Managing The Luteal Phase and PMS as an Athlete

Your Luteal Phase

During the luteal phase, an egg leaves a small sac in your ovary called a follicle and starts to travel to your uterus through your fallopian tubes. The cells that made up that leftover follicle form what’s called the corpus luteum. 

The corpus luteum is a key part of the luteal phase. It makes estrogen and progesterone, two hormones that signal certain changes in your menstrual cycle. The progesterone your corpus luteum makes controls two functions:

• Thickening the lining of your uterus (the endometrium) so that a fertilized egg can attach to it and begin to grow.

• Thickening your cervical mucus – the fluid your cervix makes – into a paste-like consistency. 

Your progesterone levels are typically highest around 6 to 8 days after ovulation. 

If the egg your follicle releases at ovulation isn’t fertilized, the corpus luteum dissolves. This decreases your progesterone and estrogen levels and you get your period. If you do get pregnant, the corpus luteum continues making progesterone for the first 12 weeks of your pregnancy until your placenta grows and takes over progesterone production. After that point, the corpus luteum dissolves.

Your body temperature also increases slightly at the beginning of your luteal phase just after ovulation. You won’t notice the change (it may be as small as 0.4 degrees F), but you can measure it using a special thermometer called a basal body thermometer. You take your temperature first thing in the morning before getting out of bed. Some people use this to help identify when they ovulate so they can increase their chances of getting pregnant. 

What is PMS? 

You know that combination of physical and emotional symptoms you experience before the start of your period? That's called PMS (premenstrual syndrome). Symptoms can vary person to person, as some women get their period without any signs of PMS, or only very mild symptoms, while others experience more intense symptoms. These symptoms can affect female athletes, causing both physical and psychological symptoms that may impact training, performance, and nutrition. Below is some more detail about common symptoms of PMS, as well as some recommendations to manage symptoms.

Hunger levels. 

The release of progesterone is preparing the body for pregnancy. This is to support a potential pregnancy and therefore, basal metabolic rate (BMR) may increase by 5-10%. However, typically the way this plays out is with BMR decreasing during the bleeding portion of the menstrual cycle,followed by a gradual steady increase after the first week of menstruation. 

Hormonal Fluctuations and Cravings

During the luteal phase,the second half of the menstrual cycle (aka the week or two before your period) progesterone levels increase. This can potentially increase appetite and specific  cravings. Estrogen, which acts as an appetite suppressant, also fluctuates and decreases before your period, contributing to increased levels of hunger. 

Serotonin and Mood. 

Serotonin is a neurotransmitter that regulates mood. These levels can drop just before your period, which explains why you may feel irritable or have mood swings. Since carbohydrates can aid in boosting serotonin levels, itis common to have cravings for carbohydrate-rich foods.

Insulin Sensitivity

This has an effect on how the body processes blood sugar, and can decrease during the luteal phase. Fluctuations in blood sugar levels are quite common, potentially causing cravings for carbohydrate-rich foods. 

Hydration Levels

During the luteal phase, itis common to experience dehydration. Since estrogen and progesterone levels are both increased,there can be a shift in fluid balance, causing a shift in basal body temperature. 

Poor Sleep.

The fluctuation of hormones can impact sleep quality. Studies have shown that changes in REM and non-REM sleep patterns during the menstrual cycle are linked to fluctuations in hormones like oestrogen and progesterone. 

Water Retention 

Increased progesterone levels can signal the kidneys to hold onto water and salt,thus causing water retention, most noticeably in breasts, abdomen, and/orlimbs. This can also contribute to a feeling of heaviness or sluggishness. 

Low Energy during High-Intensity Training

During the luteal phase, it is more difficult for the body to oxidize carbohydrates, which is used for quick energy during training. In addition,the blood is thicker, which causes a slower transport of oxygen. Not to mention that the body also has increased energy demands due to a rise in BMR (as mentioned above)! 

Some recommendations to manage PMS symptoms: 

★ Track your cycle 

★ Proper Diet  and Nutrition: 

○ Always step 1, eat a performance plate that aligs with training load! Not skipping food groups   and keeping “smart snacks” ( carbs + protein and/or fat)  on hand in order to maintain energy levels and balanced blood sugar 

Limit caffeine and alcohol 

○ Consume oxygen transport supporting foods (beets, citrus fruits, and foods rich in B vitamins are great!) 

