Managing your symptoms

The menstrual cycle is a process of hormonal changes which are important for our body. However, as it is an inflammatory process, we can end up with some unhelpful symptoms that can get in the way of daily activities or training.

You may find that your symptoms impact how or when you complete your training. So, we have put together some practical management strategies for each individual symptom. The idea of this resource is to allow you to continue to train or exercise but with the knowledge of how to minimise the impact of any symptoms.

Tracking your cycle will help you to better understand where you get symptoms within your cycle; you may experience symptoms that aren’t related to your period.

Alongside this, you may want to consider when you feel good in yourself or your daily activities (positive symptoms). Keeping track of your cycle can help you identify times in your cycle where you are training well, recovering better or feeling stronger.

Did you know?

Did you know that your menstrual cycle and your period are different things? A period refers to the days that you're actually bleeding, and your menstrual cycle is the whole time from the first day of your period to the first day of your next period.

What are the symptoms of the menstrual cycle?

Cold/ill
Breast soreness
Sleep disturbance
Headaches
Emotions and mood
Clumsy/reduced coordination
Stomach cramps
Back pain
Heavy bleeding
Food cravings
Decreased energy/lethargy
Reduced motivation
Gastrointestinal disturbance
Bloating
Reduced recovery
Ovulation bleeding
Periods stopped
Injuries

How to manage your menstrual cycle symptoms

Cold/Ill

If you experience cold symptoms, you can try taking zinc lozenges (follow pack instructions - ensure you suck these as they take effect in the mouth) and vitamin C (500mg per day). It is best to take these as soon as you notice any symptoms. These may help reduce symptoms of a cold but don’t take zinc for longer than 3 consecutive days.
Rather than 5 portions of fruit and vegetables, you could try aiming for 7 portions (dried, frozen and tinned all count). Mix up your choices, as different types provide varying amounts of antioxidants, micronutrients, fibre and prebiotics which all support immunity.
You could also try making use of spices in your cooking to include the natural antioxidants found in garlic, paprika and turmeric.
If you get ill regularly, you may want to check if you are eating enough carbohydrate around any exercise you do. Try to avoid any fasted training and make sure you are consuming carbohydrate and protein as soon as possible after exercise.
Remember, you also need to carbohydrate during any long training over 75 minutes or any high intensity training over 45 minutes.
Vitamin D is important for immunity so make sure you’re following advice to take a vitamin D3 supplement between October and March (10-50ug per day).
Aim for 2-4 portions of omega 3 rich foods per week by cooking with rapeseed oil, adding flaxseed and walnuts to salads or cereal and including oily fish such as salmon, trout, sardines, kippers with meals.
Washing your hands regularly or carrying hand sanitiser can help reduce the likelihood of you catching anything.
Regularly clean your water bottles.
If you are travelling anywhere you may want to consider a face mask.
Chewing gum may also help you avoid illness in high-risk areas such as trains or planes.

Breast soreness

Ensure your bra is correctly fitted and supportive.
Use warm compresses or ice packs depending on which feels better.
Progressive muscle relaxation – tensing and relaxing muscles daily may decrease pain.
Paracetamol or ibuprofen may help.
It is not recommended to take any supplements such as evening primrose oil, flaxseed, vitamin B6 or vitamin E.

Sleep Disturbance

Changing your environment and the way you prepare your body for bed can help with sleeping. This is commonly referred to as “sleep hygiene”. Some ideas below may help to improve your sleep hygiene:

Make your room as dark and quiet as possible when you want to go sleep
Try to fall asleep and wake up at roughly the same time each day (or within an hour of the same time)
Consider temperature of the room and bedding. Use fans in the summer to keep the space cool or keep your curtains shut to stop the sun from warming it during the day.
Build a bedtime routine whereby you follow the same pattern leading up to sleep each night.
Reduce your light exposure when you are getting close to bedtime; use side lamps instead of main lights and change your phone to a blue screen.
Some individuals find that a large meal before bed can reduce sleep quality, however this shouldn’t stop you from having enough food after any exercise you may do in the evening.
A bedtime snack can be useful to support overnight recovery and reduce any night-time hunger that may wake you. Bedtime snack options such as milky drinks with oat biscuits can be a good option. Milk contains a protein that may help sleep whilst also helping muscles to recover overnight.
Tart cherry juice has been found to improve sleep quality for some individuals. This can be purchased as a batch tested supplement if needed.

If you are still struggling to get enough quality sleep you may want to consider napping during the day. Short naps that don’t impact on your ability to fall asleep that evening can be a useful way of “topping” up your sleep. This will also help with recovery from any training.

Headaches

Ibuprofen is useful for simple headaches – follow pack instructions. If you believe you have migraines, ibuprofen may help but you should discuss treatment with your doctor.
Check your hydration levels – monitor the colour of your urine to check you are getting enough fluid. You can use a urine colour chart from the NHS website to work out if you are hydrated enough.
Tight muscles and tension can cause headaches. Consider yoga or mindfulness to help your body relax.

