Dr. Sayyada Mawji:
Can you exercise during your period? Will exercise make PMS worse? When is the best time to be active during your menstrual cycle? Do menstrual hormones impact exercise and training?
There are so many questions, myths, and emerging research around exercising and the menstrual cycle. Today, I am going to break it all down and address this topic!
Start here: Understanding the menstrual cycle
The length of the menstrual cycle can vary, but on average it is between 21-35 days. Day 1 is the start of your period and the cycle ends when the next period starts.
The Follicular Phase
The Luteal Phase
Oestrogen & Progesterone are low. Oestrogen starts to rise around day 5-8
Oestrogen levels peak
Oestrogen remains high & Progesterone also rises
If egg is not fertilized, hormone levels drop again
Lining of your uterus begins to build up again & ovulation starts
Uterine lining remains thick, preparing the body for possible pregnancy
When not pregnant, your uterine lining will break down, starting the cycle anew with your period
What impact do these hormones have on your body?
Oestrogen and progesterone are not only connected to the menstrual cycle and reproduction. They also impact other organs and systems of the body such as the brain, the heart, muscles, and even bones.
In the musculoskeletal system, oestrogen helps to maintain bone density and is essential for healthy bones. It is also known to be anabolic - increasing muscle mass and strength.
Research studies have indicated that strength training during the follicular phase results in increased muscle strength compared to strength training in the luteal phase. In fact, one study found that the maximal voluntary contraction, which measures muscle strength, was significantly greater in the early follicular phase compared to the late luteal phase.
In the brain, oestrogen increases the levels of serotonin, boosting mood and energy levels.
Changes to the oestrogen and progesterone levels in the second half of the menstrual cycle can cause premenstrual symptoms such as feeling bloated, breast tenderness, and mood changes. Progesterone also leads to a rise in core body temperature.
So what does that all mean for my training?
By understanding how these hormones work, the different bodily systems affected, and how the hormone levels change through the menstrual cycle, we can understand how training, performance, and recovery is affected. With this knowledge, you can better optimize and tailor your exercise regimen.
Here’s a rough example of the breakdown of how we can optimize training week by week:
As oestrogen gradually starts to rise, you might find that it becomes easier to get active during this time. Plus, if it wasn’t already obvious: Yes you can exercise during your period!
As the emerging research on oestrogen and muscle strength suggests, now could be the ideal time to get in some strength training.
As the oestrogen levels peak before ovulation, you might find that your energy levels go up during this week. Take advantage of the positive effects on your mood and motivation and get training!
Be aware that oestrogen can also make ligaments and tendons more lax  during this time, so it’s worth making sure you have a good warmup and exercise safely.
As progesterone levels start to rise, this can make you feel more tired or sluggish but that doesn’t mean you can’t or shouldn’t exercise! In fact, exercising at this time can give you more energy and boost your mood. Consider switching to more low-intensity training or long walks and make sure to take proper rest days.
As oestrogen and progesterone levels begin to fall, you may start to experience some premenstrual symptoms (PMS). Moderate-intensity physical activity, like yoga or active recovery workouts that prioritize stretching and mobility can actually help with these symptoms and keep energy levels up.
In fact, research shows that those who exercise regularly have fewer painful cramps during menstruation too.
Most importantly, know your cycle and listen to your body.
Whilst the above is a useful guide to tailor your training, there is more research to be done to understand this area further.
Research exists to guide us, and there are limitations to the conclusions we can draw because of the small participant numbers of the studies.
The first step everyone can take is to know your own cycle. Start by tracking your menstrual cycle in a journal or by using an app. Write down the different symptoms you experience and how you feel at different parts of the cycle. Make sure to note down your energy levels, mood, any fatigue or PMS symptoms, as well as how you feel during exercise and training.
This will help you to structure an exercise regimen that works for you.
Remember to listen to your body! If you notice any changes to your menstrual cycle or irregularity, it’s worth speaking to your doctor.
Dr. Sayyada Mawji is a London-based family physician and health & wellbeing expert. She is passionate about increasing health awareness, with a special interest in women's health and mental health, and also works to tackle health misinformation online. Dr. Sayyada regularly contributes to national and international media outlets, is a TEDx speaker, and is a health expert panelist for Women's Health Magazine. Her health advocacy work has been recognized and she was the recipient of the Professional Woman Award 2021. Dr. Sayyada also has a keen passion for international aid work and is an avid traveler. Follow her on Instagram: @doctorsayyada
 Effects of follicular versus luteal phase-based strength training in young women - Sung, E., Han, A., Hinrichs, T., Vorgerd, M., Manchado, C., & Platen, P. (2014).
 Effect of menstrual cycle on muscle strength - Rodrigues, Patrick, de Azevedo Correia, Marilia, & Wharton, Lee (2019).
Journal of Exercise Physiology Online
 Does injury incidence really change across the menstrual cycle? Highlighting a recent key study - Dr Emma Jane Lunan
 The effect of menstrual cycle and contraceptives on
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 Neurobiological Underpinnings of the Estrogen – Mood Relationship - Whitney Wharton, Ph.D, Carey E. Gleason, Ph.D, Sandra R. M. S. Olson, Cynthia M. Carlsson, M.D, M.S., and Sanjay Asthana, M.D, F.R.C.P.
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