels rise and oestrogen levels drop dramatically. During this period of your cycle, you might continue to notice an increase in body temperature, fluid retention and PMS symptoms such as bloating, headaches, weight changes, food cravings, trouble sleeping etc. Side note: Did you know that there are more than 150 PMS symptoms?! Whatever symptoms you get, these can last for 11-16 days of your cycle! Once this phase ends, if you’re not pregnant, then you will have your period again and the cycle recommences.
Exercise and recovery
Some studies suggest that performance, mood and motivation can be reduced in the luteal phase and the same exercise or pole tricks you usually find easy may feel harder. The rise in progesterone can also increase drowsiness and affect the way your brain learns new skills. You might notice difficulty learning and remembering dance choreography during this phase.
So in this phase, if you are feeling a bit sluggish and tired, taper down by decreasing your repetitions/sets, reduce the number of hard sessions and aim for lower intensity training instead. In pole terms, you might consider reducing the number of trick classes you do and substitute them for easy dance, flow or even flexibility style classes. Try to avoid increasing your strength training during this phase of your cycle.
Sometimes the PMS makes you really want to stay home in front of the TV and skip classes, but the current research suggests that regular low-moderate intensity exercise like yoga can be helpful for PMS symptoms (Tsai, 2016). So it is suggested that some gentle flow or movement like going for a walk, stretching or even an easy dance class may make you feel better. Importantly, we know that mood and motivation is reduced during the luteal phase and often contributes to prevalence of dropout and physical inactivity. So for some, continuing to move, even if it is slow and gentle, can help continue your exercise streak and reduce the risk of not training at all for months!
In saying that, remember there is very little research out there, so if you are feeling like your body needs a rest, give it what it needs and come back tomorrow.
Conversely, if it’s comp season and you need to train. Consider training early in the morning or during the day when your energy levels are still high. Often after a long day of work, our energy levels deplete in the evening and we find it much harder to train during this phase.
Hydration & Eating during your Menstrual Cycle
Hydration
As mentioned earlier, ovulation and the luteal phase is marked by a slight increase in body temperature. During this period, the increase in body temperature and increased fatigue, remember to pay extra attention to ensure that you are hydrated.
With oestrogen and progesterone peaking during ovulation and the luteal phase, your body is also more likely to retain fluid. What does this mean for exercise? Well, to put it simply, the more water you retain, the less your plasma volume, the harder it is for your body to deliver oxygen to its muscles (de Jonge, 2003). This drop in plasma volume can be helpful for polers as it reduces your sweat rate, ie. more grip! Wooh. BUT remember sweat happens to assist your body in cooling down, so this means that your body temperature will increase. So be sure to stay hydrated especially if you’re training in hot and humid conditions, you definitely don’t want to overheat.
Eating
Interestingly, the fluctuating hormones during our menstrual cycle have an impact on the way our bodies metabolise macronutrients such as carbohydrates and protein. If we understand how to supplement our bodies with the nutrients it needs, then we are one step closer to optimising our training. Because remember, we can’t train without energy, and the energy comes from the food that we eat!
Carbohydrates
Mmmmm, this bad boy gets a bad wrap. But we need carbs to survive ya’ll!
There is some evidence to suggest that, when training in a fasted state, women had better performance during the follicular phase than in luteal phase. However, when training was fueled with carbs prior, performance in the luteal phase was the same as that of the follicular phase!
It is suggested that high levels of oestrogen and progesterone, at its peak in the luteal phase can impact a metabolic process called gluconeogenesis (Campbell, Angus & Febbraio, 2001). This process is responsible for synthesising glucose when glucose dietary intake is lacking or insufficient (like a fasted state). As such, during the luteal phase when this process is also suppressed, dietary intake of carbohydrates is important in ensuring sufficient energy for exercise, especially if training sessions are over 60 minutes long.
Protein
Everybody’s favourite macronutrient!
In addition to all the other symptoms you feel during the luteal phase, the marked peak in progesterone in this phase has also been shown to impact the breakdown of muscles and other protein stores. As such, during this phase, it is important to increase protein intake, especially if you are continuing training hard and high intensity sessions.
Planning for Pole
So what does all of this mean for your pole training schedule?
Basically during the late follicular phase, days 6-12 your body will be able to tolerate harder and more training sessions. Your heart is working slightly harder than normal so expect to be able to reach higher heart rates during this period of time. This means you can look at increasing your pole trick classes in these two weeks to see some strength and muscle gains. You may however see slight decreased endurance in this phase. So if you’re training for a comp you may find you need to focus on combos instead of lots of full run throughs of your routine.
