Lucy Wilkinson, 3rd year medical student at Florida State University College of Medicine
Lucy Wilkinson, Period Pro
TikTok, Instagram, Reddit, news articles, and more are full of conversations about ways to “optimize your luteal phase”, “hack your period”, and more. What does all this really mean? Is it true? How should I be paying attention to my period and how it affects my life?
Let’s kick things off with a quick refresher! The menstrual cycle is a natural process that typically begins between ages 9 and 16, with the average age being around 12. It is a normal and necessary process where hormones are released from the brain resulting in a chain of reactions leading to the popping out of a singular egg from an ovary, thickening of the lining of the uterus, and subsequent shedding of the uterine lining, also known as a period, if a pregnancy does not occur.
The first phase is called the follicular phase (or egg prep), wherein multiple eggs begin to mature within the follicles of the ovaries. This phase begins on the first day of menstruation, also known as a period, and continues to ovulation. Ovulation is when a singular egg is released from the ovary, travels through the fallopian tube, and has the potential to be fertilized by a sperm, if present. After ovulation, the endometrium, which is the lining of the uterus, thickens with nutrients and blood flow to prepare to support a pregnancy if it occurs. This is the luteal or pre- menstrual phase. If the egg is not fertilized, the thickened lining is not needed and is shed as menstruation, aka period.
Menstrual cycles are often irregular during the teenage years, with cycles ranging from 21 to 45 days. After a few years, they typically settle into a more regular pattern, repeating every 21 to 35 days to prepare a new, cozy nest for a potential pregnancy.
Scientific literature has attempted to investigate the effect of the various phases of the menstrual cycle on athletic performance, exercise, dietary changes, and sleep. Let’s go through these one at a time.
Athletic Performance
A significant proportion of female athletes believe their athletic performance is impacted by their periods; however, research has not found a definitive answer on how athletic ability may fluctuate [1]. Studies that did observe an effect showed that strength, aerobic (jogging, cycling) and anaerobic performance (springing, HIIT training, powerlifting) were all affected differently at different times during the menstrual cycle [1]. So, while the verdict is not completely out on what types of exercise may be affected during different times of your cycle, more and more research is being completed to investigate these questions.
A point that was discussed in various research articles was the fact that a large proportion of female athletes believe their performance is impacted by the menstrual phase and when asked, athletes stated their performance was impaired during the late luteal phase (right before they started menstruating or bleeding) [1-3]. The significance of these findings is that females are noticing a change in their bodies during their periods, and while there is not a consensus on how the menstrual cycle affects everyone, this finding highlights the importance of tracking your cycle with a symptom diary and paying attention to when you are experiencing tiredness, irritability, period cramps, bloating, constipation or diarrhea, sleep changes, etc. around your period. These could be the days that instead of pushing yourself with that 10-mile run and big workout, you go for a walk around the neighborhood. Or in contrast, pushing yourself with that intense workout may be just what you need to burn out that icky mood. If you keep a good symptom diary, you can plan for your big workouts and schedule them before you start experiencing some of those premenstrual symptoms.
Furthermore, if you have one of those days when you aren’t feeling up to going to the gym or going for a walk, it would be helpful to look at your symptom diary and realize you may be coming up on your period. Periods can take it out of you sometimes and it is important to have grace with yourself during the days that are a bit tougher. Everyone’s body is unique and needs something different. The important thing is to learn the patterns of your body, be kind to yourself, and take care of yourself when your body is telling you.
Dietary Changes
In regards to the certain types of food to be eating during your period, there is not any conclusive research about what dietary changes you should be making. Something to be aware of is that iron deficiency anemia is common in people who have periods, and it can sometimes be caused by heavy bleeding. Symptoms of iron deficiency include fatigue, low energy, headaches, dizziness, pale complexion, difficulty concentrating, changes in mood, and stomach upset. If you think you are experiencing very heavy periods and possibly signs of iron deficiency, it is important to go talk to your doctor.
