Highlights of the episode:
- How a menstrual cycle works
- How the cycle affects training
- How often to monitor menstrual cycle and app she recommends
- Common misconceptions of coaches and athletes
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Jack: Next we have Liv Knowles, the high performance manager of the Hawthorn Football Club. Her topic will be how the menstrual cycle can affect athletes, training, and performance. Thanks for jumping on, Liv.
Liv: Thanks, Jack.
Jack: Let’s dive straight into it. Talk us through, how does the menstrual cycle function, firstly, as a bit of an intro?
Liv: Yeah, probably a good context for the rest of the chat. The menstrual cycle, if we talk about a 28-day cycle, knowing that a normal cycle can last from anywhere between 21 and 35 days. But if we talk about a 28-day cycle, just for this context, we step right into two phases.
The first is the follicular phase, which will last about 14 days. And the second is the luteal phase, which will last that second 14 days. And you have ovulation in the middle there and the bleeding at the start of the follicular phase. So, those are the two phases that we’re working with.
Like I said, there obviously is a lot of variability in cycle length. We also know that most of that variability comes about from the follicular phase. So most women will actually have about a 14–15 day luteal phase. That’s pretty consistent. So, you can actually count back from the start of your cycle and work out when you ovulated in the previous cycle by counting that 14 days back.
And so, if you have a short cycle, you know that your follicular phase is probably shorter. Or if you have a long cycle, it’s because that follicular phase is longer. And then obviously, as I said, characterized by those different features. So, the bleeding in the follicular phase and the ovulation at the start of the luteal phase.
Jack: And if your cycle has changed from 35 one month, can it go drastically the next month to a 28 days? Or does your body tend to have a routine with your days?
Liv: It’s a good point. A lot of women don’t have a consistent cycle. And it’s great if you do. Sometimes one of the reasons why women go on the pill, just so they have consistency in their cycle and things like that. But yeah, your cycle absolutely can fluctuate. And it’s one of the great things about tracking your cycle, so that you can see if there is a pattern to the way your cycle does fluctuate. So, yeah, it does certainly happen.
And we also know that not everyone has a normally or naturally functioning menstrual cycle. We have women who are what we call an amenorrheic. They don’t have a normal menstrual cycle. They might not bleed in that 21 to 35 days period. They might bleed every three months, six months, things like that. So, it is very individual.
Jack: And from a training perspective, how does it change when you’re in the first sort of 15 days of your cycle to the second phase of your cycle?
Liv: From a training perspective, I guess I want to preface this by saying that a lot of the data at the moment coming out in the research isn’t that strong yet. And so, a lot of the recommendations need to be taken with a lot of caution and you really should be working out what works for you individually.
But based on the research that has come out we think that performance might have a trivial decrease during the early follicular phase. That bleedy phase. So, performance might be decreased during that phase, but at the same time there’s evidence that shows that sprint performance is increased during that phase. So again, it’s about working out what works for you.
In comparison to that, we’ve seen some pretty good evidence coming out that strengths might be increased during the ovulation phase or the late follicular phase. So, in the middle of your cycle, that’s when you might have raise of strength.
But at the same time, we know that ligaments have greater laxity during that ovulation phase. So, you might be prone to more ligament-based injuries. We think there might be a link between ACLs and cycle phase and things like that. There’s certainly a need to watch this phase type of situation with the research still coming out. And endurance as well. Endurance might increase during the late follicular phase too.
Jack: Well, that’s interesting. So, you’re stronger, your aerobic capacity is higher, but you’ve got more laxity. That’s not ideal for injury anyway. Obviously, for some performance, if you’ve got good stability. To be on the positive side for athletes listening and not to freak them out, you’re going to be stronger and have better capacity as well. But for the ligaments sake, you are producing more force and you’re able to cover more distance.
Liv: But at the same time, the menstrual cycle we don’t think has an effect on things like your oxygen consumption, your energy expenditure, your spiritual rates. There’s mixed results about RPE. So, it’s very different for individual people, I think.
Jack: And then you mentioned monitoring your cycle. What would be your recommended approach? How much time should you be spending? Is it a daily ritual? Is it weekly? What would be your recommendation for young athletes?
Liv: To start with it probably needs to be daily. Just if you’re trying to work out how each different phase affects you. If you just want to know when you’re going to get your cycle, you can just do it monthly, that’s fine. But if you want to really have a solid understanding of how each phase and the way your body changes across those phases affects your training, your mood, your sleep, all of those sorts of things you are covering, you’re best to do it daily.
There’s some really great apps out there. FitrWoman is one of the better ones and really athletes specific. You can go in on there and log each day: one, whether you’ve got your period or not; but two, your different symptoms. So, it might be whether you’ve got headaches or if you’re having mood swings or you’ve got soreness or extra fatigue, all sorts of things. You can just click a little button that has little pictures come up and you can just easily click the one that fits for you. And then it just records that and you’re done in 30 seconds.
If you can do that daily, and if you can do that over a couple of months and build up a really good log of data, you can start to potentially see if there’s any patterns with your training as well. In that particular app, you can also input what your training intensity has been that day as well. So, if you’ve had a high intensity session or a low duration session, for example, you can input that too. So, you can start to match the data with your symptoms and your cycle a little bit too.
Jack: So it can act a bit like a monitoring tool.
Liv: Yeah, absolutely.
Jack: And on that topic, it might be happening already, I’m not sure. But strength & conditioning coaches in terms of individualization, is it too hard to be able to use it as a monitoring tool and adjust loads? Or is it more empowering athletes to have that awareness and to be able to communicate with a coach or their manager about where they’re at and what trends they have with their cycle?
