Menstrual cycle periodization

Ok, we admit it. We coined that term, pun intended. Scientists use phrases like ‘menstrual phase based strength training programming’. Menstrual periodization is more concise and, well, interesting. More importantly, there’s hard science behind this concept. Women can gain more strength and muscle by designing their strength training program in accordance with their menstrual cycle. Here’s how.

 

Estrogen: convicted for progesterone’s crimes

Many hormone levels fluctuate across the menstrual cycle, so to understand menstrual periodization, we have to understand these hormones. Let’s start with estrogen. Estrogen is commonly vilified as the hormone that makes you fat and frail, a reputation based largely on the results of male steroid users. Yet this reputation of estrogen couldn’t be more undeserved for women. Estrogen is anti-catabolic and aids muscle repair.

 

Unfortunately, there is a hormone that does many of the things estrogen is accused of and that is progesterone. Ironically, progesterone’s catabolic effects seem to be partly the result of counteracting estrogen’s positive effects. For example, estrogen promotes glucose uptake in type I muscle fibers and prevents protein catabolism. Progesterone cancels out both of these positive effects. Progesterone also seems to inhibit your motor cortex, reducing the brain’s ability to recruit your muscles. Worst of all perhaps, progesterone can act as a testosterone antagonist, blocking testosterone from exerting its anabolic effects.

 

In short, estrogen seems to be beneficial for muscle growth, whereas progesterone seems to be bad news. The ratio between estrogen and progesterone thus influences the results of our training sessions.

 

Hormonal changes during the menstrual cycle

Estrogen, specifically estradiol, and progesterone concentrations fluctuate strongly during the menstrual cycle. From the start of menstrual bleeding to ovulation – the follicular phase – estradiol levels tend to be higher than progesterone levels. From ovulation to the start of the next menstruation – the luteal phase – progesterone levels tend to be higher than estradiol levels.

 

Menstrual cycle estradiol progesterone

How estradiol and progesterone levels fluctuate across the menstrual cycle. Source

 

Testosterone levels also tend to be higher during the follicular than the luteal phase, though the variation isn’t nearly as large as for estradiol and progesterone.

 

Based on these differences in hormone levels, we’d expect training to be more effective for muscle growth during the follicular phase. But do the data support this theory? Let’s look at the scientific research.

 

Menstrual periodization: the research

In the graphic below we’ve compiled the research on how strength varies throughout the menstrual cycle. It is difficult to measure this, as training of course greatly influences your strength level as well. Still, as you can see, the trend corresponds almost perfectly with the ratio of progesterone to estradiol. Women tend to be stronger during the follicular phase when the estradiol to progesterone ratio is high. After ovulation, right about when the ratio reverses, strength levels decrease until the ratio becomes positive again. It’s not a major difference in strength, but it’s there.

 

Menstrual cycle strength

 

So both strength as well as the anabolic hormonal environment are favorable for your training from the start of menstrual bleeding until the end of ovulation. But do these changes actually influence long term strength development and muscle growth?

 

Sung et al. put menstrual periodization to the test. 20 Women trained one leg with 8 workouts in the follicular phase and 2 workouts in the luteal phase for 3 months. The other leg trained with the higher training frequency in the luteal phase. The legs with more workouts in the follicular phase gained 42% more strength (maximum isometric force) and 46% more muscle (sum of 3 diameters) than the legs trained mostly in the luteal phase. Furthermore, the diameter of type II fibers and the nuclei-to-fiber ratio increased significantly in the leg that trained with higher frequency in the follicular phase; these changes were not observed in the leg with a higher training frequency in the luteal phase.

 

Earlier research by Reis et al. had compared training one leg with a constant training frequency of one workout every 3 days to a program in the other leg with a higher training frequency (every other day) in the follicular phase and a lower training frequency in the luteal phase. So same total workouts, just performed either regularly across the menstrual cycle, as most people do, or with a higher frequency in the follicular phase. The legs trained with menstrual periodization had a 33% increase in maximal strength compared to just 13% in the regularly trained leg.

In support of hormones as the driving force behind the effectiveness of menstrual periodization, there were positive correlations between the women’s gains and estradiol & testosterone and negative correlations for progesterone.

 

A recent study from 2017 confirmed that having a higher training frequency in the follicular phase results in the best progress. This study was longer (4 months), had more subjects (59), included only strength trained women and had 3 study groups:

  1. A control group training 3x per week across the whole study.
  2. A group with a higher training frequency in the follicular phases and lower frequency in the luteal phases (sensible menstrual periodization).
  3. A group with a lower training frequency in the follicular phases and higher frequency in the luteal phases (opposite of sensible menstrual periodization).

While not all tests reached statistical significance, the researchers concluded: “Our results indicate that, high frequency periodized leg resistance training during the first 2 weeks of the menstrual cycle is more beneficial to gain power, strength and to increase lean body mass, than the last 2 weeks.” In fact, the menstrual periodization group was the only group with a significant increase in lean body mass in the legs.

