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Exercise and Menstrual Function - An Overview

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The study aims to find out the impact of intense exercise on menstrual function, serum hormones, and peptides. Read to know more.

Written byDr. Aysha Anwar

Medically reviewed byDr. Ali Osman

Published At May 22, 2025
Reviewed AtMay 22, 2025

Introduction

The menstrual cycle is a normal physiological phase that begins in adolescence when the progestational endometrial is shredded, resulting in blood loss and other hormonal changes. The typical menstrual cycle involves a complicated interplay between progesterone and estrogen hormones. Under usual conditions, it occurs each 28 to 35 days, lasts three to five days, and results in an average blood loss of 30 to 80 ml. It can be affected by the young lady's health in general, in addition to the social and dietary circumstances. The hypothalamic-pituitary-ovarian axis regulates activity. Menstrual disorders include menstrual cramps, amenorrhea, hypomenorrhea, polymenorrhea, menstrual cramps, monthly bleeding, metrorrhagia, and premenstrual syndrome. Several variables might impact those results, such as age, family cigarette history, and regular exercise levels. It is crucial to understand the interaction between exercise, menstruation, reproductive hormones, and fertilization since it determines fertility outcomes. Studies indicate that regular exercise may drastically decrease the risk of menstrual disorders.

What Are Menstrual Disorders?

Dysmenorrhea refers to painful uterine cramps that occur during menstruation. Pain occurs in the lower stomach and inner thighs. Symptoms in many cases include low back discomfort, nausea, vomiting, diarrhea, exhaustion, and headache. It is fairly prevalent, and over half of all women suffer from it. Ten percent of women suffer greatly.

There are two divisions here:

Primary and Secondary

  • Once ovulation has been confirmed, primary dysmenorrhea develops shortly after menarche. Secondary dysmenorrhea is caused by any pelvic pathology, including ovarian cysts, fibroids in the uterus, adhesions, and cervical narrowing of or adenomyosis. It can even occur as a result of using intrauterine contraceptive devices.

  • Primary dysmenorrhea symptoms can be treated with electrotherapy, which includes areas of high-intensity laser or TENS.

  • Premenstrual syndrome occurs when many women of sexual maturity experience discomfort before menstruation. Symptoms include mood swings, stress, breast tenderness, abdominal discomfort, irritability, sadness, and fearfulness. One study found that exercise, such as swimming, can help reduce both the psychological and physical signs of the condition known as premenstrual syndrome.

Amenorrhea: There are two types: one primary and one secondary.

  • Primary menarche failure occurs as a result of chromosomal abnormalities such as ovarian insufficiency or anatomical abnormalities.

  • Secondarily, there is a lack of regular menstruation for three months or irregular menstruation for six months.

Menorrhagia: Menorrhagia is defined as heavy menstrual bleeding of more than 80ml every menstrual cycle. This is prevalent, affecting one-quarter of girls. It can cause unpleasant physical and emotional effects, as well as reduced work ability. Heavy bleeding during menstruation is seen in elite athletes and has been linked to iron deficiency anemia, as well as impaired oxygen-carrying capacity and hemoglobin levels. All of this reduces performance. Athletes are in danger of bleeding from the gastrointestinal tract, sweating, and hemolysis, particularly those who participate in contact sports. Hence, excessive exercises contribute to menstruation irregularities.

What Are the Effects of Menstrual Cycle Phase on Physical Activity?

  • Female hormones are constantly altering during the ovulatory menstrual cycle. It has a bearing on several biological components, including cardiovascular, respiratory, thermal, and metabolic functions, all of which influence the physiological effects of exercise. A menstrual cycle is divided into four phases: the early follicle phase, the ovulation phase, and the middle luteal phase. The initial follicular phase is marked by low progesterone and ovulation hormone levels. The ovulatory phase is distinguished by a high estrogen with little progesterone content. The mid-luteal stage has significant levels of estrogen and progesterone. It is further divided into the early follicular phase with one late follicular phase, the ovulation early luteal, mid-luteal, and late luteal phases.

  • According to studies, low levels of both estrogen and progesterone impair exercise performance during the follicular period. Estrogen has anabolic properties and restores glycogen reserves. It also serves as a protective antioxidant and membrane stabilizer, thus it protects against exercise-induced harm to muscles and lowers inflammation. It has neuroexcitatory effects, which means it increases voluntary activation and decreases inhibition. As a result, exercise performance increases as estrogen levels rise throughout other menstrual stages. According to one study, maximum endurance decreases during the mid-luteal period.

  • Progesterone contains anti-estrogenic properties. As a result, when estrogen impacts are high during the ovulatory and late follicular phases, performance is optimal since progesterone interference is eliminated.

  • While some studies observed a decline in physical performance during the early follicular phase, others discovered no significant changes in total physical performance. For example, a narrative examination of athletes' reported and objectively evaluated results reveals that female athletes believe that their achievement is slightly poorer during the early ovarian and late luteal phases. However, data based on objectively assessed performance (aerobic, anaerobic, and strength-related evaluations) show that menstrual cycle phases have no substantial impact on physical performance.

What Happens to Performance and Risk of Injury During the Menstrual Cycle?

The possibility of harm may be determined by a variety of reproductive cycle-related factors. The menstrual cycle influences the following mechanisms:

  • Strength balance.

  • Stiffness.

  • Thermoregulation.

  • Metabolism (substrate availability).

  • Body composition.

The late reproductive phase is thought to have a higher frequency of accidents than other phases due to muscle stiffness caused by high levels of estrogen. This consideration is related to estrogen's negative effect on collagen production. However, the findings are inconsistent. According to some research, "any increase in estrogen is not great enough to have a significant impact on collagen density."

What Are the Benefits of Exercise During Period?

Here are a few of the possible benefits a person can experience while exercising throughout their period:

  1. Improves Mood:

Exercise, according to gynecologists and obstetricians, can help people feel less depressed. As a result, exercising may assist in boosting mood when a person is depressed, irritable, or angry during their period.

  1. Reduces Tiredness:

Hormonal alterations to the body can cause people to feel more tired during their periods. According to the Office on Women's Health (OWH), physical activity can increase rather than decrease energy levels during a period.

  1. Relieves Menstrual Pain:

A study found that people who ran for 30 minutes three times every week for eight weeks experienced fewer issues during their periods. than those who did not. They determined that exercising before and during a period may help alleviate symptoms.

Exercise does not need to be strenuous or prolonged. Even two 15-minute walks per day can be beneficial. Exercising is also a healthy option in general. It helps a person manage their weight while also keeping their lungs and cardiovascular system healthy.

Exercising is a good idea both during and after a period.

Conclusion

According to studies, women who exercise daily are more unlikely to experience menstruation pain, cramps, or mood swings. Excessive physical training may hurt physical health. Low energy intake paired with high energy expenditure can cause reproductive dysfunction. Exercise-related reproductive abnormalities have been demonstrated to have substantial repercussions, most notably osteoporosis. Thus, preventive measures, quick evaluation, and management of at-risk persons are strongly advised.

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