To make sure you are getting enough iron in your diet, you can try to include foods such as leafy greens, nuts, red meat, beans, vegetables, and fortified grains in your diet. Vitamin C has been shown to increase the absorption of iron into your body, so it is always a good idea to make sure you are including citrus fruits, bell peppers, broccoli, and other fruits and vegetables into your meals. It is helpful to focus on eating these foods during and outside your period!
Overall, there is no recommendation of what specific foods you should be eating during your period, but it is always important to remember to maintain a balanced, healthy diet. There have been studies that have shown excess caffeine, alcohol, and foods high in salt and sugar can worsen premenstrual symptoms. Go check out our other blog post “How Foods May Impact Painful Periods” for more information!
Sleep
The menstrual cycle is associated with natural fluctuations in hormones that can affect the circadian rhythm of your sleep. There is very limited research studying the mechanisms of premenstrual sleep, however many women report decreased sleep quality leading up to their periods [4]. There has been research indicating that premenstrual syndrome, dysmenorrhea (painful periods), and abnormal menstrual cycle or heavy periods can negatively impact your sleep in terms of quality, duration, daytime sleepiness, and efficiency (initiating and maintaining sleep) [5].
If you feel as though you are having significant difficulties with your sleep, speak to your doctor about it and there may be options to help. It is important to maintain healthy sleep habits during all times of your menstrual cycle to support your overall health. Tips for healthy sleep habits include creating a bedtime routine (reading, listening to music), avoiding caffeine and alcohol in the afternoon and evening, keeping your bedroom dark and quiet, or practicing relaxation techniques such as deep breathing and meditation.
Once again, everyone’s period is different and requires a personalized approach. Keeping a symptom diary can help you track days during your period when you are more tired during the day or having trouble sleeping. Knowing when these symptoms are going to happen can help you understand your body better and adjust your habits as necessary to take care of yourself (like maybe taking a good nap during a tough period day!).
Not One Size Fits All
There is a lot of chatter on the internet about hacks for your period and ways to live in sync with your menstrual cycle. Make sure to take all of these with a grain of salt and remember not one size fits all! More research is happening all the time about the effects of periods on women’s health, so stay tuned into research (or updates on this blog) to stay up to date on the most current information. Also, if these topics excite you as much as it excites us, maybe you could be the future researcher in these topics! There is always more research needed for us to better understand our bodies.
Everyone’s period is unique, and the most important thing is to take care and be kind to yourself, track your period symptoms in a diary, and adjust your habits when your body is telling you something is off.
- Carmichael MA, Thomson RL, Moran LJ, Wycherley TP. The Impact of Menstrual Cycle Phase on Athletes’ Performance: A Narrative Review. Int J Environ Res Public Health. 2021;18(4):1667. Published 2021 Feb 9. doi:10.3390/ijerph18041667
- Jacobson BH, Lentz W. Perception of physical variables during four phases of the menstrual cycle. Percept Mot Skills. 1998;87(2):565-566. doi:10.2466/pms.1998.87.2.565
- Solli GS, Sandbakk SB, Noordhof DA, Ihalainen JK, Sandbakk Ø. Changes in Self-Reported Physical Fitness, Performance, and Side Effects Across the Phases of the Menstrual Cycle Among Competitive Endurance Athletes. Int J Sports Physiol Perform. 2020;15(9):1324-1333. Published 2020 Sep 21. doi:10.1123/ijspp.2019-0616
- Nowakowski S, Meers J, Heimbach E. Sleep and Women’s Health. Sleep Med Res. 2013;4(1):1-22. doi:10.17241/smr.2013.4.1.1
- Jeon B, Baek J. Menstrual disturbances and its association with sleep disturbances: a systematic review. BMC Womens Health. 2023;23(1):470. Published 2023 Sep 1. doi:10.1186/s12905-023-02629-0
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