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Understanding your menstrual cycle

What is the menstrual cycle?

The menstrual cycle is a natural, recurring process in the female body that involves a series of hormonal and physiological changes. 

Here are some key points about the cycle.

How long is a menstrual Cycle?

Menstrual cycles can vary in length but typically range from 21 to 35 days, depending on the individual. 

What's the difference between a period and the menstrual cycle?

Menstruation, commonly known as a period, refers to the days when a female experiences bleeding. The menstrual cycle, on the other hand, encompasses the entire time between the first day of one period to the first day of the next period. It's important to note that many changes occur throughout the menstrual cycle, not just during menstruation.

Hormonal Contraceptives

Females who use hormonal contraceptives like birth control pills may have different hormonal fluctuations compared to a naturally occurring menstrual cycle. 

What are the stages of the Menstrual Cycle?

A naturally occurring menstrual cycle can be divided into various stages defined by changes in hormone levels. These stages have different effects on the body and may affect an individual's physical and emotional well-being. The tracking video will give you a better overview of these stages. You can find further information on the stages of the cycle here 

Understanding the menstrual cycle is essential for understanding how your body is responding to the changes in hormones and the positive or negative impact on any exercise you do. Once you better understand your own cycle, it will be easier to harness the benefits of the menstrual cycle to optimise your sporting performance.

Tracking your menstrual cycle

Monitoring changes that are caused by hormonal fluctuations can be useful for:

  • Monitoring and managing symptoms.
  • Noticing changes to your symptoms.
  • Picking up on missed or delayed periods.
  • Tracking any hormonal changes happening even if you don’t have a period.

Downloading a tracking app on your phone can help you to monitor changes and symptoms that are occurring across your cycle (remember your period isn’t the only change that happens in a cycle). 

It can be useful to track your cycle alongside your training notes. That way you can correlate any differences to your cycle to any significant competitions or changes that were made to training. 

Useful tracking apps include Clue, FitrWoman or Apple Health. Your sports watch may also provide a similar tracking system that can be easier to monitor alongside training.

What if I’m not having periods? 

The menstrual cycle is a useful indicator of your general health, and missing periods shouldn’t be ignored. There are several explanations for missing periods and speaking to someone about this can help you better understand what might be happening to cause your missing period.  

I have never started my period….

This is referred to as primary amenorrhoea. If you haven’t started having a regular period by the age of 15 years you should make an appointment with a health practitioner (GP/Nurse practitioner) to investigate the cause of this.  

Your menstrual cycle plays an important role in your development, and it is therefore important to establish a regular cycle. 

My period was regular but has now stopped…

Lots of situations can result in periods starting late or disappearing for a while, however, if you haven’t had a period for 3 months or more then you should discuss this with your GP.

Lack of periods can be associated with Relative Energy Deficiency in Sport (REDS).  This is an energy deficit caused by not meeting the nutritional demands of your training. 

If you use 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.  

For more information on REDS you can look at this useful website. 

If you are concerned about REDS and are seeing your GP, there is a helpful information sheet you can take to your appointment. Download this below.

Hormonal Contraceptives

Hormonal contraceptives are an important discussion point for female athletes as we know they can impact on sports performance. Here is some information on hormonal contraceptives and key things to consider. 

There are various types of hormonal contraceptives. Some of these may be taken in the form of a pill, whilst others are inserted into the body (e.g. implant in the arm or IUD in the cervix) and these gradually release hormones over several years.

What are they for?

Hormonal contraceptives are used predominately as a contraceptive to avoid pregnancy but also to control symptoms such as abdominal cramps and mood swings or to prevent having a period for training or competition.

How do they work?

The synthetic hormones control natural hormones in the body and prevent a natural menstrual cycle and period. Hormonal contraceptives work by preventing ovulation, preventing changes in hormones releasing from the brain (Luteinising Hormone and Follicle Stimulating Hormone) and stopping the message to the body to release oestrogen and progesterone.

Withdrawal bleed

Sometimes bleeding is experienced at a regular time each month whilst on contraception. This is called a “withdrawal bleed” and is because of the ‘withdrawal’ from synthetic hormones. For this reason, a withdrawal bleed is NOT the same as a period and is not classed as a period.

A regular withdrawal bleed is NOT indicative of a normal menstrual cycle, those who use hormonal contraception cannot use their withdrawal bleed to indicate irregular cycles or loss of menstrual cycle (amenorrhoea).

Side effects

Some may experience symptoms whilst using hormonal contraception such as irregular bleeding, headaches, changes to mood and reduced motivation.

Symptoms should not be severe or disrupt daily activities.

It is important to make informed decisions, weighing up the reasons to use them and to explore alternative strategies in consultation with a doctor, there may be a different form of hormonal contraception that works better.

Types of hormonal contraceptives

  • Combined pill: Oestrogen and progestin - 1 pill every day for 21 days and a 7 day ‘break’ or placebo pills
  • Progestin only ‘mini’ pill: Progestin only - 1 pill every day
  • Implant: Progestin only - lasts 3 years
  • Hormonal IUD: Progestin only - lasts 3-5 years
  • Contraceptive patch: Oestrogen and progestin - one patch every week for 3 weeks and then a week break
  • Vaginal ring: Oestrogen and progestin - lasts 21 days with a 7 day break
  • Injection: Progestin only - lasts 8-13 weeks

Conversations about contraceptives

Having conversations about hormonal contraceptives might feel awkward and intimate. It can feel like this information isn’t relevant to sport performance or training and instead crosses into sexual activity (contraceptives are often associated with avoiding pregnancy). However, it is important to note that some individuals may be using contraceptives to manage symptoms as prescribed by a medical professional or side effects might be affecting training/performance. 

Explain that hormonal contraceptives can affect the menstrual cycle, which can influence performance, so it’s useful information to know​ if they are having a natural cycle or not.