Aim! Scientists studied the players of the FC Barcelona women’s team
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The idea that we should adapt our lifestyle based on where we are in our menstrual cycle is gaining traction online as well as in scientific circles. Now, researchers have discovered that athletes who suffer a sports injury while on their period seem to take longer to recover than at other times in their cycle.
#cyclesyncing is tagged in thousands of social media posts that encourage changing diet and physical activity levels at different stages of the menstrual cycle, to adapt to the hormonal changes that are occurring. The evidence supporting such dietary changes is weak, and while exercise-related studies on this topic are more robust, their results are also mixed. However, rugby teams in the United States and England are already adapting their training to the cycles of their members.
To try to better understand this, Eva Ferrer and her colleagues at Sant Joan de Déu Hospital in Barcelona followed 33 professional footballers from the FC Barcelona women’s team over four seasons between 2019 and 2023.
As part of their normal workout routine, the women self-reported the days they had their periods. All injuries occurring across seasons were graded in terms of severity by a physician using a standard scale.
The researchers found that although the women did not suffer more injuries during their periods, those they did suffer during this period appeared to be more serious. For example, soft tissue injuries sustained during this period resulted in more than three times the loss of training days compared to other times.
This may be because estrogen levels are low over a period of time. This hormone is linked to muscle recovery and repair. “The combination of low estrogen, possible iron loss and more intense symptoms [such as cramps] and increased fatigue could contribute to a worse injury prognosis at this stage,” says Ferrer.
However, Stuart Phillips of McMaster University in Canada points out that we don’t fully understand the role of estrogen in muscle repair. “The philosophy is that estrogen is protective and restorative [for muscles]”But the majority of these results come from animal studies and not human trials,” he says. The study also did not measure the women’s iron levels or potential confounders, such as fatigue.
Ferrer admits that few injuries occurred overall, with 69 occurring on non-bleeding days and only 11 during bleeding. “A small number of very serious injuries can distort the overall impression if sample size and confidence intervals are not taken into account,” she says. We also don’t know if the results apply to those who exercise or play sports more casually rather than at a professional level, Ferrer says.
She hopes the picture will become clearer with further research, which could lead to tailored exercise recommendations at different points in the cycle. “The most responsible approach is for decisions about load and type of training during menstruation to be individualized,” says Ferrer, “taking into account each player’s symptoms and relying on objective data (internal and external load, injury history, well-being, etc.), while research continues to incorporate hormonal measurements, iron markers, sleep habits, nutrition and other variables that can help refine recommendations.”
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