Exercise During Luteal Phase Key Points
- Some researchers have suggested that women perform higher volume exercise earlier in their menstrual cycle when in an estrogen-dominant state; conversely, exercise during luteal phase should be lower in volume when estrogen is lower.
- A new meta-analysis reported no difference between strength and hypertrophy over the menstrual cycle phases.
- Menstrual phase workouts are not supported by recent evidence but rather by an individualized approach. Exercise program design should consider nutrition, fatigue, sleep quality, stress, injury, motivation, and program enjoyment. The influence of the menstrual cycle could be a factor to consider in program design; however, practitioners should discourage coaches from designing resistance training programs based solely on the menstrual cycle phase due to the lack of high-quality evidence to support this approach.
Introduction
With its unique hormonal fluctuations, the menstrual cycle has been proposed to affect the potential for gain in muscle size. This concept, often called the “menstrual phase workout,” suggests that the various phases of your menstrual cycle could influence muscle size and strength gains in response to resistance training. This suggests exercise during luteal phase should be lower in volume to accommodate lower estrogen.
Some have suggested that women can perform higher-intensity workouts earlier in the menstrual cycle (i.e., the first half of the menstrual cycle). Studies have found follicular phase exercise routines are associated with greater muscle and strength gains than training in the later phase of the menstrual cycle (i.e., the luteal phase).(Wikström-Frisén et al., 2017)
This has led some coaches to design training cycles around phases of your cycle with lower training loads or longer recovery periods in the early follicular phase and high training loads in the mid-luteal phase. Should you incorporate menstrual phase training into your fitness routine for more muscle gains? This article delves into the current evidence on the impact of the menstrual cycle phase on acute strength performance and adaptations to resistance exercise training. It also discusses a recent review that determined if you should base your training around hormone changes and the ovulatory phase.
The Menstrual Cycle
The menstrual cycle, which averages 28 days in length but can vary from woman to woman, is a complex process regulated by various hormones. It involves a series of physiological changes in the female body to prepare for a potential pregnancy. Here’s a general overview of the main phases and the physiological responses that occur:
Menstrual Phase (Days 1-5):
The “time of the month.” The menstrual phase is the first phase of the menstrual cycle. It starts the phase of your cycle and is marked by the shedding of the uterine lining (endometrium), resulting in menstrual bleeding. This occurs in response to low levels of estrogen and progesterone, which signal to the body that no fertilized egg has been implanted in the uterus. A female may experience cramps, discomfort, and decreased energy levels during this phase. Some women have found yoga and gentle stretching helpful.
Follicular Phase (Days 1-13):
This phase overlaps the menstrual phase. It begins on the first day of menstruation and ends with ovulation. The pituitary gland releases follicle-stimulating hormone (FSH), which stimulates the ovaries to produce around 5 to 20 small sacs called follicles. Each follicle contains an immature egg. Usually, only one follicle will mature into an egg while the others die off. During this phase, the level of estrogen increases, which helps to thicken the lining of the uterus, preparing it for the potential implantation of a fertilized egg.
Ovulation Phase (Day 14):
Triggered by a surge in luteinizing hormone (LH) and FSH, the mature egg is released from the ovary into the fallopian tube. This is the stage where the egg can be fertilized by sperm. People who wish to conceive can watch for signs of a slight increase in their basal body temperature. A person can measure their basal temperature at home using a sensitive thermometer.
Luteal Phase (Days 15-28):
After ovulation, the ruptured follicle closes after releasing the egg and forms a corpus luteum, which produces progesterone. Progesterone further prepares the uterus for pregnancy by stimulating the lining to secrete nutrients. If the egg is not fertilized, the corpus luteum degenerates, leading to a drop in progesterone and estrogen. This drop in hormone levels causes the uterine lining to break down, leading back to the menstrual phase. During the luteal phase, a person may experience premenstrual syndrome (PMS) symptoms. These may include mood changes, exhaustion, and reduced stamina.
These physiological responses are also associated with various symptoms that some women experience, such as changes in mood, bloating, and abdominal cramping. The severity and type of symptoms can vary greatly from woman to woman.
The Role of Hormonal Changes in Different Phases of the Menstrual Cycle on Muscle Mass Regulation
Unlike men, who have constant levels of the male hormone testosterone over the month. Females have large fluctuations in hormones monthly. The levels of ovarian hormones, primarily estradiol and progesterone, fluctuate during the different phases of the menstrual cycle.
Estrogen levels are at their highest before an egg is released during ovulation (i.e., follicular phase). After ovulation, progesterone levels are the highest during the middle part of the luteal phase. Even though a long-lasting drop in these hormone levels can be harmful, it’s normal for these levels to go up and down over many days during each menstrual cycle.
