The Menstrual Cycle, Exercise & Nutrition How To Make Your Cycle Work For You

The menstrual cycle is something that will affect many of us throughout our lives, with fluctuating hormones impacting everything in our day-to-day, from our mood, to energy levels, to the foods we crave. While the last few years have seen much more openness around the menstrual cycle and menstrual health, it’s something that even in 2023, we feel simply isn’t spoken about enough. Despite so many people having a menstrual cycle, a large percentage are still mystified about their hormones and cycles, even after many years of experiencing periods.

With a huge link between menstrual health, and overall health, there’s a clear need to bring the discussion about menstrual health out into the open - so we’ve taken a deep dive into how the nation’s knowledge of the menstrual cycle currently stands, and how the cycle impacts our exercise and nutrition. We’ve also enlisted a panel of experts to provide medical and fitness-based advice which will help you to make your menstrual cycle work for you.

Despite around half the population experiencing menstruation at some point during their life, with the average person starting periods at 12 years old, menstrual health wasn’t made compulsory as part of the national curriculum until 2019. While it is now taught in primary schools; the level of education is inconsistent and often incomplete, with some schools covering this topic in as little as one lesson. It’s no wonder that more than a third (35%) of women say they have no understanding of the menstrual cycle.

The average menstrual cycle lasts for around 28 days, although this can vary between women, and cycles between 21-40 days are also deemed normal. The cycle can be broken down into a number of phases - the menstrual phase (days 1-7), the ovulatory phase (days 4-14), the follicular phase (day 14) and the luteal phase (day 14-28). While these phases are something many of us have experienced from early teens, and may have even been taught in school as part of Science or PSHE, our research found that more than a third (35%) of women have no understanding of either the terminology or the biological processes.

The discussion around the menstrual cycle has increased in recent years, with more women stepping forward to talk about their experiences, be that on social media or through platforms like online news publications. Technology has also helped to further this conversation, with apps, fitness trackers and smart watches developing cycle tracking functions that help women learn more about their menstrual cycle that can even predict their periods and ovulatory phases.

However, this increased discussion hasn't necessarily led to more understanding. Almost half (47%) of the women we surveyed said that they track their own menstrual cycles using apps or other methods, which makes the previous stat even more shocking - we're tracking our periods and utilising this tech, but often with very little understanding of its meaning, importance or how it can be used.

Sadly, these statistics aren't surprising to Dr Shireen: "Women's health is poorly taught in our schools, and most of the research that exists around exercise is based around men and male physiology. There is a huge gap in general knowledge around hormones, the menstrual cycle and how they impact our wider lives, such as with exercise."

It's not all bad news, however. Our research shows that younger generations have more awareness of the menstrual cycle, a sign that increased conversations are making a change. Generation Z are well known for having a passion for mental health, self care, and all-round wellbeing, and it seems the menstrual cycle too. Just 28% of those aged 16-24 say they have no understanding of the cycle, and more than two thirds (68%) of 16-24s said that they track their own cycles, the highest of any age group. Dr Shireen thinks this is likely due to the availability of cycle tracking apps and technologies, but "it may also be generational - the stigmas around menstruation are breaking, and perhaps the younger generations feel more comfortable talking about their periods and tracking them."

With just 23% of those aged 45-54 tracking their cycles, and 39% having no understanding of the cycle, the generational differences in our knowledge and attitudes towards menstrual health are clear.

You may think the only time it’s worth tracking your cycle is if you are trying to get pregnant, but the reality is we can all benefit from doing this. Our physical and mental wellbeing can be impacted by the changing hormones, and tracking your cycle allows you to better understand why you feel a certain way. Track long enough and you can predict and prepare for symptoms.

In addition to this, Dr Shireen reminds us that tracking can also make it easier for us to know when something changes or may be wrong - particularly for those with menstrual conditions such as PCOS that may cause irregular periods. In older women, tracking your cycle can also help to alert you when you begin to enter the menopause.

If you thought craving chocolate before your period was just an overdone cliché, you'd be wrong. Changes in hormones can affect both how hungry you are, and what you are hungry for. While this can look different for different people, there's no shame if you find your appetite being strange at certain points in your cycle.

