Dr. Stacy Sims encourages coaches and athletes to leverage the menstrual cycle to improve training adaptation. This means that menstrual cycle irregularities should not be ignored.
If the athlete notices a change in her bleed pattern in two consecutive cycles, it’s time to make an adjustment to training. According to Dr. Sims, the majority of female athletes with an irregular cycle are, at best, in a subclinical state of low-energy availability. Not only does it affect their cycle, it limits their response to the training stimulus.
Protocol for addressing irregularities in the menstrual cycle
Coaches need to adjust the training plan as follows:
- Drop the volume.
Why: High volume exploits shortfalls in energy availability and puts the athlete at risk of clinical conditions like Low-Energy Availability (LEA) or RED-S. - Continue fueling for training.
Why: Endurance athletes are prone to under-fuel when volume is reduced. - Incorporate more power and strength.
Why: Sprint intervals (20- to 30-second intervals) and resistance training don’t put the same hit on energy availability, which allows the athlete to maintain metabolic control.
This protocol equips the athlete with the necessary neural stimulus, engaging the central nervous system to muscle recruitment. In other words, it provides the athlete with an opportunity to recover and regenerate without losing power or strength. This will help the athlete’s menstrual cycle get back on track, which serves as an indication that the body is resilient and ready to adapt to the training.
Protocols for female athletes racing in the low-hormone phase
Dr. Sims is quick to point out that when considering performance, there’s actually no negative day in the menstrual cycle for female athletes to perform at their best. However, athletes who suffer from heavy bleeding and excessive cramping need to address these symptoms in order to be physically and mentally set for success.
If an athlete is tracking her cycle and she knows she will be on her period on race day, she can alleviate symptoms as follows:
- To alleviate heavy menstrual bleeding, incorporate a series of anti-inflammatory supplements in the two cycles leading up to the race. Practice this protocol in training. If it doesn’t adequately mitigate heavy bleeding, athletes can consider medical interventions. Many athletes rely on IUDs to control heavy bleeding.
- To alleviate bad cramping, athletes can take aspirin in the two to three days leading up to their period, and then take ibuprofen for the first few days. This combination avoids interference with coagulation and/or kidney issues.
Performance is more often derailed by the psychological effect of racing with discomfort. By learning and practicing the protocol to address the dreaded physical symptoms of PMS that impede performance, athletes can regain a sense of control and confidence.