What is the menstrual cycle?

The menstrual cycle is a biological rhythm that usually begins with the onset of puberty. In addition to the female reproductive cycle, the menstrual cycle regulates many other facets of female health. This includes physiological, metabolic, thermoregulatory, and cognitive functions. As a result, there are ways female athletes can work with our cycles to improve our sport performance and reduce the risk of injury.

The menstrual cycle usually lasts around 28 days and is made up into two phases: the follicular phase and the luteal phase. Ovulation occurs in the middle, around day 14, and is triggered by the rise in luteinizing hormone. It is the interplay of rising and falling hormone levels (Oestrogen and Progesterone) which result in the changes throughout the menstrual cycle.

Why should I track my menstrual cycle?

Tracking symptoms, length, and needs for your period (using an app or journalling manually) may help identify your menstrual health and detect deviations or irregularities prompting a doctor's visit. It is also useful for forecasting your menstrual cycle so you can take proactive action to reduce symptoms, maintain energy levels, and know when to pack an extra tampon or pair of shorts in case you need them.

Menstrural Cycle FAQ

1. What are the different hormones in the menstrual cycle and how do they affect me?

• Oestrogen – increases the anabolic response to exercise and may result in greater adaptations to strength training and increase hypertrophy
  
  
• Progesterone – increases body temperature and ventilation which could show greater adaptation to aerobic exercise
  
  
• Luteinizing Hormone (LH) – peaks around day 14 of the menstrual cycle to stimulate ovulation. This is when the body is more prone to injury as there is an increase in joint laxity and a reduce in ligament stiffness

2. How do I train while experiencing pre-menstrual symptoms or while I am on my period?

• Increase sleep duration
  
  
• Yoga or moderate intensity aerobic exercise
  
  
• Nutrition that reduces inflammation (cumin, omega-3 fatty acid, etc.)
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• Interventions recommended by your GP

3. Is period pain normal?

Although period pain may be a common symptom for most females, it is not normal if the pain is debilitating and effects your ability to perform day-to-day activities. You should contact your GP if your period pain is affecting your ability to work, study, train, or exercise.

Women and girls are more susceptible to such injuries as:

• Concussion
  
  
• Anterior cruciate ligament (ACL) injuries
  
  
• Stress fractures.

This may be due to any number of reasons including the menstrual cycle and the hormones it regulates, female biomechanics and anatomy and other social and cultural factors (resources, training access and exposure, etc.)

How do these factors affect the risk for injury in female athletes?​​​​​​​

• ACL and ligament injuries – during the menstrual cycle, the release of luteinizing hormone stimulates ovulation at around day 14. This results in an increase in joint laxity and the reduction of ligament stiffness, which increases the risk of an ACL tear or rupture.
  
  
• Biomechanics and anatomy – Females generally have a wider hip which creates a larger angle between the hip joints, and the knees. This may influence female athletes’ biomechanics, putting them more at risk for knee injuries. Strengthening the leg muscles, such as the glutes, hamstrings, quadriceps, and calf muscles, may aid in reducing the risk for knee injuries.
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• Social and cultural factors – Formally, football was banned for women and girls in New Zealand until 1973. This history comes with systemic factors that still effect female athletes today. These factors include reduced resourcing, equipment, and facilities for female players. Coaches should consider the impact of these factors on the training and motivation of female players. Clubs and administrators should continue to work towards equal access of both male and female resourcing across the country.
  
  

How can we reduce the incidence and severity of injuries?

• Complete the 11+ warmup with correct technique
  
  
• Include a strength and conditioning program in your weekly schedule
  
  
• Track your cycle to know when you’re more at risk for injury
  
  
• Track your symptoms and cycle length to monitor any deviations from your norm
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• Communicate how you are feeling to your coach so appropriate action can be taken to increase your well-being and sport performance goals

What is LEA and how does it affect my sport performance?

• Low energy availability (LEA) occurs when energy output is not supported by adequate energy intake over an extended period.
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• Energy deficiency can result in poor athletic performance as the body competes to recover properly between training sessions and starts to prioritise fuelling basic bodily functions rather than the working muscle.
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Signs of LEA may include:

• Recurring injuries
  
  
• Frequent illness
  
  
• Irregular or changes in menstrual cycle
  
  
• Fatigue and lethargy

What is RED-S and how is it associated with LEA?

Relative energy deficient in sport (RED-S) is the constant state of insufficient energy availability that leads to the impairment of multiple body systems and functions. In women and girls, this usually occurs when low energy availability (LEA) is persistent, and the body forgoes fuelling basic bodily functions.

Signs of RED-S may include:

• Recurring injuries
  
  
• Irregular or changes in menstrual cycle
  
  
• Changes in mood
  
  
• Fatigue and lethargy
  
  
• Under performance and lack of improvement
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• Loss of enjoyment in sport and exercise

RED-S and the effects on the body

How do we prevent LEA and RED-S?

• Ensure energy from the diet meets the demands of exercise and daily activities
  
  
  • Regular meals, snacks throughout the day, recovery options
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• Evaluate your training load and exercise regime and ensure it is balanced with rest periods, accompanied by regular fuelling

What do we do if we suspect we or someone else has RED-S?

• Consult with your GP or a medical professional for assessment and testing
  
  
• Work with your GP or medical professional to identify and address possible causes​​​​​​​
  
  
• Plan to address these causes.
  
  
  • Ensure an appropriate diet to meet the demands of your activity level
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  • Ensure a sustainable and healthy training load and exercise regime
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• Regularly meet with and follow up with your medical and health professionals