More than half (53%) of those surveyed said that they felt hungrier and/or thirstier during certain phases of their cycle, and 38% said that they crave different foods and/or levels of fluid during each phase. As a result, a whopping 9 in 10 (90%) women said that they ultimately find it hard to maintain a healthy diet throughout their full cycle. While this is a shocking number of people, it makes sense - if the amount and type of food you crave varies each week, it's hard to plan and stay on track.

According to Dr Shireen, all of these feelings surrounding nutrition are completely normal, as a result of hormone fluctuations causing changes to our basal (resting) metabolic rate, and therefore the calories we burn - in the second half of the cycle, this can translate to burning an extra 300 calories a day!

This highlights how important it is to listen to your body - if you're feeling extra hungry in the run up to your period, it may be because you're undereating. This also explains why many people crave fatty, sugary foods like chocolate - these calorie dense foods are a quick way for your body to get the energy it needs, however eating fibre rich carbohydrates such as sweet potato and butternut squash can help curb these cravings. It's also best to avoid going 'low carb' at this point before your period too as a result.

Another reason cravings for sugary and fatty foods can occur before your period is that these foods release serotonin, a hormone which improves mood. If your PMS is accompanied by a side of low mood, you may find yourself reaching for these foods to improve mood.

People who menstruate also need to make sure they are eating enough iron in their diet, particularly before and during their period. Women who have a monthly cycle have a higher iron requirement than men of the same age, and not getting enough iron can make PMS symptoms worse.

Nutritionist Sarah Jackson comments on this, saying: "There are two main sources of dietary iron; haem iron which is found in animal-based food and non-haem iron which is found in plant-based foods. Haem iron is the most bioavailable form of iron, with red meat being a rich source of this. However, non-haem iron is the predominant source in our diets and is in foods such as cereals, pulses, beans, nuts, fruit and vegetables. Non-haem iron absorption can be affected by different foods, for example calcium reduces the absorption, while vitamin C increases the absorption. A great way to increase the iron you get is pairing beans and pulses with veg rich in vitamin C like tomatoes. You can also sprinkle seeds on your salads, add beans to your dishes, and eat small amounts of dried fruit."

Our expert PT, Zoe MacFayden from PureGym Cambridge has shared her top tips for keeping on track for your wider nutrition goals throughout the month, even if you find yourself struggling to maintain a healthy diet:

1. Use a flexible dieting approach to plan in things you know you crave - If you track your food, a good way to approach cravings is to include the foods you crave into your diet. Using a flexible approach like calorie counting or macro counting allows you to add in the food you're craving and still hit your daily targets to support your goals. You can either add in the food you think you're going to crave to your food tracker at the start of the day and work around it or save 100-200 calories a day as "free calories" to use on what you're craving. If you don't track your food or aren't dieting, make sure to include moderate amounts of the food you are craving - this will help to prevent binging on these foods!

2. Look to increase your "feel good" neurotransmitters through other methods - We know that serotonin is lower during your luteal phase which can cause cravings, so a good way of managing this is to find that mood boost elsewhere. Exercise, sunlight, and socialising with loved ones have all been reported to help boost mood.

3. Remember this feeling will pass! - Sometimes it feels like these cravings are overwhelming, but the change in hormones is temporary and after about day 3-5 of menstruation your PMS symptoms and cravings should ease. Knowing your body and when to expect these feelings can be helpful in managing them. Why not try tracking your cycle so you know when to expect cravings, and when they should go.

4. Take a diet break during this week - If you're really struggling with your diet during this phase of your cycle, it might be a good idea to take a diet break each month for it. This involves bringing your calories up to maintenance level for a short time and then reducing them back down once you feel able (normally about day 3-5 of your bleed). During this phase of your cycle, many people's metabolism is slightly higher, which is one of the reasons why you feel so hungry. Bringing your calories up helps to account for this, and as long as you stay around maintenance level, it won't impact your progress in the long term. In fact, allowing more flexibility to enjoy some of the food you're craving without feeling like you've "blown" your diet can actually be more beneficial than restricting and binging.

The follicular phase overlaps with menstruation, starting on day 1 of your cycle and ending in ovulation - this typically lasts around 14 days. During the first half of this phase, including menstruation, oestrogen is low which can lead to symptoms such as cramps, low energy, and slower recovery. You may continue to benefit from lower intensity and more recovery-focused exercises during this time.