Emotions and mood

Use the Wheel of Emotions or the Mood chart POMS to help track your mood for 2-3 cycles. This will help you to identify what is happening and when. There are multiple factors that can affect your mood and emotions: food, sleep, hormones… think about some of these strategies to help

Rest and have a break - be kind to yourself!
Food can impact on our mood as detailed by the British Dietetic Association.
Tryptophan is the protein involved in serotonin production and is found in foods such as chicken, dairy and nuts. Carbohydrate is required for these foods to be effective so pair them up with a carb for a delicious snack. Snack examples: milky drinks, dried fruit and nuts, chicken sandwich.
Aim for at least 30 minutes of daily activity and exercise - the benefits will be even better if you are able to do this outside.
Think about sleep hygiene strategies to improve your sleep, take a nap if you aren’t able to sleep properly as building up enough sleep will support your mood.
Stress relief strategies will look different for individuals. Find something that helps you to relax, examples might include reading, watching some “easy TV”, meditation, yoga, socialising, having a hot bath etc.
Consider your time management to stop you getting overwhelmed. Oestrogen has a positive energy effect in the follicular phase, take note. Do not agree or commit to too many things and then find yourself stressed in the luteal phase!

To effectively implement most of these strategies, it might be useful to map out your week to ensure you include time for doing things that you enjoy whilst juggling your other commitments. This will also give you perspective as to whether you are able to take on anymore.

If you are finding your mood is impacting you, you can also reach out for support. Speak to your GP surgery to find out what local support is available for you.

Feeling clumsy or noticing reduced coordination

Try increasing the length of your warm-up the week before and the week of your period. Focus on isolated muscle activation before gradually increasing movement speed and power. Speak to your coach (or someone like a PT at the gym) to get help with this.
Monitor how much training you are doing the week before your period to avoid excessive fatigue or further reduction to your coordination. Increase rest between sets of exercises if needed.
Work on reaction times pre-training, particularly if this is something that is important to training in a team (e.g. goal keeping).
Your brain relies on carbohydrate to concentrate. You could experiment with including carbohydrate during any training you do to see if this helps. Make your water bottle up with half fruit juice for a simple carbohydrate drink.
Include balance skills into your training: single leg squats, yoga single leg balances

Stomach Cramps

Eat at least 5 portions of fruit and vegetables each day and increase omega 3 intake (oily fish, flaxseeds, rapeseed oil) the week before your period.
Yoga and light exercise can feel difficult when in pain but may help relieve symptoms.
Heat applied to the area – heated wheat bags, hot water bottles or a hot bath.
Ibuprofen and paracetamol can help with pain management (follow pack instructions).
Yoga, mobility or stretching may help to relieve tension.
Ginger products (ginger tea, ginger biscuits, adding crushed or dried ginger to foods) can reduce nausea.
Peppermint tea may help with stomach cramps.
High frequency TENS machines can be helpful (can buy online or at chemists).
If your pain is affecting your life or continues past your period, then you should discuss with your GP. Keep a log of the amount of pain you are in and how long it lasts to discuss further with them.

Back Pain

Apply heat to the area – heated wheat bags, hot water bottles or a hot bath.
Ibuprofen and paracetamol can help with pain management (follow pack instructions).
Yoga, mobility or stretching may help to relieve tension.

Heavy Bleeding

Heavy bleeding is classed as changing your menstrual product more than every 2 hours or needing to use 2 products together. Or, more than 80ml blood lost each period (about 5 tablespoons!).

With this amount of blood loss, some females can experience iron deficiency anaemia as iron is lost with blood. Find out more about this and increase your intake of iron containing foods.
Apart from the physical symptoms of anaemia (dizzy spells, tiredness and breathlessness), heavy bleeding can sometimes interfere with normal daily life and may affect the social and emotional well being.
If you are struggling with heavy bleeding, speak to your GP as they can refer or offer potential management strategies.

Food cravings

Check that you're fuelling around training sessions (carbohydrate is required before, sometimes during and immediately after).
Avoid going longer than 3-4 hours without eating.
Missing meals, snacks and key fuelling timepoints, can increase food cravings at any point in the cycle.
If symptoms are making eating difficult, opt for liquid nutrition e.g., milkshakes and smoothies to avoid long gaps without nutrition.
Include protein and carbohydrate within snacks as this will help to reduce cravings.

Snack examples: milky drinks, dried fruit and nuts, chicken sandwich, seed and nut flapjack.

Injury Prevention

Some females find they can be more prone to injury or niggles at certain points in their cycle. Below are some ideas that may help with reducing this risk so you can train consistently:

Structure your training with the aim of spreading high intensity sessions evenly across the week.
The mid point of your menstrual cycle can be a time that the body is more prone to injuries. Therefore, warming up prior to any exercise becomes even more important.
Maintaining training may be useful to support other symptoms but you may want to be more careful of high intensity training. Tracking your cycle will help you to work out what type of training is best for you at different points in your cycle (low intensity or high intensity).
To help you manage high intensity training, remember to include a good warm up and gradually build the intensity.
Keep your muscles warm by wearing extra layers, warming up inside if possible and warming up again immediately after training.
Collagen can support with repair of tendons and ligaments and is found naturally in gelatine. Try adding jelly to your daily diet during times where you are more susceptible to injury and help support with the repair process.
Vitamin C is also useful in repair and recovery after training. You can also add in some vitamin C foods (berries, oranges, potatoes).

