The menstrual cycle is a complex biological process that not only impacts a woman's overall health but also may play a significant role in the performance and recovery of female athletes. Hormonal fluctuations throughout the cycle can influence metabolism, energy levels, and recovery, raising the question:
Should there be alternative nutrition interventions to reflect the variation in menstrual phases?
Understanding the menstrual cycle
Before we delve into the specifics of nutrition recommendations, let's first understand the different phases of the menstrual cycle. The menstrual cycle is typically divided into two main phases: the follicular phase and the luteal phase. The follicular phase begins on the first day of menstruation and lasts until ovulation, while the luteal phase starts after ovulation and ends with the onset of the next period.
During the follicular phase leading into ovulation, estrogen levels rise while progesterone remains low, which may positively influence force production. It has been proposed that “female sex hormone concentrations could be responsible for altered force production” through various hypothesized mechanisms, including:
1. Neuroexcitatory effects for estrogen
2. Bioavailability of testosterone
3. Changes in tissue stiffness
4. Shift in thermoregulatory set point
5. Substrate availability and metabolism
6. Transient fluctuations in body composition throughout the menstrual cycle. (Carmichael et al., 2021)
Figure 1: Fluctuations in female sex-specific hormones during the main phases of the menstrual cycle from GSSI: www.performancepartner.gatorade.com
Research findings on energy intake and expenditure
Emerging research suggests that there may be slight changes in ad libitum energy intake. This means that individuals may naturally consume more calories during this phase compared to the follicular phase. Research conducted by Rogan et al. (2023) found energy intake with no restrictions, instructions, or control increases by +159-529 kcal/day during the luteal phase compared to the follicular phase. In addition to changes in energy intake, resting energy expenditure has also been found to be slightly higher during the luteal phase. Löfberg et al. (2024) conducted a study that demonstrated a slight increase in metabolic rate by ~40 kcal/day during the latter part of the menstrual cycle.
Implications for nutrition recommendations
While these studies provide valuable insights into the fluctuations in energy intake and expenditure throughout the menstrual cycle, it is important to note that (1) individual variations exist and (2) there is not enough high-quality evidence to suggest a broad and generalized recommendation for female athletes. There are many nuances when it comes to dietary intake and energy availability across the menstrual cycle to suggest an additional 100 kcal/day during the luteal phase, for example. Not to mention the variations within exercise itself including; training adaptations, the undulation of training volume and intensity, and unique high-performance demands. Therefore, it is crucial to consider these findings on a case-by-case basis rather than applying general recommendations across the board.
Final thoughts
So what can athletes do?
Maintain semi-structured and regular eating patterns. Consistent eating behaviors can give athletes a solid baseline to track dietary intake, allowing athletes to better recognize when they are hungrier than usual. If an athlete consistently notices elevated hunger during their luteal phase (assuming all training factors are relatively constant), they can plan to consume an extra snack during the day and, ideally, around training time.
Foods rich in calcium, magnesium, vitamin B6, and iron can be especially helpful to consume around menses. Athletes may notice cravings towards certain foods (i.e. dark chocolate is high in magnesium and steak is high in iron).
I would suggest leaning into these cravings as this may be a way for our bodies to try and communicate with us to fill these nutritional gaps!
Menstruating athletes are at a higher risk of underfueling, making it essential for them to work with sports dietitians to optimize their nutrition. Proper fueling not only supports peak performance but also helps minimize the risk of iron deficiency and menstrual cycle disruptions caused by low energy availability.
By listening to your body and making informed choices based on research findings, you can fine-tune your nutrition plan to support overall health and vitality.
References
Carmichael, M. A., Thomson, R. L., Moran, L. J., & Wycherley, T. P. (2021). The impact of menstrual cycle phase on athletes’ performance: A narrative review. International Journal of Environmental Research and Public Health, 18(4), 1667. https://doi.org/10.3390/ijerph18041667
Caroline Tarnowski, Rebecca Randell, Chloe Errington, Neelam Rawat, Lisa Heaton, Emilie Burgess, Meg Steffey Schrier, Melissa Walker, Kimberly Stein, Lindsay Baker, Ian Rollo, Stephen Bailey. (2024). The Female Athlete Sports Nutrition and Hydration Resources for Practitioners. Gatorade Sport Science Institute. www.performancepartner.gatorade.com
Löfberg, I. E., Karppinen, J. E., Laatikainen-Raussi, V., Lehti, M., Hackney, A. C., Ihalainen, J. K., & Mikkonen, R. S. (2024). Resting energy expenditure, metabolic and sex hormones in two phases of the menstrual and hormonal contraceptive cycles. Medicine and Science in Sports and Exercise. https://doi.org/10.1249/MSS.0000000000003518
Rogan, M. M., & Black, K. E. (2023). Dietary energy intake across the menstrual cycle: a narrative review. Nutrition Reviews, 81(7), 869–886. https://doi.org/10.1093/nutrit/nuac094
About the Author
Jourdan Delacruz is a 2X Olympian and represented Team USA in the sport of Weightlifting for both the 2020 and 2024 Olympic Games. Jourdan holds a bachelor's in nutrition and dietetics from the University of Northern Colorado. She is pursuing her master's degree in sports nutrition with hopes of becoming a sport-registered dietitian. Jourdan is the founder of Herathlete, a brand committed to supporting female athletes through education and community.
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