However, during the later stages of the follicular phase (days 10-14), oestrogen levels surge, and progesterone levels are low. High oestrogen levels create a boost in energy. It can also promote muscle building and enhance recovery, meaning this is the optimal time to be doing strength training in the gym. Whether your goal is hypertrophy or strength, use this natural increase in energy and recovery to beat some PBs and smash some goals.

PureGym Colchester based PT Hannah Kerridge says: "The first two weeks of your cycle can be where some of your best training sessions happen, and research shows we recover from workouts faster here too! Use this time to get the most out of strength and muscle growth by incoporating compound exercises like squats, bench, and deadlifts, get those personal bests, and progressively overload your lifts."

Looking at the exercises that are most popular during this phase, the picture is mixed as a result of these hormone changes - although walking remains most popular (38%), followed by running (17%) and yoga (16%), weight training also ranks among the top 5 workouts for this time.

In terms of nutrition, it seems that this is something that mystifies many, with more than half (55%) of women saying they don’t know which foods they should be eating during the follicular phase. To help combat our confusion, Dr Shireen has shared her top tips for nutrition: “During this phase it is important to stay hydrated and to eat nutrient rich foods, to keep energy and blood sugar levels steady. A good mix of lean protein, healthy fats and whole grains can all help to support our biological processes.”

The luteal phase is the final phase in the menstrual cycle, and sees both progesterone and oestrogen levels increase, and the lining of the uterus to thicken in preparation for potential pregnancy. During this time, increased progesterone can cause bloating and fluid retention, symptoms which can prevent women from reaching their full potential with exercise due to discomfort. Body temperature also increases, which can make high intensity exercise feel more uncomfortable as a result.

As oestrogen levels remain high into the mid-luteal phase, the opportunity for women to push themselves with higher intensity workouts continues. However, towards the end of this phase as oestrogen drops, many will experience PMS symptoms and a decline in energy. Switching to lower intensity workouts can be beneficial here.

According to our research, yoga (18%) and Pilates (13%) are the two forms of exercise that prove to be much more popular in this phase than others, which matches up with the lower intensity exercise that best suits the later stages of the luteal phase. However, running (15%) and legs, bums and tums (12%) workouts also remain staples for the earlier parts of the phase - a sign that, as always, everyone is different, and some may prefer not to change their workouts throughout their cycle. If you do prefer to keep the type of workout consistent but find your energy drops at certain points, you can lower the intensity of the workout itself by dropping the pace, adding in more rests, decreasing the workout length, or swapping to lower intensity variations.

Hannah Kerridge says: "If you find during this phase that workouts feel tougher, just scale the workout down and listen to your body. You may want to reduce intensity slightly which can be by swapping compound movements out for machine work, focusing on lower weights with more volume work, or going for walks rather than runs. Research has shown that continuing to exercise during your period helps to ease symptoms so I would suggest always to keep your body moving if you can!"

While the preferred exercise for each phase differs, it’s clear that there is still a lack of knowledge surrounding each phase. Over half (56%) of women admit they have no understanding of how the luteal phase impacts core body temperature, resting heart rate, and breathing rate.

Additionally, another 3 in 5 (62%) said that they have no understanding of the foods they should be eating during the luteal phase. As this is the point of the cycle where women may experience PMS and begin to have cravings in the run up to their period, understanding nutrition requirements for the luteal phase will help women to understand why their appetites can feel so different here.

Dr Shireen explains: “As the progesterone levels increase during the luteal phase, so does the appetite and cravings. There is also an increase in the resting metabolic rate during this time, so in terms of keeping an ‘energy balance’ there is an increase in needs - this is why women often crave high fat and carbohydrate-based foods at this point.

“The hormonal changes that occur during the luteal phase can increase cravings for high fat and high carbohydrate-based foods. Incorporating fibre rich carbohydrates such as sweet potato and butternut squash in the week before your period can help curb the cravings for processed carbohydrates like ice cream and chocolate! It’s definitely best to avoid going ‘low carb’ before your period too.

“If you’re someone that finds yourself suffering from PMS, foods rich in magnesium such as tofu, dark greens, eggs, lentils and chickpeas can really help.”

Hormonal contraception is often prescribed as a ‘solution’ to many menstrual symptoms - including particularly painful or heavy periods. But how does it impact our cycles and our relationship with exercise and nutrition as a result?