Tiredness and lack of energy

Start by tracking your symptoms for three cycles. This will allow you to work out what is causing you to feel tired. Is it lack of sleep, stress, feeling ill or your period?
Implement sleep strategies (refer to our sleep symptom section).
If you are unusually tired, you may want to discuss with your GP in case of low iron levels (common in females who exercise).
Check in on your fuelling and hydration: Are you fuelling enough through the day and avoiding long gaps without food? Check the colour of your urine to see if you are hydrated.
Rest – give yourself permission to stop and allow your body to recover.
Light exercise – ideally outside – may help you feel more energised.

Reduced Motivation

Track your motivation levels across your cycle. Identifying and putting strategies in place for other symptoms may help boost motivation levels.
Review the advice for sleep, mood changes and decreased energy levels as these could all be contributing to motivation.

Find out how you can use your monthly periods as a productivity tool.

gastrointestinal (GI) Disturbance

Gastrointestinal disturbance can include constipation, bloating, reflux, nausea, vomiting, diarrhoea, abdominal pain and cramping.

Monitor your fluid intake – check that you are drinking enough. Urine colour is a good indicator of hydration levels – download a urine colour chart from the NHS.
If you are losing more fluid than normal then you may want to consider an electrolyte in your drinks. You can make your own by adding a pinch of salt and fruit juice to your water (50:50 juice:water).
Caffeine can cause changes to your bowel habits so you may want to swap your tea or coffee for an alternative: ginger tea may help with nausea and peppermint tea may help with stomach cramps.
Avoid any food or drinks that contain sweeteners ending in "-ol" as these can have a laxative effect. These type of sweeteners are commonly found in chewing gum and “sugar free” products.
Probiotics can improve gut health which may support with reducing these types of symptoms. Yakult, Actimel or Activia yogurts consumed twice a day can provide a source of probiotic. Prebiotics are also needed for probiotics to be effective, found in: beetroot, garlic, leeks, chickpeas, lentils, baked beans, apricots, nectarines, watermelon, mango, nuts, chamomile tea. These would also be useful after these symptoms have passed as they will help to restore your gut bacteria to normal levels.

Bloating and Weight Changes

Check your urine colour and compare to a hydration colour chart to check you are hydrated.
Try peppermint tea to reduce bloating.
Yoga and certain stretches may reduce bloating. Low level movement is encouraged.
Review our information about GI disturbance as this information will also support with symptoms of bloating.

Reduced Recovery

Check you are eating before and after any exercise.
Avoid long gaps without eating (aim to eat every 3-4 hours). Include a portion of protein every 3-4 hours to support muscle recovery e.g. Greek yogurt with fruit and honey, milky drink, boiled eggs on crackers with some pepper or chilli flakes.
Failing to get enough nutrition around exercise can hinder recovery. You need carbohydrate and protein as soon as possible after exercise.
Try a bedtime milky drink to support overnight recovery.
Check in on your sleep quality and consider increasing time asleep to improve recovery (may need to add in naps to support this).
Increase your intake of antioxidants to reduce inflammation. Inflammation is good, but too much can slow recovery. Antioxidant foods include oily fish, flaxseeds, fruits and vegetables, turmeric, garlic and paprika.
Omega 3 supplements may be useful if you struggle with muscle soreness and are unlikely to get 3 portions of omega 3 each week. These can be purchased as batch tested supplements if needed.
Ensure any high volume or intense training is spread evenly across the week.

Mid cycle (Ovulation Bleed)

Ovulation bleeding is vaginal bleeding during or immediately before or after ovulation. Ovulation occurs in the middle of the menstrual cycle and is caused by changes in oestrogen levels. It is normally light spotting and lasts 1-2 days.

The bleeding is much lighter than your period and affects around 5% of females. It is important to note that this is not your period. The bleeding should not be heavy or painful.

It is useful to keep a diary of any unusual bleeding including how long it lasts for and then discuss this with your GP.

Never had a period or your period has stopped

If you haven’t started having a period by the age of 15 years, this is called primary amenorrhoea. You should make an appointment through your GP to investigate the cause for this.
The menstrual cycle is a useful indicator of your general health. Lots of situations can result in periods becoming absent for a period of time. However, should you not have a period for 3 months then you need to discuss this with your GP.
Lack of periods can be associated with Relative Energy Deficiency in Sport (RED-S). RED-S is caused by your energy needs not being met. Read more information on RED-S.

If you are concerned about RED-S and are seeing your GP, here is a helpful information sheet you can take to your appointment with you.

If you are on hormonal contraception such as the pill or Mirena coil, your withdrawal bleed that you have once a month is not a period. The pill is not an acceptable substitute for a natural menstrual cycle and should not be used to address a lack of periods.