FSHP Academy
Women’s Health — all lessons

Anatomy and Physiology

Pelvic floor anatomyUnderstanding the menstrual cyclePhysiological changes before and after pregnancy

Life-Stage and Hormonal Conditions

MenopauseOsteoporosisPCOSThyroid disordersHormonal imbalance: what exercise can and cannot doExercise guidelines: step-by-step prescription

Prenatal Exercise

Contraindications and precautions of prenatal exercisePrenatal exercise prescriptionFirst trimester: strengthening and stretchingSecond trimester: strengthening and stretchingThird trimester: strengthening and stretching

Postnatal Exercise

Postnatal evaluation and abdominal rehabilitationBenefits of postnatal exercise for mother and childPostnatal risks and contraindicationsC-section: post-op management and precautionsPostnatal exercise prescription

Understanding the menstrual cycle

The phases and hormones of the menstrual cycle, what the evidence says about training and performance across the cycle, and how to individualise.

Beginner Evidence: Emerging evidence 3 min read Reviewed 2026-10-31 Status: draft

Learning objectives

  • Describe menstrual cycle phases and hormone changes
  • Summarise evidence on cycle phase and performance
  • Individualise training using cycle tracking
  • Recognise menstrual disturbances needing referral

Why this matters

Many women notice energy and symptoms change across their cycle. Understanding it supports individual coaching.

Hormone changes across the menstrual cycle A schematic 28-day cycle. Days 1 to about 5 are menstruation within the early follicular phase, when oestrogen and progesterone are both low. Oestrogen rises to a peak in the late follicular phase, a brief luteinising hormone surge triggers ovulation around day 14, and in the luteal phase progesterone rises to a peak around day 21 with a secondary oestrogen rise, before both fall before the next period. Menses Follicular Ovulation Luteal Day 1Day 7Day 14Day 21Day 28 Oestrogen Progesterone LH (surge triggers ovulation) Relative, schematic levels for a 28-day cycle. Hormonal contraception alters these profiles.
Figure 1. Typical oestrogen and progesterone patterns across a 28-day cycle. — Original diagram, FSHP Academy (schematic, not to scale).

Phases (28-day example)

PhaseDaysHormones
Menstruation1–5Low oestrogen and progesterone
Follicular1–13Oestrogen rises
Ovulation~14Oestrogen peak, LH surge
Luteal15–28Progesterone high, oestrogen moderate

Cycle length commonly ranges ~21–35 days.

Evidence

On average, performance may be trivially reduced in the early follicular phase, but evidence quality is low and individuals vary [mcnulty2020].

Practice

Track symptoms (cramps, fatigue, sleep, mood), adjust session intensity when needed, and plan comfort strategies.

Red flags

Absent or irregular periods may indicate low energy availability [mountjoy2023] or other conditions — refer.

Common mistakes and misconceptions

Case study

A runner tracks her cycle for three months and notices fatigue in the two days before her period. She moves her hardest interval session away from those days and reports better sessions.

Further learning: video lessons

Video links are only marked “verified” after a human has watched them. Unverified entries open a YouTube search for that channel and topic rather than a guessed link.

Introductory needs verification — opens a YouTube search

Understanding the menstrual cycle

pelvic-health physiotherapists and women’s health clinicians (search)

You will understand: understanding the menstrual cycle

Why: Clinician-led content; verify the specific video.
Introductory needs verification — opens a YouTube search

Exercise guidelines explained

professional bodies (search, e.g. ACOG, CSEP, RCOG)

You will understand: current guideline recommendations

Why: Clinician-led content; verify the specific video.

Knowledge check

Knowledge check · 0/5

1. The luteal phase is characterised by…

Answer B. Corpus luteum.

2. McNulty et al. (2020) concluded that cycle phase effects on performance are…

Answer B. Individualise.

3. A practical approach is…

Answer B. Individualised.

4. Ovulation occurs about…

Answer B. Varies.

5. An athlete who has not had a period for 4 months should…

Answer B. Possible low energy availability.

Short-answer & application questions

  1. Create a symptom-tracking template.
  2. Explain cycle phases to a client.
  3. Discuss the evidence for cycle syncing.

Key takeaways

  • A typical cycle has menstrual, follicular, ovulatory and luteal phases driven by oestrogen and progesterone.
  • On average, performance may be trivially lower in the early follicular phase, but evidence is low quality and individual responses vary.
  • Tracking symptoms and adjusting training individually is more useful than rigid “cycle syncing”.
  • Missing periods is not normal for athletes and needs medical review.

Connected topics

womens health

Hormonal imbalance: what exercise can and cannot do

sports nutrition

Energy availability and RED-S

womens health

PCOS

References

  1. McNulty KL, Elliott-Sale KJ, Dolan E, et al. (2020). The effects of menstrual cycle phase on exercise performance in eumenorrheic women: a systematic review and meta-analysis. Sports Medicine, 50(10):1813–1827. Meta-analysis check pending
  2. Mountjoy M, Ackerman KE, Bailey DM, et al. (2023). 2023 International Olympic Committee’s (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs). British Journal of Sports Medicine, 57(17):1073–1097. doi:10.1136/bjsports-2023-106994 Guideline check pending

Educational content only — not medical advice. Consult a qualified clinician for diagnosis or treatment.