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Key Hormonal Considerations for Female Athletes

Courtney Hook is a Certified Athletic Trainer (ATC) at Motion UT, a physical therapy and high-performance clinic in Park City, Utah. Read on for her top insights on what female athletes should know about their hormones.


One of the greatest things about Women of the Wasatch is that it’s a community that loves to get after it: Whether it’s joining a weekly trail run with WoW, meeting up with friends for a mid-week hike, or going on weekend adventures across the state (and beyond), WoW members are out there pushing their limits and accomplishing great things.


In a community that loves being so active, it’s important to think about the impacts that this active lifestyle—and all the activities it encompasses—can have on our bodies. And, for female athletes in particular, it’s critical to understand the role that hormones play. So today, we’re digging into key hormonal considerations for female athletes. We’ll cover everything from what you should know about your menstrual cycle, the importance of rest, and considerations for fueling, to symptoms you might be overdoing it. Ready? Let’s dive in.


Female Hormone Basics

Females’ hormones can easily be impacted by overtraining, lack of sleep, lack of food, and other stressors. But before we can understand these other factors and how they’re impacting our hormones, it’s important to understand the basics of female hormones. Unfortunately, many people with periods don’t get significant education about their menstrual cycles and what happens during each stage. Though we can’t cover everything, here’s a brief overview:


Estrogen and progesterone are the main hormones for females. And, throughout the menstrual cycle, their levels rise and fall. The first day you have your period is considered the “start” of a cycle, and an average cycle is 28 days in length (though it is considered normal anywhere from 21 to 35 days). Unless using hormonal birth control or having gone through menopause, every female should have a period—and the lack of one could indicate a problem (more on this later!).


Your cycle is split into two phases:


The Follicular Phase (days 1-14ish)

The first several days of your follicular phase are your period (aka menstruation). During your period, your hormones are at their lowest. After your period is finished, estrogen slowly rises and peaks during ovulation, which marks the end of the follicular phase. This phase has some research suggesting higher strength gains and you may have more energy when training during this phase. However, the validity of this can vary significantly from person to person.


The Luteal Phase (days 15-28ish)

Following ovulation, estrogen drops off rapidly. Then, throughout the luteal phase, both estrogen and progesterone rise together. Right before your period begins again (i.e., during the late luteal phase), both drop off again. This is often when premenstrual syndrome (aka PMS) kicks in, and many view this as a “less beneficial” time to train. You may notice you need an extra rest day during this phase or an extra snack throughout the day to help keep your energy up.


Understanding the basics of what’s happening to your hormones throughout your cycle is important. But what’s even more important? Paying attention to how your body feels throughout it. Are you more tired during your luteal phase or your follicular phase? Are there times when you have more energy or less? Are there times when you find yourself insatiably hungry or feel like you need to eat more? By paying attention to your energy levels and how you feel throughout your cycle, you can adapt your training, fueling, and recovery to ensure it’s optimal for you.


The Importance of Rest and Recovery

With so many mountains to explore and races to run, it can be tempting to pack your days full of trail runs, hikes, cross-training sessions, and more. But, recovery is crucial—especially for female athletes. Many think that it’s during workouts that they’re getting stronger; the reality is that most of this happens during recovery. In other words, if you aren’t recovering, you probably aren’t going to see improvements.


For recovery and rest, sleep is key—and should be focus number ONE. The average recommended range is 7 to 9 hours per night, but everyone is different. At minimum, you should be getting 7 good hours of sleep every night, otherwise, it can affect both your physical and cognitive performance.


Beyond getting adequate sleep, it’s important to have days focused on recovery. This could mean doing active recovery days, or taking full days of rest if you’re in a high-intensity training block. Which leads us to our next point…


Trust Your Body (And Its Signals)

This applies to recovery and rest, fueling, and your menstrual cycle. By paying attention to what your body is doing and how it’s feeling, you can help optimize your athletic performance and prevent illness and/or injury.


Recovery and Rest

If your body is feeling exhausted, honor that. Give it the rest it needs. Try not to let what you think your body should be doing override what your body is actually feeling.


Fueling

As women, we face a ton of societal pressure, especially when it comes to our weight and outward appearance. Diet culture is pervasive, and its messages can be harmful—especially for athletes. As such, it’s no surprise that adequately fueling is difficult and many athletes struggle with under-fueling.


One of the best ways to ensure you’re properly fueling is by listening to your hunger and fullness cues. If you aren’t adequately fueling, it will impact your energy availability, and you’re going to feel it in your performance: It’s what often causes athletes to feel like they’ve “hit a wall” partway through their training. Another key thing to pay attention to is how you feel at the end of the day. It can often be difficult to eat during or directly after a run; and, if you’re ending the day feeling starving, this is a big red flag that you aren’t meeting your body’s fueling needs throughout the day. If you find you’re consistently struggling with fueling and/or underfueling, we highly recommend working with a professional.


Menstrual Cycle

As noted earlier, it’s important to understand how your cycle works and note how you feel during each phase of it. If you notice certain phases you’re more tired, need more nutrition, etc., it’s important to honor that. By respecting your body, you can improve your performance. And, if you aren’t having a period, don’t just ignore this! Not having a period or having an irregular period has become almost normalized, when it’s really a serious symptom you should discuss with your doctor.


RED-S and Female Athletes

Improving your performance by understanding and working with your hormones is important. But even more so? Understanding red flags to look out for that might indicate a larger issue that could lead to injury and other serious complications.


Female runners, in particular, need to be aware of the symptoms of RED-S and what they should do if they are showing those symptoms. RED-S, aka relative energy deficiency in sport, is a disorder characterized by a few key warning signs:

  • Amenorrhea (not having a period)

  • Low energy availability (inadequate caloric intake, with or without disordered eating)

  • Low bone mineral density (which can result in multiple stress fractures)

If you are showing symptoms of RED-S, it’s important to discuss with your doctor and/or healthcare team, so you don’t face long-term negative impacts.


Wrapping Up: Quick Tips for Hormone Optimization

Whether you’re a professional runner, a semi-pro, or an enthusiastic amateur, it’s important to understand the impact your hormones have on your training and performance—especially as a female. If you’re looking for a place to start, here are a few ways to begin:

  1. Track your cycle. Bring awareness to how you’re feeling throughout it, and consider tracking your energy levels to see if you notice any patterns. If you do, capitalize on the weeks you feel great and give yourself grace on the weeks you do not.

  2. Focus on sleep and recovery. If you’re noticing dips in your energy levels, implementing tactics to improve your rest will likely help.

  3. Eat. Eat enough. Trust your body’s hunger and fullness cues. And, if you’re struggling, consider working with a nutritionist (ideally, one who is familiar with endurance sports!).

By focusing on these as a starting place, you can build a strong foundation for your training and ensure you are working with your hormones—rather than against them.


Courtney Hook is a Certified Athletic Trainer (ATC) at Motion UT, a physical therapy and high-performance clinic in Park City, Utah. There, she works one-on-one with all levels of athletes on performance, rehabilitation, injury prevention, and risk reduction, as well as education around hormonal considerations. You can schedule with her on the Motion website and find her on Instagram at @atccourtney_motion


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