Liv: I think it’s probably the latter at this stage, just based on where the research is at. I think the current stat is that 70% of the current research is considered low quality. So, it’s probably not strong enough to be making group changes from a coaching perspective. It’s hard in a football sense anyway. You’ve got 30 girls on a list. It’s not very likely that they’re all cycling at the same time. It’s really hard from that perspective.
But I think, as you said, empowering and educating from an individual level and being able to create conversations with coaches as well, between your coach and your athlete. So, the athlete can say, ‘Look, I’m not feeling right because I’m in this phase. This might be why.’ And then you can discuss that with the coach, with the doctor, whatever it might be. Maybe you need to be eating more during that particular phase of your cycle to supplement your lack of energy or things like that. So, it’s just a good way for you to be able to understand your body better. And that’s what being an elite athlete’s about, right?
Jack: Yeah, a hundred percent. Well, I think in that sense, males, we don’t have that direct feedback as such. You’ve still got to have good body awareness, but it could be a strength in the sense that, once you’ve worked out what your trends are as an individual athlete, you’ve got this tool that can give you some feedback.
On that topic of nutrition, recovery, preparation as well, in the wake of strength & conditioning. Once you’ve worked out your cycle and what works well for you, what would be some success stories that you’ve seen with athletes in some decisions they make due to their menstrual cycle?
Liv: I think, as I said before, it’s just being able to have those conversations. But I think some of the players that I’ve worked with have understood when they sleep better and what they need to do around their sleep particularly. Women often report poor sleep when they’re about to get their period. So, putting strategies around this phase.
For example, during that stage that might be just doing some extra mindfulness before they sleep, so that they can get to sleep, things like that. Or making sure they’re having really consistent bedtimes during that phase. Because we know that’s one of the best ways to improve athlete’s sleep: consistent bedtime and awake time.
So, they implement that around specific phases. It’s probably the biggest success I’ve had. But at the same time it’s also educating your athletes that even if you have seen a pattern and you might feel like you lack energy during a particular phase, we also know that medals are won and records are broken at all stages of the cycle. We don’t get to change competitions just because you’ve got your period.
So, at the same time you kind of have to suck it up a little bit too. It’s a little bit of a double-edged sword. You want to be aware of it and have that indication and knowledge and be empowered by that, but you also need to be able to put that to the side and say, ‘I’ve trained for this. I can execute this performance regardless of what my body is telling me from a bleeding or hormone perspective.’
Jack: I love that. It’s like a long-term future self. You’re using it to make smart decisions, but at the end of the day, on the game day, focus on the task.
Liv: Yeah, spot on.
Jack: What about common misconceptions from athletes or coaches? What’s out there that pops up?
Liv: I think probably that this is a female-only space. I think there’s probably a lot of taboo around talking about menstrual cycles and things like that, particularly from male coaches and things like that. And I think it’s something that we can do better at opening up.
It doesn’t mean that we all have to deep dive on the topic and things like that. But it’s just about being able to have conversations with your athletes regardless of your gender. I think that’s one of the biggest things. Just being able to have conversations with your athletes about how they’re feeling. Because that’s how you build trust and buy into a program as well.
Jack: I can’t remember where I heard it, but I’ve heard, that if females have been long enough with each other, their cycles do connect. Is that a myth?
Liv: I don’t know if there’s actual research on it. But I think we have all heard that, that cycles tend to match. But I haven’t seen any proof of it.
Jack: You can potentially periodize for performance. Maybe if you find out your calendar, you have your fixture…
Liv: Yeah, potentially. But, I mean, if you want to control your cycle, that’s what contraceptives are for as well. A lot of our athletes are also using things like the pill or NID, so they can control their symptoms. If they have a really bad period pain, for example, they can speak to their club’s doctor and potentially use a contraceptive that will help with those symptoms.
And the research also shows that your performance doesn’t really change on the pill either. I think there’s evidence that there might be a small detriment to performance compared to naturally cycling women. But if you’re alleviating symptoms, it outweighs that performance detriment.
Jack: There’s assistance there, that’s great. And for the developing footballers, again, what would be some of your top tips to have better awareness around your menstrual cycle? So, you mentioned journaling and the importance of lifestyle tips. What about from a physical training point of view? What are some important things that you’d like to see athletes are doing as a high performance manager?
Liv: Just listening to their bodies. And we try and use a bit of a regulation method in terms of our training. We know, for example, that 1 RM changes on a daily basis. And that’s the same and that can fluctuate with your sleep, and that can also fluctuate with the menstrual cycle and things like that. So, being able to regulate your training, knowing when you can really push and when you might need to pull back a bit and listen to your body, so that you can recover better, potentially for the game on the weekend.
So, it’s just really about, like we said throughout this whole chat, knowing your body and having that understanding. But also that education piece. There’s a lot of great pages out there, resources. There’s a lot of podcasts, and Instagram pages. One, periodoftheperiod is really athlete focused. So, I can chuck that to you, so you can chuck it in the show notes. But yeah, there are great resources out there.
Jack: Fantastic. We’ll definitely add that in the show notes and on that, thank you so much for jumping on. And like you said, it’s important we normalize the topic and look after athletes by considering their menstrual cycle and sleep and nutrition and training in the gym. It’s an important factor for training and performance, and health. For those that want to pick your brain a little bit more, where’s the best place to connect with you, Liv?
Liv: Probably Twitter. I don’t use Instagram for work really. So, Twitter is the best place to find me. I think my handle’s @LivKnowles1.
Jack: Fantastic. We’ll add that in the show notes. Thank you.
Liv: Thanks, Jack.