The Missing Foundation: What Every Athlete and Coach Should Know About the Menstrual Cycle

Period Talk⏤Part 1 of collaboration with Jessica Beal, PharmD 

“You can’t optimize what you don’t understand. And for too long, the menstrual cycle has been misunderstood, overlooked, or worse, ignored, in sport.” -Jessica Beal, PharmD

Menstrual Literacy

Despite the progress we’ve made in sport science, training programs, and mental health awareness, menstrual health literacy (MHL) in athletics is still lagging. And not just among athletes but also coaches, healthcare providers, and even sports scientists.

Here’s what the research tells us: (PMID: 36778065) (PMID: 38275983)

• Menstrual health knowledge is low

• Communication around the menstrual cycle is limited

• Sport-specific education is nearly nonexistent 

  
  

Check out this report!

And that’s not just a missed opportunity—it’s a performance, recovery, and long-term health risk. When we ignore or overlook the unique physiological needs of female athletes, especially those tied to hormonal cycles, we limit their potential and increase their vulnerability to burnout, injury, and underperformance.

If we want to develop strong, resilient, and truly healthy female athletes, we must begin with a critical foundation: understanding the menstrual cycle.

The menstrual cycle is far more than a reproductive function. It’s a vital sign—a window into the body’s overall health. It's also a powerful, dynamic rhythm that influences nearly every system in the body. Throughout the month, natural hormonal fluctuations can impact sleep quality, energy levels, appetite, mental focus, and even susceptibility to injury. These are all key elements that influence performance, both objectively and subjectively. Yes, we should absolutely continue to value the athlete’s rate of perceived exertion (RPE). Even if there’s no measurable drop in metrics like force production or velocity, a heightened perception of effort can still impact overall performance. If an athlete feels that a session is more challenging than usual, that perception alone can influence both mental and physical output.

Good luck trying to tell a woman athlete her feelings aren’t valid when it comes to her own body, especially!

When coaches, athletes, and healthcare professionals start tracking and recognizing these hormonal shifts, female athletes are more likely to train smarter, recover faster, and perform at their best, not just temporarily, but sustainably. And here’s the thing. It’s not always about tailoring or modifying the workouts (though it can be), but more so increasing their confidence in understanding what their body needs and what they can do to mitigate any potential adverse symptoms better. 

But before we can apply this knowledge, we need to understand the biology behind it. A typical menstrual cycle is often described as 28 days for simplicity, but what’s considered “normal” actually ranges from 23 to 32 days. Anything outside this range may be considered irregular and could indicate an underlying health concern that needs attention.

Image provided by Clue, a mobile menstrual and reproductive health app.

The Four Phases of the Menstrual Cycle

While the cycle is often split into two broad phases—follicular and luteal—there are actually five important hormonal chapters that impact a female athlete’s experience:

Phase 1: Early Follicular Phase (Menstruation)

When: Day 1 of your period to ~Day 5

What’s happening: Estrogen and progesterone are at their lowest. The body is shedding the uterine lining. Energy may be low, mood may dip, and cramps or fatigue may be present.

Athlete Tip: Gentle movement, psoas release techniques, magnesium, and adequate hydration can reduce cramps and support recovery. Honor your energy—walks, yoga, or deloading may feel best.

Phase 2: Late Follicular Phase

When: After bleeding stops, ~Day 6–12

What’s happening: Estrogen rises as follicles mature and the uterine lining builds. Energy, mental clarity, and strength often peak here.

Athlete Tip: Make the most of this high-energy window! It’s a great time to push strength gains, increase intensity, or test performance. Just note: your brain might race just as fast as your body, so build in mindfulness to balance it.

Ovulation Phase

When: Around Day 13–15 (can vary)

What’s happening: Estrogen peaks, triggering a surge in luteinizing hormone (LH), which causes an egg to be released. This is the only time in the cycle you can become pregnant.

Athlete Tip: Although you may feel strong, be aware of potential ligament laxity and a slightly increased risk of injury, as studies have suggested. Wearables may show a spike in body temperature just after ovulation.