Of the women surveyed who noted that they currently take hormonal contraception, 1 in 10 (11%) said that they found exercising easier without it. However, 14% of those who have previously taken hormonal contraception, but no longer do, said that they found exercising easier while on contraception.1

This didn’t make things a lot clearer, so we asked Dr Shireen for her expert opinion on the matter:

“Most of the research has shown that there’s no significant change in strength or high intensity exercise between women who take the pill and those who do not.

“Many women take the pill to help alleviate period pain (particularly if they suffer from conditions such as endometriosis). The pill can also help to regulate periods which is great for women who suffer from irregular cycles, such as those with PCOS. Many women use contraceptives as a long-term solution, particularly in cases such as these where there is no ‘cure’ for their menstrual condition, so we ultimately want to manage their symptoms.”

So, if you’re someone that feels like the symptoms associated with menstruation and your menstrual cycle are having a big impact on your life, contraceptives could be a potential route forwards, particularly when it comes to establishing a healthy routine and relationship with exercise. And you can be rest assured that outside of relieving symptoms, they shouldn’t impact your workout performance.

It is clear from our research that there is a lack of knowledge around menstrual health and the impact the cycle has on exercise and nutrition. Few women have knowledge on the phases of the cycle, the associated hormonal changes, and the impact they can have on energy levels, appetite and metabolism, and education on this topic can give women a better understanding of why they might struggle with exercise and nutrition at certain stages each month.

Using cycle tracking to know what phase of the menstrual cycle you are in can help you to work with your body rather than against it, for example by modifying your workouts, switching up your nutrition, or simply being kinder and more understanding to yourself! However, not everyone will see the same benefits from doing so, as everyone is affected by these hormonal changes differently. Those who experience pronounced symptoms and changes through the cycle will likely find this more beneficial than those who don't notice big fluctuations. Regardless, tracking is a helpful tool to listen to and work with your body, and can help to alert to any issues early on.

The research also highlighted that there are large numbers of women that avoid exercise when menstruating or during their menstrual cycle, as a result of their symptoms. As Dr Shireen has reminded us, symptoms that are so severe they interfere with daily activities like exercise are not normal and can be improved: "I would urge these women to see their GP, and to get control of their symptoms so that these in particular aren't a limiting factor when it comes to their exercise routine."

If you struggle with extreme symptoms associated with your menstrual cycle, a visit to the GP should be the first point of call. Dr Shireen has shared her top tips for your GP appointment, to help make the most of it, and ensure you end up on the right course to treatment:

1. Make a list of the main symptoms troubling you, and how they impact your life - for example, are your periods heavy, painful, or irregular? Are there any other symptoms that are bothering you outside of your period, such as irregular spotting? It's easy to be overwhelmed or nervous during consultations, so write down your
points on paper or in the notes on your phone to help you remember!

2. Discuss your expectations with your GP - some women want a diagnosis, but don't mind about the symptoms, while others just want their symptoms to go away, but don't care about the diagnosis. Similarly, some will be happy to be treated by their GP, while others want to go straight to a specialist. If you can explain what you want to happen to the GP, it can make setting up a plan of action much easier.

3. Take any resources with you - if you're someone that's done some research before your appointment, take these articles or websites with you to discuss. In the case of periods, if you're someone that uses tracking, take the app or data along with you, as it can be very helpful for GPs to review.

If you've found the workouts, recipes and tips compiled by our team of PT's, and feel you could benefit from more regular advice from a fitness pro, you can learn more about getting a personal trainer here . Alternatively, you can find more workouts that can be applied to each phase of your cycle in our free workouts and exercises sections!

PureGym partnered with Censuswide to survey 2,025 women who have a menstrual cycle/period - 50% of whom take part in at least 30 minutes of exercise, two days per week, and at least 500 of whom do not currently take any form of hormonal contraception.

Dr Shireen, and our panel of PureGym PTs provided expert insight on the results of the survey, and helped to craft the survey, as well as suggested workouts/recipes.

[1]Full survey question reads - "Q8. You previously noted that you are currently taking or have taken hormonal contraception in the past. Have you found that exercising during your cycle is easier or harder to manage in either scenario? For example, you find that it is/was easier to train consistently throughout the month when on contraception that managed your hormones, or vice versa"

*Those who are currently taking or have taken hormonal contraception in the past

- The 11% represents respondents currently on hormonal contraception who selected the combined 'harder' options

- The 14% represents respondents who have previously taken hormonal contraception, but no longer do, who selected the combined 'harder' options

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