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Working with the Menstrual Cycle in Female Athletes

by Calli Doan and Justin Kilian, MEd, CSCS,*D
NSCA Coach December 2021
Vol 8, Issue 3

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The goal of this article is to promote professional dialogue and broaden the knowledge of ways to use nutrition and recovery techniques to work with the physiological changes that come throughout the menstrual cycle.

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This article originally appeared in NSCA Coach, a quarterly publication for NSCA Members that provides valuable takeaways for every level of strength and conditioning coach. You can find scientifically based articles specific to a wide variety of your athletes’ needs with Nutrition, Programming, and Youth columns. Read more articles from NSCA Coach »

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References

1. Abdollahifard, S, Rahmanian Koshkaki, A, and Moazamiyanfar, R. The effects of vitamin B1 on ameliorating the premenstrual syndrome symptoms. Global Journal of Health Science 6(6): 144-153, 2014.

2. Alaunyte, I, Stojceska, V, and Plunkett, A. Iron and the female athlete: A review of dietary treatment methods for improving iron status and exercise performance. Journal of the International Society of Sports Nutrition 12(38): 1-7, 2015.

3. Armour, M, Parry, KA, Steel, K, and Smith, CA. Australian female athlete perceptions of the challenges associated with training and competing when menstrual symptoms are present. International Journal of Sports Science and Coaching 15(3): 316-323, 2020.

4. Bharati, M. Comparing the effects of yoga and oral calcium administration in alleviating symptoms of premenstrual syndrome in medical undergraduates. Journal of Caring Sciences 5(3): 179-185, 2016.

5. Bruinvels, G, Burden, R, Brown, N, Richards, T, and Pedlar, C. The prevalence and impact of heavy menstrual bleeding (menorrhagia) in elite and non-elite athletes. PLoS ONE 11(2): 1-8, 2016.

6. Draper, CF, Duisters, K, and Weger, B. Menstrual cycle rhythmicity: metabolic patterns in healthy women. Scientific Reports 1-15, 2018.

7. Esmaeilpour, M, Ghasemian, S, and Alizadeh, M. Diets enriched with whole grains reduce premenstrual syndrome scores in nurses: An open-label parallel randomised controlled trial. British Journal of Nutrition 121(9): 992-1001, 2019.

8. Findlay, RJ, Macrae, EHR, Whyte, IY, Easton, C, and Forrest Née Whyte, LJ. How the menstrual cycle and menstruation affect sporting performance: experiences and perceptions of elite female rugby players. British Journal of Sports Medicine 54(18): 1108-1113, 2020.

9. Gorczyca, A, Sjaarda, L, Mitchell, E, Perkins, N, Schliep, K, Wactawski-Wende, J, and Mumford, S. Changes in macronutrient, micronutrient, and food group intakes throughout the menstrual cycle in healthy, premenopausal women. European Journal of Nutrition 55(3): 1181-1188, 2016.

10. Hackney, AC, Kallman, AL, and Eser Ağgön. Female sex hormones and the recovery from exercise: Menstrual cycle phase affects responses. Biomedical Human Kinetics 11(1): 87-89, 2019.

11. Hashim, MS, Obaideen, AA, Jahrami, HA, Radwan, H, Hamad, HJ, Owais, AA, et al. Premenstrual syndrome is associated with dietary and lifestyle behaviors among university students: A crosssectional study from Sharjah, UAE. Nutrients 11(8): 1939, 2019.

12. Janse de Jonge, XA. Effects of the menstrual cycle on exercise performance. Sports Medicine (Auckland, N.Z.) 33(11): 833-851, 2003.

13. Koikawa, N, Takami, Y, Kawasaki, Y, Kawana, F, Shiroshita, N, Ogasawara, E, and Kasai, T. Changes in the objective measures of sleep between the initial nights of menses and the nights during the midfollicular phase of the menstrual cycle in collegiate female athletes. Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine 16(10): 1745-1751, 2020.

14. Lane, DJ, and Richardson, DR. The active role of vitamin C in mammalian iron metabolism: much more than just enhanced iron absorption! Free Radical Biology and Medicine 75: 69-83, 2014.

15. McLay, RT, Thomson, CD, and Williams, SM. Carbohydrate loading and female endurance athletes: Effect of menstrualcycle phase. International Journal of Sport Nutrition and Exercise Metabolism 17(2): 189-205, 2007.

16. Melin, A, Tornberg, ÅB, Skouby, S, Møller, SS, Sundgot, BJ, Faber, J, et al. Energy availability and the female athlete triad in elite endurance athletes. Scandinavian Journal of Medicine and Science in Sports 25(5): 610-622, 2015.

17. Owen, M. Physiological signs of ovulation and fertility readily observable by women. The Linacre Quarterly 80(1): 17-23, 2013.

18. Pallavi, LC, Souza, UJD, and Shivaprakash, G. Assessment of musculoskeletal strength and levels of fatigue during different phases of menstrual cycle in young adults. Journal of Clinical and Diagnostic Research 11(2): 11-13, 2017.

19. Petty, L. Plant protein primer: A cheat sheet for vegans. Alive: Canada’s Natural Health and Wellness Magazine 423: 47-50, 2018.

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21. Sawai, A, Tochigi, Y, Kavaliova, N, Zaboronok, A, Warashina, Y, Mathis, BJ, et al. MRI reveals menstrually-related muscle edema that negatively affects athletic agility in young women. PLoS ONE 13(1): e0191022, 2018.

22. Solli, GS, Sandbakk, SB, Noordhof, DA, Ihalainen, JK, and Sandbakk, Ø. Changes in self-reported physical fitness, performance, and side effects across the phases of the menstrual cycle among competitive endurance athletes. International Journal of Sports Physiology and Performance 15(9): 1324-1333, 2020.

23. Tenforde, AS, Beauchesne, AR, Borg-Stein, J, Hollander, K, McInnis, K, Kotler, D, and Ackerman, KE. Awareness and comfort treating the female athlete triad and relative energy deficency in sport among healthcare providers. German Journal of Sports Medicine 71(3): 76-80, 2020.

24. Tornberg, ÄB, Melin, A, Manderson Koivola, F, Johanssen, A, Skouby, S, Faber, J, and Sjoden, A. Reduced neuromuscular performance in amenorrheic elite endurance athletes. Medicine and Science in Sports and Exercise 49(12): 2478-2485, 2017.

25. White, CP, Hitchcock, CL, Vigna, YM, and Prior, JC. Fluid retention over the menstrual cycle: 1-year data from the prospective ovulation cohort. Obstetrics and Gynecology International 138451, 2011.

26. Yamada, K, and Takeda, T. Low proportion of dietary plant protein among athletes with premenstrual syndrome-related performance impairment. The Tohoku Journal of Experimental Medicine 244(2): 119-122, 2018.

About the author

Calli Doan

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About the author

Justin Kilian, PhD, MEd, CSCS,*D

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Justin Kilian is a doctoral candidate in health and humanperformance, currently working through the dissertation process.He is an Assistant Professor ...

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