 

Only one study failed to find positive effects of menstrual periodization. In Sakamaki-Sunaga et al. 14 women performed 3 sets of 8-15 reps of arm curls 3 times a week during the follicular phase and once a week during the luteal phase with one arm, and performed the same routine once a week during follicular phase and 3 times a week during luteal phase with the other arm. The lack of positive effects here may have been due to lack of statistical power or because hormonal effects are not very relevant when only exercising 1 small muscle in your body. This study was also the study with the lowest training frequency of the literature on menstrual periodization.

 

Here’s an overview of the studies looking at when in the menstrual cycle higher training frequencies are more effective.

 

 

Menstrual periodization

 

 

Practical application

If you’re a woman with fluctuating hormone levels during the menstrual cycle, planning most of your workouts in the follicular phase of your menstrual cycle can significantly increase strength development and muscle growth. Alternatively, it is likely similarly beneficial to keep your training frequency the same but increase training volume during the follicular phases compared to the luteal phase. The late follicular phase is the ideal time for your muscles to exercise.

 

If you have a perfectly normal menstrual cycle of 28 days, the follicular phase consists of the first 14 days after the start of menstruation. However, a range of 22 to 36 days is considered a normal duration of the menstrual cycle. It can be useful to measure your body temperature to estimate your menstrual cycle structure. Body temperature tends to spike by at least 0.3° C around ovulation, the midpoint of your cycle between the follicular and luteal phase.

 

Ladies, it’s time to make those hormones work in your favor. Let Aunt Flow help you grow!

 

Article contributors: Nasti, Joe and Menno

18 Comments

  1. Rod says:

    This is one of the best articles I have ever read on a bodybuilding Website ! Keep doing the good work !

  2. Interested says:

    What about those women who use contraceptives (pills, implant)? How would you modify their workout plans?

    • We’ll address that in a future article, but the short version is that whether menstrual periodization is helpful depends on whether you have fluctuations in hormone levels. With multiphasic oral contraceptives and some IUDs that’s still the case.

      • Anja says:

        I guess this does not apply for women who use hormonal contraception continuously without any breaks (or only one 7 days break every couple of months), right? Can you say anything about the best training programming for these women?

        Another question: Is it true that it is harder to gain muscles for women who take hormonal contraception containing anti-androgenic substances? I found this study about that: https://www.ncbi.nlm.nih.gov/pubmed/12590431

        • We’ll address that in a future article, but the short version is that whether menstrual periodization is helpful depends on whether you have fluctuations in hormone levels. With multiphasic oral contraceptives and some IUDs that’s still the case.

  3. Laura says:

    Hi,
    I really appreciate your work, including the latest on menstrual cycle periodization. I wonder if you might consider publishing a similar analysis on training in the perimenpausal/menopausal athlete. … For example, I’ve recently been diagnosed with low testosterone, estradiol and progesterone. I am not menstruating. My FSH/LH are normal, however. And, from what I can tell, low testosterone is NOT symptomatic of menopause (though it naturally declines with age), since it is not produced by the ovaries? (So my low hormones may signify lack of fat in the diet… however, I am also 48 yo.) I imagine you have a zillion other readers in a similar situation who might benefit from your scholarship.

    L

    • We’ll consider that for sure, but you probably don’t need to change that much. Low testosterone is indeed not normal during menopause, so I’d strongly recommend you to look into hormone replacement therapy. A healthy diet and body fat percentage may solve the problems already though.

  4. Excellent piece Menno. This will be a strong topic as competition bound women begin to understand these cyclical patterns regarding training and weight loss.

  5. Julius says:

    Keep pushing man! Its such amazing to watch your progress!

  6. Ben says:

    A very neat application of basic physiology and very well presented. I really enjoyed the read.
    Three cheers for Aunt Flow!

  7. Ethan Hyde says:

    This is a great article. I was only looking for this information last night when the PTDC recommended this one. Good timing.

  8. Erica says:

    For females, how do you typically plan overload? Do you add reps first, then weight, or both at the same time?

    • How do you define ‘overload’?

      • Erica says:

        Progressive overload for muscle hypertrophy.

        One more question , you know how different muscle groups consists of different muscle fiber makeups, and some muscle groups respond better to lower rep/ higher intensity while others respond better to higher reps ?

        For example, triceps consist of more fast twitch fibers so a rep range of 6-8 is probably good. But you also mentioned that females respond better to higher reps in genera. So in this case, should I train in the 8-10 rep range but keep intensity the same ? So like instead of 70% at 6 reps I’d do 70% at 8 reps ?

        Thanks Menno <3

        • Indeed, you’ll want to take both into account. I have a special method to autoregulate this. That may go in a future article.

          The principle of progressive overload works the same way for men and women.

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