However, once you’re in the luteal phase and experiencing some PMS symptoms, it’s important to listen to what your body needs. More often than not, it needs increased hydration and slightly decreased exercise intensity.
De Jonge (2003) found that the hormonal changes in your cycle do not have a significant impact on your strength training. And there aren’t any other studies at the moment to really justify a rigid training schedule around cycle, to be honest. So, like I have been saying throughout, it’s super cool to know how we can adjust how we train throughout our cycle, but the evidence is low and what we know for absolute sure, is that YOU know your body best. So if you need to taper down and do more recovery sessions because of your PMS or period symptoms, then do what your body needs!
Tracking your Cycle
To better understand where you are at in your cycle, we suggest tracking your period and symptoms on an app like Clue, Flo, Glow, My Calendar or apple health etc. Once you start to understand when your follicular and luteal phases start, and document the usual symptoms you feel at different points in your cycle, you can make changes to your schedule to optimise your pole training! We suggest tracking your cycle and symptoms over the space of 6 months to understand how your body responds to hormonal changes. Tracking your cycle helps you to understand when your body enters each phase, and how to accordingly adjust for any resulting symptoms.
We recognize that every woman's cycle is different and a multitude of factors can play a role including the use of hormonal contraceptives, eating disorders, and medical conditions such as polycystic ovary syndrome (PCOS) or uterine fibroids.
As pole dancers and athletes, taking a look at how our bodies change throughout our cycle can be an incredibly helpful tool. By understanding what’s going on inside our bodies, we can work with our team of coaches and health care professionals to set ourselves up for success in reaching our health and fitness goals.
Do you find yourself struggling with the fluctuations of your menstrual cycle?
If you want to work with a physiotherapist that understands your hormonal cycle needs and the best way to set yourself up for pole success, then look no further than booking an appointment with our team of Pole Physios here. Assessment and tailored rehabilitation are provided in accordance with best practice and evidence-based treatment to help you unleash your 'poletential'.
Until next time, train safe.
The Pole Physio
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References:
Armour M, Ee CC, Naidoo D, Ayati Z, Chalmers KJ, Steel KA, de Manincor MJ, Delshad E. Exercise for dysmenorrhoea. Cochrane Database of Systematic Reviews 2019, Issue 9. Art. No.: CD004142. DOI: 10.1002/14651858.CD004142.pub4. Accessed 18 September 2022.
Campbell S, Angus D, Febbraio M. Glucose kinetics and exercise performance during phases of the menstrual cycle: effect of glucose ingestion. American Journal of Physiology-Endocrinology and Metabolism. 2001;281(4):E817-E825. doi:10.1152/ajpendo.2001.281.4.e817
Chidi-Ogbolu, N., & Baar, K. (2019). Effect of Estrogen on Musculoskeletal Performance and Injury Risk. Frontiers in physiology, 9, 1834. https://doi.org/10.3389/fphys.2018.01834
Enns, D. L., & Tiidus, P. M. (2010). The influence of estrogen on skeletal muscle: sex matters. Sports medicine (Auckland, N.Z.), 40(1), 41–58. https://doi.org/10.2165/11319760-000000000-00000
Janse de Jonge X. Effects of the Menstrual Cycle on Exercise Performance. Sports Medicine. 2003;33(11):833-851.
McNulty, K. L., Elliott-Sale, K. J., Dolan, E., Swinton, P. A., Ansdell, P., Goodall, S., Thomas, K., & Hicks, K. M. (2020). The Effects of Menstrual Cycle Phase on Exercise Performance in Eumenorrheic Women: A Systematic Review and Meta-Analysis. Sports medicine (Auckland, N.Z.), 50(10), 1813–1827. https://doi.org/10.1007/s40279-020-01319-3
Prado, R., Silveira, R., Kilpatrick, M. W., Pires, F. O., & Asano, R. Y. (2021). The effect of menstrual cycle and exercise intensity on psychological and physiological responses in healthy eumenorrheic women. Physiology & behavior, 232, 113290. https://doi.org/10.1016/j.physbeh.2020.113290
Tsai S. Y. (2016). Effect of Yoga Exercise on Premenstrual Symptoms among Female Employees in Taiwan. International journal of environmental research and public health, 13(7), 721. https://doi.org/10.3390/ijerph13070721