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Nutrition, Training and Performance for the Menstruating Female Athlete

A woman puts her hands behind her head at a track as the sun sets

As a woman, have you ever wondered how you can feel totally flat during a track session this week when, just a few weeks ago, you felt smooth and fast despite running the same session, eating the same food, sleeping the same amount and performing your normal recovery routine? The good news is that it probably has nothing to do with losing fitness. Natural female hormone fluctuations can trigger it all. But how?

Females are physiologically different from their male counterparts, starting at the onset of puberty. Hips widen, body fat is more easily stored and menstruation begins. This period of a “hormonally-driven roller coaster” can send a female athlete into a downward spiral, negatively affecting fitness and performance. However, it’s not as bleak as it sounds.

The trick is understanding and learning how to master your cycle to support you being the best athlete you can be. The menstrual cycle consists of three hormonal phases: the follicular, ovulation and luteal phase. And two major hormones play a key role throughout all phases. Estrogen is the hormone responsible for the development and maintenance of both the reproductive system and physical female characteristics. Progesterone plays an important role in the menstrual cycle and in maintaining the early stages of pregnancy.

A woman races alone on a greenway

PHASE 1

The follicular phase (also known as the low hormone phase), begins with day one, the first day of the period, lasting for approximately two weeks. During this time, estrogen and progesterone are low. Despite popular belief, the first day of menstruation is actually a performance enhancer since hormones drop, leaving you with energy at your disposal for exertion/output. Here’s why.

  • During this time a female’s exercise physiology is more similar to a male’s than at any other time in the cycle
  • The body is primed to hit top-end efforts, store and utilize carbs for fuel
  • You will feel stronger and have an increased ability to make strength gains
  • You may also feel less pain or experience a lower rate of perceived exertion
  • You will recover faster from hard or taxing efforts
  • Your hydration status is optimal

Tips for using the follicular phase to your advantage in training:

  • Training: This is the best time to seek fitness gains via high intensity, strength and HIIT sessions.
  • Nutrition/Fueling: Aim for 30 to 40 grams of carbs per hour of training (ideally from glucose and sucrose sugar substrate), if your session is longer than 75 to 90 minutes.

Recovery: Prioritize a snack within 30 to 45 minutes of your workout consisting of 20-plus grams of protein and easy-to-digest carbohydrates.

A woman wearing a GPS running watch runs on a track

PHASE 2

Ovulation: Approximately day 12 to 14. During ovulation, estrogen levels are high and progesterone levels are low.

It’s common during ovulation to have elevated oxidative stress, or inflammation, and some women may experience pain related to ovulation while others experience no symptoms.

  • Due to elevated estrogen levels, the body's ability to store carbs can be negatively affected which may affect performance in an endurance session.
  • For training sessions or endurance events longer than 75 to 90 minutes, prioritize sports fueling to optimize performance and recovery.
  • Sports fueling during training sessions helps the body combat stress from training and hormonal fluctuations.

PHASE 3

The luteal phase is defined as the phase between ovulation to menses. Estrogen and progesterone levels are high, especially in the last week before the onset of menstruation. Here’s what to expect during the last five to seven days before your period starts:

  • Carbohydrate burning and glycogen storage ability is reduced at the same time that your metabolism increases five to 10 percent (100 to 200 calories), thus explaining increased cravings. This also makes it harder to reach high-end efforts/intensity since carbs are harder to utilize.
  • The rate of perceived exertion is higher even at moderate efforts, and it’s harder to build muscle.
  • You will experience increased bloating due to water retention. Your blood is also thicker and your hydration status is sub-optimal.
  • Your heart rate will be higher even at moderate efforts compared to the low hormone phase.
  • You may find that you’re less tolerant to heat, you're more tired than normal and recovery seems to be slow.

Tips for using the luteal phase to your advantage in training

  • Training: Lower stress, aerobic efforts and technique-focused sessions are most effective during this phase. However, if you have a race or event during this phase, refer to the fueling guidelines outlined below.
  • Nutrition/Fueling: During sessions lasting longer than 90 minutes or high-intensity workouts, increase fueling to 40 to 50 grams of carbohydrates per hour. Prioritize recovery fuel of 20-plus grams of protein and easy-to-digest carbohydrates within 30 to 45 minutes of your workout. Avoid fructose and maltodextrin as fuel sources in sports fueling as these contribute to GI distress. Your best choices are glucose and sucrose. Avoid protein and fat in sports fueling products to reduce Gi distress.
  • General nutrition: Be mindful of eating well with adequate protein, fruit and veggies and add salt to foods to support optimal hydration during this phase.
A woman in new balance shoes and CEP socks rests on a track

Historically, discussing the female menstrual cycle has been off-limits and never considered to hinder or enhance performance. Research from industry experts like Stacy Sims and Asker Jeukendrup allows us to better understand the physiological differences between men and women and how to use that knowledge to enhance athletic performance.

Thankfully we are in a new era, and females are being recognized not as much by how they look but by what they say, how they perform and their valuable contribution to society. Women are taking their rightful place at the training table, standing proudly on center stage with their equal male counterparts. Treating female athletes with the same sports fueling and training plan as male athletes is a massive injustice. It’s time to acknowledge, treat, train and fuel women according to their unique physiology.

Tips for mastering your cycle:

Sports Hydration and Fueling

Ideal hydration solution per 8oz to optimize hydration, provide energy and offset GI distress for the female athlete:

  • 3-4% carbohydrate solution (7-9.4g carb per 8oz)
  • Sugar substrate from glucose and sucrose
  • Sodium 180-225 mg
  • Potassium 60-75mg (co-transporter of sodium)

Headaches: Just before the start of menstrual flow, hormones drop, causing a change in blood pressure due to the dilation and constriction of blood vessels. The best way to mitigate these hormone-induced headaches is to stay adequately hydrated and eat foods rich in nitric oxides such as beets, pomegranate, watermelon, and spinach in the days leading up to your period.

Cramping: 5-7 days before your period, you can reduce the effect of cramping by taking magnesium, omega three fatty acids, and a low dose (80mg) baby aspirin. NOT ibuprofen or Advil®. Make sure it is aspirin, which suppresses the production of prostaglandins where NSAIDS do not.

Anti-Cramping Cocktail

Take the following each night for seven days before your period starts to reduce premenstrual side effects and optimize performance.

250 mg magnesium (glycinate or citrate form)

45 mg of zinc

80mg aspirin (baby aspirin)

1g or 1000mg Omega 3 fatty acid (combo of DHA and EPA)

Track your cycle

Most females don’t track the menstrual cycle phases but loosely track cycle duration and period length. Thanks to technology, FitrWoman is an app that provides personalized training and nutritional tips tailored throughout each phase. All you need to get started is to plug in the first day of your last period, estimated period length and cycle duration.

By Susan Kitchen. Susan is a Sports Certified Registered Dietitian, USA Triathlon Level II Endurance Coach, IRONMAN Certified Coach, published author and founder of Race Smart, a sports nutrition and coaching company.

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