Coaches, strength and conditioning coaches, and teammates have one thing in common: they only exist if there are other people who share the same sporting goal. These men and women, who we pursue a common goal with, are the precious individuals with whom we create relationships which touch our lives forever.
As a member of staff, it is important to understand that we should not only concern ourselves with the physiological systems to improve. We are dealing with men and women who are not only athletes, but above all human beings. These people have lives, feelings and morals which influence their sporting practice/career. Today we are going to tackle a physiological subject, which has direct effects on women. We are going to discuss the menstrual cycle of sports women and the effect that this can have on their ability to practice and compete. But above all, we are going to try and understand and give some thoughts on the role of the coach in this situation.
A little taboo, very ignored, and barely taught, the influence of the menstrual cycle on sporting practice is clearly a phenomena of which we have reduced the importance of too much. Yet, in an article which appeared in the French journal “L’Équipe” in February 2017, British woman Paula Radcliffe, a record-holding marathon runner says “it is a subject we absolutely should be talking about and should be studying, as it is linked to all aspects of elite sporting activity : the organisation of training, the impact on competitions, the recovery, the mentality. This reflection is essential in order to gain the most out of ones carrier.”
Very well Paula, so be it ! Let’s dive into the literature to see what we can learn. To do this we will start by looking at the human physiology:
I ) The menstrual cycle — A little physiology class :
The menstrual cycle is a chain of physiological events which allows a women to be fertile and human beings to reproduce. Menstruation starts at puberty and finishes in menopause. The hormonal changes caused by the different phases of the cycle can have overriding effects on the human body and thus on their adaptations to training. In order to better understand, let’s break down the menstrual cycle.
The data described here represents averages, rather than exact values. The duration of cycles, or the different phases that make it up, can vary from cycle to cycle, as well as from woman to woman, thus is very diverse. As is often the case, everything is variable, however there are also common tendencies and averages from which we can obtain pertinent information.
Two main 14 day phases make up the 28 day cycle: the follicular phase (day 1-14) and the luteal phase (day 14-28).
• The Follicular phase :
The first day of the cycle corresponds with the first day of menstruation. It finishes in ovulation. During menstruation, oestrogen levels are very low. This stage of the cycle has very variable effects on women. It is possible to have pain or other symptoms which directly impact sporting practice. During this time, athletes must listen to their body, and coaches to their athlete. In some cases, adjustments to the training schedule may be necessary. Nevertheless, nothing contraindicates practicing sport during menstruation. Physical exercise can even help to reduce pain associated with periods.
During the rest of the follicular phase, from the end of menstruation followed to the ovulation, the secretion of oestrogen increases in a linear fashion. As for progesterone, there is no secretion. These hormonal characteristics often drive an increased consumption of carbohydrates, increased energy and increased motivation which can have a direct effect on sporting practice.
- The Luteal phase :
This phase begins with ovulation, which marks a strong increase in the level of progesterone while the level of oestrogen decreases. Core body temperature increases and one’s ability to consume sugar reduces, whereas the ability to consume lipids is optimised. During this time, favouring longer training sessions at a lower intensity would be well advised. The physiological changes of this phase are above all important during the second part, at the very end of the cycle, which precedes menstruation.
Just prior to menstruation, a number of physiological upsets can hinder training – this is called the pre-menstrual syndrome (PMS). This syndrome can be manifested by different symptoms depending on the individual: irritability, loss of energy, fatigue, weight gain, etc. According to Dr Carole Maitre, doctor of sport and gynaecology at INSEP, 83% of sportswomen experience or have experienced PMS at some point in their carrier. This phase of the cycle is the hardest to manage for sportswomen, and so good support is needed for this week to become manageable and have the least possible impact on their development.
II) So books are telling us that … But what does the field tells us ?
There are a lot of studies interested in looking at the effects of physical exercise on the menstrual cycle, hormonal levels and pathologies linked to this system. On the other hand, there are very few studies going the other way, meaning studying the effect of the menstrual cycle on adaptations to training regimes or sporting performance. Paula Radcliffe was clearly not wrong when she said this area wasn’t studied enough.