The impact of these hormonal changes, which are unique to each menstrual cycle phase effects on muscle mass in women is poorly understood. (Enns & Tiidus, 2010; Ikeda et al., 2019) For example, post-menopausal women, who experience a decline in estrogen, are particularly susceptible to losing skeletal muscle mass and strength. (Collins et al., 2019) Thus, hormone fluctuations throughout the menstrual cycle have been suggested to lead to reductions in performance.(Romero-Parra et al., 2021)
Luteal Phase and Exercise
There is conflicting evidence regarding changes in muscle strength during the menstrual cycle. Some studies have reported significant variations in muscle strength during different phases of the cycle (Nagahori & Shida, 2022; Pournasiri et al., 2023; Sarwar et al., 1996), while others have found no significant differences (Ashraf et al., 2023; Jonge et al., 2001; Sung et al., 2014).
The Potential Anabolic Effects of the Follicular Phase: A Crucial Phase in the Menstrual Cycle Workout
Some evidence suggests that estrogen may play a role in the myogenic activation of satellite cells during muscle repair and regeneration (Chidi-Ogbolu & Baar, 2018; Enns & Tiidus, 2010). Thus, training in the estrogen-dominant phase may be more conducive to muscle gains and strength.
The late follicular phase of the menstrual cycle, when estrogen levels peak, has been proposed to influence resistance training responses. Some researchers report enhanced resistance exercise performance during this menstrual cycle phase, suggesting a potential anabolic effect during the follicular phase of the menstrual cycle. (Blagrove et al., 2020; McNulty et al., 2020)
Evidence Supporting the Influence of Menstruation Cycle Phase on Resistance Training: The Practical Application of the Menstrual Phase Workout
Certain studies have found that the menstrual cycle phase might affect resistance training responses. These studies support tailoring training according to the phases of the menstrual cycle, known as the menstrual phase workout concept. Researchers have documented changes in skin blood flow, cardiovascular response to stress, endothelial function, temperature variation, and inflammatory and endothelial markers during different menstrual cycle phases.
Two review studies suggested that the menstrual cycle phase could potentially influence resistance training outcomes. Romero-Parra and his team found that the symptoms of Delayed Onset Muscle Soreness (DOMS) and the loss of strength were more pronounced during the early follicular phase and least during the mid-luteal phase. Based on these findings, they recommended adjusting training loads and recovery periods according to the menstrual cycle phase. Specifically, they suggested lower training intensities or extended recovery periods during the early follicular phase and higher training loads during the mid-follicular phase, basing these recommendations on indirect indicators of muscle damage. (Romero-Parra et al., 2021; Thompson et al., 2020)
New Review of Literature on Ovulation and Menstrual Phase Training
The new study by Colenso-Semple reviewed the evidence from meta-analyses and systematic reviews on the influence of the menstrual cycle phase on acute performance and chronic adaptations to resistance exercise training. The review found no differences between menstrual cycle phases in strength, exercise performance, and hypertrophy. The authors emphasized the importance of using a robust methodological approach to determine the menstrual cycle phase. They concluded that developing resistance exercise training prescriptions based on cyclical hormonal changes is not an evidence-based approach. (Colenso-Semple et al., 2023) The study also found that 90% of studies found no difference in strength performance between menstrual cycle phases when only moderate-to-high-quality studies were included in the analysis.
Conclusions and Recommendations: The Future of the Menstrual Phase Workout
Without high-quality evidence to support designing resistance training programs based on the menstrual cycle phase, coaches and athletes should tailor an exercise plan to the individual. The influence of the menstrual cycle could be a factor to consider in program design, along with other factors: nutrition, fatigue, sleep quality, stress, injury, motivation, and program enjoyment.
In conclusion, while the menstrual cycle and its associated hormonal fluctuations may have some influence on resistance training outcomes, the current evidence is inconsistent and, therefore, not enough evidence to suggest that you should change your routine based on your menstrual cycle. Therefore, making definitive recommendations for resistance training programming based on the menstrual cycle phase is premature. Future research should address the existing literature’s methodological limitations and provide more robust evidence to guide practice.