○ Consume adequate calories and fuel properly around training (increase intake as needed) 

○ Increase intake of complex carbohydrates - these increase the level of tryptophan, a serotonin precursor, and also keep you satisfied and stabilize mood 

○ Some Key Vitamins and Minerals: calcium, vitamin D, vitamin E, B vitamins, omega-3’s, iron, chromium, and magnesium may help to ease physical and emotional symptoms such as bloating ,fatigue, irritability, and sleep issues. Note you don’t need a supplement for all of these unless determined by a qualified professional, but these are one to keep in mind.  

■ Calcium and vitamin D (some studies suggest that women with higher dietary intakes of calcium and vitamin D are less likely to experience PMS) (1) 

■ B vitamins - play an important role in metabolism of neurotransmitters like mood-regulating serotonin (researchers have reported higher dietary intakes of riboavin and thiamine to be associated with a lower incidence of PMS) (2) 

■ Vitamin B6 (one study found that vitamin B6 supported the reduction of many PMS symptoms including food cravings, anxiety, low mood, and waterretention) (3) 

■ Chromium - may help balance energy and reduce cravings (involved in maintaining normal blood glucose levels 

■ Eat iron-rich foods, such as lean meats (studies have shown that women who consumed more than 20mg ofiron daily were 30-40% less to experience severe PMS) (4) 

■ Magnesium - plays a role in normal psychological function (may support the reduction of emotional changes with PMS such as anxiety and tiredness) (5) 

■ Vitamin E - can improve mood,reduce fatigue, and help manage cravings ■ Omega-3 fatty acids - a powerful anti-inammatory with mood-regulating properties

★ Hydration/Fluid Shifts: 

○ Stay hydrated ( boring but oh, so important):, sip on water throughout the day (carry a water bottle with you), and aim for meeting daily hydration needs ( ½ body weight) + average amount you lose during exercise ( sweat rate calculator provided on Meteor site) . If weighing yourself this week for sake of knowing fluid loss isn’t the vibe though, aim for 0.75-1 oz/lb of rough body weight. 

○ Hydrate immediately upon waking 

○ Add quality electrolytes to water(or a pinch of sea salt and lemon, lime, orange, cucumber, etc) or sports drink 

○ Consume electrolyte-rich foods (fruits, potatoes, veggies, coconut water) 

○ Wear loose clothing that makes you feel comfortable because fluid shifts are normal! 

★ Sleep: 

○ Maintain a consistent morning and night routine, and try to go to bed and wake up at the same times daily 

○ Read or rjournal before bed 

○ Enjoy some tea in the evening 

○ Stretch before bed 

○ Avoid blue light and screens before sleep 

○ Keep your room cool 

○Exogenous melatonin ( 2 mg) has been linked with lowering basal body temperature during luteal phase 

○Myo inositol ( 2 g) can help to promote sleep quality and duration during the luteal phase 

○ Avoid caffeine in the afternoon and evening 

○ Drink tart cherry juice before bed - cherries contain natural melatonin and also manage inflammation, ,and promote muscle and exercise recovery 

★ Herbal remedies: 

○ Ginger ,turmeric, and gingko can help with cramps, bloating, digestion,fatigue, detox, and achy muscles 

★ Essential oils: 

○ Lavender oil - known for it’s relaxing effects to help ease stress and anxiety, and promote restful sleep

○ Peppermint oil - known to help with symptoms such as headaches, muscle aches, and stress 

○ Lemon oil - can help with exhaustion, mood, and inflammation 

★ Training and Workouts: 

○ Personally, I don’t subscribe to the wellness idea of “cycle-syncing” but more listening to body and training within yourself. You don’t have to decide how a workout is going to go before you get there. My advice is to use information and support your body, and see how you feel! 

References: 

1) Ebrahimi E. et al., Effects of magnesium and vitamin b6 on the severity of premenstrual syndrome symptoms. J Caring Sci. 2012;22;1(4):183-9. 

2) Chocano-Bedoya PO. et al., Dietary B vitamin intake and incident premenstrual syndrome. Am J Clin Nutr. 2011;93(15):1080-1086. 

3) Bertone-Johnson ER. et al., Calcium and vitamin D intake and risk of incident premenstrual syndrome. Arch Intern Med. 2005;165(11):1246-1252. 

4) Patricia O. et al., Intake of Selected Minerals and Risk of Premenstrual Syndrome. American Journal of Epidemiology. 2005;177 (10): 1118–1127. 

5) Quaranta S. et al., Pilot study of the efficacy and safety of a modified-releasemagnesium 250 mg tablet (Sincromag) for the treatment of premenstrual syndrome.Clin Drug Investig. 2007;27(1): 51-8.