Phase 3: Mid-Luteal Phase

When: ~Day 16–22

What’s happening: Progesterone rises to prepare for potential pregnancy. You may feel warmer (body temp rises), and your metabolism speeds up. Sleep may be impacted.

Athlete Tip: You may need more recovery time and additional calories, particularly complex carbs and magnesium-rich foods. PMS symptoms may start creeping in. Prioritize sleep and hydration to stay ahead of fatigue.

Phase 4: Late Luteal Phase

When: ~Day 23–28

What’s happening: Hormone levels drop, especially progesterone. If pregnancy doesn’t occur, the uterine lining begins to break down.

Athlete Tip: This is the most common window for PMS, characterized by bloating, irritability, low energy, and sleep disruptions. Nutrition can help steady carbs, leafy greens, and fiber. Be kind to yourself, shift to lighter loads if needed, and don’t mistake fatigue for laziness. Rest is a training tool too.

And Then It Begins Again…

The beauty of the menstrual cycle is its predictability, but only if we take the time to observe and respect it. Tracking your cycle doesn’t need to be complicated. Start by jotting down:

• First day of bleeding (Day 1), length and heaviness of flow

• Mood/energy shifts

• Sleep quality

• Appetite/hunger changes

• Performance patterns

Even just two months of awareness can be a game-changer for optimizing training, preventing injuries, and gaining a better understanding of your own body.

Let’s End the Silence

Improving MHL in sport is not just about handing out facts. It’s about building a culture of curiosity, communication, and empowerment.

We’re calling on:

• Athletes to track and trust your cycle

• Coaches to learn and listen, not cringe or change the subject

•  Healthcare Providers to prioritize menstrual literacy as much as injury prevention

Because we can’t support female athletes without understanding how their physiology affects performance, recovery, and mental health.

By deepening our understanding, we can begin to find strategies that work for each individual, while also building the agency to make informed adjustments when needed. Let’s not limit our capabilities to the calendar.

References

1. Critchley, Hilary O.D. et al. Menstruation: science and society American Journal of Obstetrics & Gynecology, Volume 223, Issue 5, 624 - 664

2. Fraser IS, Critchley HO, Broder M, Munro MG. The FIGO recommendations on terminologies and definitions for normal and abnormal uterine bleeding. Semin Reprod Med. 2011;29(5):383-90.

3. Munster K, Schmidt L, Helm P. Length and variation in the menstrual cycle-a cross-sectional study from a Danish county. BJOG. 1992;99(5): 422–9.

4. Treloar AE, Boynton RE, Behn BG, Brown BW. Variation of the human menstrual cycle through reproductive life. Int J Fertil. 1967;12(1 Pt 2):77-126.

5. Fehring RJ, Schneider M, Raviele K. Variability in the phases of the menstrual cycle. JOGNN. 2006;35: 376-384.

6. Thiyagarajan DK, Basit H, Jeanmonod R. Physiology, Menstrual Cycle. [Updated 2024 Sep 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK500020 

About the Authors

Jourdan Delacruz is a 2X Olympian and represented Team USA in the sport of Weightlifting at the 2020 and 2024 Olympic Games. Jourdan holds a bachelor's in nutrition and dietetics from the University of Northern Colorado. She is pursuing her master's degree in sports nutrition to become a sport-registered dietitian. Jourdan founded Herathlete, a brand committed to supporting female athletes through education and community.

Jessica Beal-Stahl, PharmD, is a clinical sports pharmacist and the founder of The Athlete’s Pharmacist. She specializes in female athletes, optimizing hormones, and understanding medication impacts on performance. Consulting with athletes, teams, and healthcare providers, Jessica takes an integrative approach, ensuring no foundational aspect is overlooked in pursuit of peak performance and well-being.

You can connect with Jess on Instagram @jess_rx or through email at jbealrx@gmail.com

Be sure to check out her services and offerings at www.theathletespharmacist.com