Some scientists are still looking into the subject, for example, Dr Lisbeth Wiktstöm-Frisén, Swedish researcher, is interested in the effects of different distributions of training load on the menstrual cycle. 51 women were randomly separated into 3 groups which distributed their lower limb weight training differently.
- The first group trained 5 times per week during the follicular phase and once a week during the luteal phase
- The second group did the opposite: 5 training sessions during the luteal phase and one a week during the follicular phase.
- Finally, the third group, the control group, trained 3 times a week throughout the entire cycle.
The protocol was spread out over 4 x 28 day cycles, and the end results are amazing. The first group showed a significant improvement compared to the two other groups when looking at the power of their lower limbs and the iso-kinetic strength of the extensors and flexors of their knees on both legs. The control group achieve the second best results, and finally group 2.
This study clearly shows us that the same training regime, distributed differently throughout the menstrual cycle, has very different results. It would seem that the first two weeks of the cycle constitute the best opportunity to undertake intensive training, with the aim of improving neuro-muscular qualities.
There are very few studies on the effect of different training distributions in accordance with the menstrual cycle. Nevertheless, studies undertaken on endurance exercises across a range of intensities, show that there are no significant differences. On the other hand, during exercises where a high aerobic intensity is maintained, markers of physiological and psychological fatigue were sometimes more elevated during the luteal phase, while the effort remained the same. This effect is even more pronounced during hot and humid conditions. This may seem insignificant, given that in the end, the athletes achieved the same performance. But don’t be fooled! This difference in fatigue markers has a direct influence on recovery time, so the following training sessions or performances will no doubt be affected.
Finally, regarding pure performance or the gross result, a number of studies have tried to find differences in evaluating all known physical qualities, across different phases of the cycle. The only quality suffering a significant difference is the VO2 MAX. All other energetic and neuro-muscular qualities showed no significant differences in performance across the different stages of the cycle.
While it is true that VO2 MAX is a very important performance factor in rowing, the differences found in the literature, although significant, are very small. The whole performance of a crew will not be affected by this single aspect.
Sportswomen can be hindered by their periods, or by pre-menstrual syndrome, during a competition, but when it comes to the physiological expression of their performance, it doesn’t seem to make a difference. Again, I repeat, this can depend on the athletes, the goal of researches is to find the common characteristics across all the individuals taking part. Special cases are not uncommon and must be taken into account.
So ladies, no matter where you are in your menstrual cycle during a competition, you should, normally, be able to perform at your best level.
III) What are the lessons for coaches ?
1- Being aware that the menstrual cycle plays a role
The world of sports training is for the majority, made up of men who will never have any idea of the disruptions sustained by women during their cycle. The most important thing is to be aware that this can play a role, and it could affect everything : mood, recovery, fitness, motivation, performance, weight, and it goes on and on …
Being aware of this allows one to better accompany the athlete in their entirety, as a woman and not only as a sportswoman.
This goes for sportswomen as well, being conscious of which phase you are in can influence your training, and if you feel like something isn’t right, don’t hesitate to talk to the staff about it. Competent professionals are all capable of understanding that hormonal changes can influence one’s physiology and so, the person. If you don’t feel comfortable talking about it with your members of staff, they aren’t taking you seriously, or they don’t understand, talk to a doctor. They could even act as a mediator if necessary. I am giving this advice while I have no idea what women experience during their cycle, I have just read during my research the testimony of women who didn’t want to talk about it, or who weren’t taken seriously. I obviously find this deplorable. Coaches are supposed to be experts of the human body and it is their job to understand such a phenomenon and its effect on sportswomen and their practice.
2 – A tool for the training planification ?
According to the study by Lisbeth Wiktström-Frisén, we can very legitimately think that it would be valuable to take into account the menstrual cycle when establishing a training program. The goal would be to optimise development, just as was done with the women in Group 1 of her study. According to this study, and other works that I have read, notably on the subject of endurance training, here is what I would recommend:
During the Follicular Phase: Prioritize training at an elevated intensity, working on maximal strength, the power, anaerobic abilities and Maximal aerobic power (MAP)
During the Luteal Phase: Take the opportunity to work on basic endurance, get a large volume of work done, to a low and moderated intensity. It’s also a good opportunity to work on mobility and flexibility.
