As I am playing in a volleyball tournament, I start feeling nauseous and having unusual body aches. This confuses me and makes me wonder what I did wrong. Could it be something I ate, or did I not train as well as I thought? Even though I have been doing well in practice all week, I continue losing points for my team, struggling to score, and missing passes. Then I wonder if the post I saw on social media this morning about using menstrual cycle-based training to help sustain endurance had any truth to it.
When approaching my coach, parents, and teammates about how I was feeling, I got many different suggestions. My coach encouraged me to meet with her for extra training before practice, like sprints, weight-lifting, and agility training, to help increase my stamina and overall physical fitness. Next, my parents wanted me to consider taking a short break from all intense physical activity and focus on lower-impact exercises, such as pilates and yoga. Then, a teammate suggested combining both the opinions of my coach and my parents, and considering my menstrual cycle. My teammate said that she had seen a similar video on TikTok, my generation’s favorite source of information, and suggested focusing on rest and recovery during certain phases of my cycle and implementing higher intensity training during other phases.
With these opinions and new information, it seemed as though a universal opinion was impossible. Young athletes have more access to new workouts and fitness challenges because of the rise of social media. This visibility has led to mainstream fitness influencers suggesting a new question about the health of female athletes: Can menstrual cycle tracking be taken into consideration when planning training to improve performance?
The phases of a woman’s menstrual cycle can be compared to my volleyball training routine. To begin practice, I always make sure to start with a warm-up stretch or jog. This helps me make sure my body is ready for training by slowly starting to move my muscles and joints. During the follicular phase of the menstrual cycle, the ovaries and uterine lining are being prepared for a potential pregnancy. This causes a slow increase in hormones and the development of follicles. After a thorough warm-up, I move on to drills. Exercises, like partner passing to improve accuracy, help me focus on the fundamentals of volleyball before my main training. In the late stages of the follicular phase, a woman’s body is preparing for ovulation, which is the main event of the menstrual cycle. As hormone levels continue to rise, one follicle grows to become stronger than the others. Next, my team and I move on to the main portion of practice with the highest intensity training that I have been preparing for. Just as I reach the peak of my practice, the menstrual cycle reaches its peak during ovulation. The follicle becomes an egg and is released from an ovary. After a difficult practice, taking my time to stretch again and cool down is very important to injury prevention. My cool-down is similar to the luteal phase. The luteal phase is when the body waits to see if the egg is fertilized after all the work during ovulation. Finally, my recovery process starts strong because of the cool-down. This prepares my body for practice again tomorrow. After the luteal phase, the body resets, and if the egg has not been fertilized, menstruation occurs, and a new cycle begins. Just as I go through this schedule every practice, the menstrual cycle goes through the same phases every month.
Just like how not all volleyball games do not go as planned, the menstrual cycle causes many physical changes in a woman’s body that affect more than just her reproductive system. Grandi and colleagues, of Azienda Ospedaliero-Universitaria Policlinico di Modena, a university hospital in Italy, found that up to 84% of women report that they experience some form of pain during menstruation, and at least 1 in 4 women’s lives are negatively affected by it. These symptoms can include abdominal pain and backaches, which can be extremely painful and peak during the luteal phase and menstruation. Pain from cramping is a result of the uterine lining being shed during menstruation. Many women may also experience nausea. I personally experienced periods of lightheadedness and feeling like I may faint, and I was diagnosed with iron deficiency anemia from heavy bleeding. The most severe and frustratingly stubborn are migraines caused by rising hormone levels. Silberstein and Merriam, of the Thomas Jefferson University Hospital and the University of Washington School of Medicine, found that these migraines begin in 33% of affected women during their first menstruation. Women who suffer from the most intense migraines often persist throughout their lives until menopause. These painful symptoms that can occur throughout the cycle affect a woman’s subjective strength. This affects how women, like myself, feel about our current strength and athletic performance.
Endurance training is any exercise that increases heart rate, frequency of breathing, and uses large muscle groups for a consistent amount of time. This can include running, cycling, dancing, hiking, and swimming. Hormone changes can influence how a woman’s body uses food for energy, regulates body temperature, and air flow in her lungs during an endurance workout. This may cause a woman to feel like her performance varies throughout her cycle due to these physical changes. Understanding how hormone changes affect a woman’s body is vital when considering syncing workouts to the menstrual cycle to potentially maximize performance.
Every woman has a unique experience with her own menstrual cycle’s regularity, symptoms, and use of contraceptives, which makes finding consistent results difficult. For example, Solli and colleagues, of Nord University in Norway, discovered that about 40-70% of female athletes use a form of hormone-based birth control and get positive side effects, like easier prediction of menstruation and lower levels of pain. On the other hand, there are negative observations as well, athletes who use birth control pills have tested with higher levels of stress hormones, lower amounts of oxygen the body can use effectively during exercise, and less adaptation to sprint training than athletes who do not use birth control pills, whose endurance performance seems to stay the same. Another factor relating to the lack of consistency is the scarcity of accessible information for female athletes about their menstrual cycle. Many female athletes do not even know what symptoms are from their cycle or how to report them due to the stigma around menstruation. These examples of differences between women’s cycles highlight the importance of understanding every influential factor that could impact results when researching a topic as diverse as the effect of the menstrual cycle on endurance training.
The key physical qualities an athlete focuses on to increase performance are muscular and cardiovascular endurance. Increased body temperature, caused by hormonal shifts in the luteal phase, can intensify the symptoms of cardiovascular strain. Although menstrual symptoms may affect how a woman feels she may perform, it does not appear to affect their actual performance outcome. Although adjusting training routines may help an athlete feel as though they can perform better, their performance and strength are typically unchanged.
Looking back on that specific volleyball tournament, I now realize that although my nausea and body aches might have been caused by the menstrual cycle, they may not have been significant enough that I am convinced to change my entire exercise routine. Considering the results of my research, my personal advice would be to remain open to new ideas, do your own research, and come to a conclusion based on your findings and personal experience. Influencers on social media are not trained medical doctors, and may or may not be advertising the most accurate information. I encourage you to embrace curiosity and not blindly trust someone you see online. Once you have put in the time necessary to investigate all the facts, then you can feel confident making your own independent decision.
Sources:
https://journals.sagepub.com/doi/full/10.1046/j.1468-2982.2000.00034.x
https://pmc.ncbi.nlm.nih.gov/articles/PMC3392715/
https://journals.humankinetics.com/view/journals/ijspp/15/9/article-p1324.xml
https://www.sciencedirect.com/science/article/abs/pii/S0306453020303188
https://link.springer.com/article/10.2165/00007256-200232010-00001
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