References
Ashraf, S., Yousuf, N., Nisar, S., Gupta, R., & Gupta, M. (2023). Muscle Strength Variations and Rate of Fatigue in Various Phases of the Menstrual Cycle in Young Adult Females of Jammu. National Journal of Physiology Pharmacy and Pharmacology. https://doi.org/10.5455/njppp.2023.13.09422202212012023
Blagrove, R. C., Bruinvels, G., & Pedlar, C. R. (2020). Variations in strength-related measures during the menstrual cycle in eumenorrheic women: A systematic review and meta-analysis. J Sci Med Sport, 23(12), 1220-1227. https://doi.org/10.1016/j.jsams.2020.04.022
Chidi-Ogbolu, N., & Baar, K. (2018). Effect of Estrogen on Musculoskeletal Performance and Injury Risk. Front Physiol, 9, 1834. https://doi.org/10.3389/fphys.2018.01834
Colenso-Semple, L. M., D’Souza, A. C., Elliott-Sale, K. J., & Phillips, S. M. (2023). Current evidence shows no influence of women’s menstrual cycle phase on acute strength performance or adaptations to resistance exercise training [Systematic Review]. Frontiers in Sports and Active Living, 5. https://doi.org/10.3389/fspor.2023.1054542
Collins, B. C., Laakkonen, E. K., & Lowe, D. A. (2019). Aging of the musculoskeletal system: How the loss of estrogen impacts muscle strength. Bone, 123, 137-144. https://doi.org/10.1016/j.bone.2019.03.033
Enns, D. L., & Tiidus, P. M. (2010). The influence of estrogen on skeletal muscle: sex matters. Sports Med, 40(1), 41-58. https://doi.org/10.2165/11319760-000000000-00000
References
Ikeda, K., Horie-Inoue, K., & Inoue, S. (2019). Functions of estrogen and estrogen receptor signaling on skeletal muscle. J Steroid Biochem Mol Biol, 191, 105375. https://doi.org/10.1016/j.jsbmb.2019.105375
Jonge, X. J. d., Boot, C. R. L., Thom, J. M., Ruell, P. A., & Thompson, M. W. (2001). The Influence of Menstrual Cycle Phase on Skeletal Muscle Contractile Characteristics in Humans. The Journal of Physiology. https://doi.org/10.1111/j.1469-7793.2001.0161m.x
McNulty, K. L., Elliott-Sale, K. J., Dolan, E., Swinton, P. A., Ansdell, P., Goodall, S., Thomas, K., & Hicks, K. M. (2020). The Effects of Menstrual Cycle Phase on Exercise Performance in Eumenorrheic Women: A Systematic Review and Meta-Analysis. Sports Med, 50(10), 1813-1827. https://doi.org/10.1007/s40279-020-01319-3
Nagahori, H., & Shida, N. (2022). Relationship Between Muscle Flexibility and Characteristics of Muscle Contraction in Healthy Women During Different Menstrual Phases. Physical Therapy Research. https://doi.org/10.1298/ptr.e10173
Pournasiri, F., Zarei, M., Pardos-Mainer, E., Rubio-Morales, A., & Nobari, H. (2023). Isometric and Isokinetic Strength of Lower-Limb Muscles in Female Athletes During Different Menstrual Cycle Phases: A Causal- Comparative Study. https://doi.org/10.21203/rs.3.rs-2490644/v1
References
Romero-Parra, N., Cupeiro, R., Alfaro-Magallanes, V. M., Rael, B., Rubio-Arias, J., Peinado, A. B., & Benito, P. J. (2021). Exercise-Induced Muscle Damage During the Menstrual Cycle: A Systematic Review and Meta-Analysis. J Strength Cond Res, 35(2), 549-561. https://doi.org/10.1519/jsc.0000000000003878
Sarwar, R., Niclos, B. B., & Rutherford, O. M. (1996). Changes in muscle strength, relaxation rate and fatiguability during the human menstrual cycle. The Journal of Physiology, 493(1), 267-272. https://doi.org/https://doi.org/10.1113/jphysiol.1996.sp021381
Sung, E., Han, A., Hinrichs, T., Vorgerd, M., Manchado, C., & Platen, P. (2014). Effects of Follicular Versus Luteal Phase-Based Strength Training in Young Women. Springerplus. https://doi.org/10.1186/2193-1801-3-668
Thompson, B., Almarjawi, A., Sculley, D., & Janse de Jonge, X. (2020). The Effect of the Menstrual Cycle and Oral Contraceptives on Acute Responses and Chronic Adaptations to Resistance Training: A Systematic Review of the Literature. Sports Med, 50(1), 171-185. https://doi.org/10.1007/s40279-019-01219-1
Wikström-Frisén, L., Boraxbekk, C. J., & Henriksson-Larsén, K. (2017). Effects on power, strength and lean body mass of menstrual/oral contraceptive cycle based resistance training. J Sports Med Phys Fitness, 57(1-2), 43-52. https://doi.org/10.23736/s0022-4707.16.05848-5
Is it better to do aerobic or strength exercise during the luteal phase?
Both aerobic and strength training are beneficial during the luteal phase. However, focusing more on strength training is recommended as it can help improve muscle strength and prevent injury during this phase.
What are the benefits of exercising during luteal phase?
Exercising during the luteal phase can help reduce symptoms of premenstrual syndrome (PMS), such as mood swings, cramps, and bloating. It can also improve overall mood and energy levels during this phase of the menstrual cycle.
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