Once again, this is general advice. The best thing to do is to discuss it directly with the athlete. Do not forget that the start of the follicular phase is menstruation. As noted previously, individual reactions and physiological capacities at this moment are very variable depending on the woman. It seems wise to talk to the sportswoman, so as to understand when she would feel most comfortable to train at a high intensity during this period.
3- But how does this work in a crew or a team setting ?
Rowing has the advantage of being a sport where there are so many things to work on that we can always work on different aspects if we need to avoid certain things. Thus creating a program of “two weeks of volume – two weeks of intensity” would have been easy to put into place. But rowing also has some limits to individualisation, as it is also a team sport, and as in all team sports, there is a lot of group/crew training. As well as this, women don’t all have their periods at the same time.
So how do we manage this ? Well as always, we adapt ! There are multiple solutions, I will let you imagine them. If you would like to know my ideas, you’ll have to buy the little guidebook that goes with this article.
IV ) Contraception and the absence of menstruation
Before we finish up, we are still going to skim over two points which are important for our athletes as women, but that we should as trainers, have a slight awareness for. Of course, we need to know our place, we are not doctors.
Oral contraception is a way to regulate the effects of the menstrual cycle. Knowing this is to know that an athlete who doesn’t take the pill will be more affected by hormonal imbalances of the menstrual cycle. Secondly, almost all studies, including that of Lisbeth Wiktström-Frisen, were undertaken with some women taking the pill and others who were not. So the effect of creating a program adapted to the menstrual cycle is effective with or without oral contraception. In my opinion, advising athletes on their choice of contraception is not part of our job, so I am not going to dwell on the subject any longer. Each to their own job. If you would like to know more, I invite you to consult my biography.
The second point I wanted to touch on is amenorrhoea, the absence of menstruation. It is sometimes possible for women who train a lot and eat very little (for example, lightweights) to no longer get their period. This is due to the lack of fat in their body. This is quite a common occurrence in sports of endurance, or with high volume training, and in sports where athletes are dieting. With or without weight constraints, the sudden drop in energy intake can very quickly make you lose weight and also stop your period.
This phenomenon is not too serious, in that it is reversible, however it creates bone fragility caused by the lack of oestrogen. Sportswomen who don’t have their periods will have a higher chance of getting a stress fracture, or of achieving a very bad result. It is also, a factor of infertility. According to a study by Dr Carole Maitre, gynaecologist at INSEP, 6% of 74 sportswomen were had amenorrhea in athletics. There was no further information provided on their speciality, which is a shame. Dr Maitre also tells us that it is very important to not go longer than 5 months without having a period, and that it is essential to consult a specialist if this occurs.
As a coach, it is important to make your athletes aware of this problem, so that they don’t put themselves in danger by thinking that having a period isn’t “convenient”. As a sportswoman, it is also important to take care of your body, you don’t get more than one. As well as this, it is the working tool of the professional sportswoman, so it deserves all her attention.
This subject is very interesting, although studies are still limited and education surrounding it is really lacking. It is sure that we must take into account the menstrual cycle, we need to know that it can have a real influence, but above all, we need to listen to our athletes. So often, athletes learn to deal with in on their own. On the other hand, they cannot imagine that it is possible to improve their development by arranging their training around their cycle. It is up to the coach to be proactive in putting this monitoring in place. Furthermore, I think that adapting training to the cycle, and so anticipating the sportswomen’s symptoms can help to handle this phenomenon from a psychological point of view.
In my opinion, it is very important to educate coaching professionals and athletes about this subject. If you agree, I encourage you to share this article on your social networks. If you have read up to this point, I am very grateful and I hope that you enjoyed the article. To keep digging I actually wrote the “little guide of menstrued training” if you would like to know more on the topic. I explain my ideas for adjusting training to the cycle. There is an example of an individual training program as well as a crew program. As well as this, I present a tool for women to find out where they are in their cycle in a precise way.
Thank you for your time, and see you again soon!
The Little guide of “menstrued” training
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