Women In Sport: Exercise, Movement and Hormones
Whether you're a marathon-runner, a swimmer, a Pilates fanatic or perhaps you're running around after little ones all day, we're all on the move. The importance of physical activity for your overall health cannot be understated and when it comes to your hormones, it is one of the best tools you have to improve balance and harmony. In this article, we're unpacking some important topics including the impact of your cycle on recovery, performance and motivation.
It is important to say that the relationship between exercise and hormones is really a synergistic one: exercise helps to balance your hormones and in turn, balanced hormones can help to improve performance, recovery and even our motivation to exercise.
Why Is Exercise So Important For My Hormones?
We can all appreciate that exercising is good for your health, in fact there is not a single system in the body that doesn't benefit from you moving more and your endocrine system is no exception.
Regular exercise prevents the build up of excess adipose tissue in the body. Adipose (fat) tissue produces oestrogen, therefore when we have too much adipose tissue in the body, our oestrogen levels can rise and this will present as symptoms of oestrogen dominance. The reason that exercise is so encouraged in those with hormonal imbalances is to target this mechanism of raised oestrogen - bring levels of adipose tissue down and therefore reduce oestrogen production.
Exercise is particularly important for the regulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis, which is a chief endocrine regulatory pathway. Chronic stress can dysregulate the HPA axis, resulting in widespread damage across many different systems in the body. Studies have found that levels of growth hormone and cortisol are impacted by exercise, leading to a healthy cascade of hormonal signals which is felt across the body.
A dysregulated HPA axis leads to problems in the menstrual cycle. When your adrenals, hypothalamus or pituitary (key endocrine organs) are overworked or burned out, they cannot support the first stage of the menstrual cycle (the release of FSH and LH from the anterior pituitary gland) and therefore the maturation and release of an egg is negatively impacted and often delayed or missed. This reduces oestrogen levels and when ovulation is delayed or missed, this impacts progesterone release too. This is why it is critical to manage stress to support your fertility.
Why Do Athletes Lose Their Period?
Intense, sustained exercise can put the body into a state of stress. The adrenal glands are firing and the body is directing energy towards the performance of muscles, rather than the very energy-intensive process of ovulation. Your body perceives, simply, that it is in danger and therefore it is not safe to carry a pregnancy - so it doesn't risk it. An egg isn't released and without ovulation, a period very rarely follows.
What Role Does Testosterone Have In Females?
Testosterone is often thought of as the male hormone and little attention is given to it in female health. However, testosterone is the most abundant biologically active hormone in female bodies (yep, even more than oestrogen!). It is a powerful hormone and wears several important hats in the female body, including:
- Boosting confidence
- Reducing anxiety
- Boosting libido
- Supporting muscle growth and strength
- Improving memory and cognition
- Stamina
- Bone density
For women, testosterone levels peak in your 20s and then steadily decline over time, reaching levels of around half their original peak by the time of menopause. The drop in testosterone can be hugely detrimental for women, with many of them reporting symptoms of low mood, irritability, anxiety, loss of interest in sex, low confidence, fatigue, insomnia and even incontinence.
Due to the plethora of symptoms listed above, many women can find benefit in incorporating testosterone as part of their Hormone Replacement Therapy (HRT) regime. However, this needs to be an individual decision that you make under the guidance of a doctor. They will be able to advise you about your options and what makes sense for you, in terms of your medical history, current symptoms and lifestyle.
How Do Hormones Impact Muscle Recovery?
I have often felt that most of the conversation around muscle recovery focuses on testosterone and doesn't give women the full picture with regard to the rest of their hormones. Testosterone is an anabolic steroid, meaning that it builds muscle. During times where our testosterone is highest, such as during our ovulation, it could be easier to build muscle and therefore many trainers and coaches might suggest planning your workouts around this.
Progesterone is a catabolic steroid, meaning that it breaks muscle down. For this reason, when progesterone is high, it can be more difficult to build muscle (i.e. in the luteal phase). Cortisol can also have catabolic effects on muscles, so during times of stress it can be more difficult to build muscle.
Interestingly, during pregnancy, levels of progesterone are high and levels of cortisol can be mildly elevated too. This may be contributing to difficulty in gaining or maintaining muscle mass through pregnancy and emphasises the importance of regular and appropriate strength training through pregnancy. This will support the mother through birth and through the post-natal period as she regains her strength.
How Does My Cycle Impact My Performance?
Firstly, testosterone rises in the middle of the cycle which drives performance, focus, confidence and muscle strength and so we may find it easier to go for personal best (PB) attempts or push ourselves across the board during this time. We feel more confident in our ability and more determined and focus to reach the goal.
Progesterone rises in the second half of the cycle and a woman's metabolic needs increase too, as her basal metabolic rate goes up from 5-10%. This means that women need an average of 150 extra calories per day to meet their needs. We can feel fatigued in the luteal phase, which can make exercise feel more of an effort and we may be more likely to skip workouts or engage in lower impact exercise.
The impact of our sex hormones on muscle strength is complex and our lack of understanding is compounded by (unsurprisingly) a lack of research in this area of female health. Oestrogen has been shown to have a beneficial effect on muscle strength, however studying this can be difficult due to the variation in our oestrogen levels monthly (oestrogen can rise anywhere from 10 to 100 fold higher across the menstrual cycle). Oestrogen has been found to increase the laxity of ligaments and tendons, altering the structure of these muscle fibres and making them, at points, weaker and less resistant to impact.
How Do Hormones Impact Sports Injuries?
The effect of oestrogen on tendon and ligament laxity is significant enough to impact rates of these injury types across the cycle. In fact, studies have shown that Anterior Cruciate Ligament (ACL) tears are more common in the ovulatory phase, when oestrogen peaks.
Women are four to eight times more likely to suffer an ACL tear, which naturally led scientists to enquire about the impact of hormones on ligaments. The phenomenon is largely due to oestrogen's effect on collagen metabolism within these structures, which impacts how easily they tear under stress.
Listening To Your Body
Every body is different and no two cycles are the same, even for the same woman. So it's important to be kind to yourself and learn how to really listen to your body. When you don't feel like a workout, it's totally fine to rest. You could take a gentle walk instead, some slow yoga, go for a gentle cycle or simply save your energy for another day.
At the same time, when your mood is low or you just feel a bit crummy, movement is absolute medicine. It allows you to move emotions through you, to get out of your mind and into your body. It's a natural release of endorphins and supports mood, energy levels and your overall health more than any other tool! Just a 10 minute walk outside allows your nervous system to regulate and acts as a rest for your brain.
To conclude, your hormones and exercise have a two-way relationship. Regular exercise, including strength training, is vital for hormone balance and this in turn will support you in building muscle and improving your performance. At different points in our cycle, we may feel more motivated to exercise but might be more prone to injuries in our ligaments and tendons.
Written and edited by Dr Rachel Denham, a trained medic and Women's Health Practitioner, who has worked across the charity and humanitarian sector and now specialises in women's health. Rachel is the creator of Bloody Nora, a women's health and wellbeing zine that fuses storytelling, art and science.
