Women Specific Training
It is often shown that sports science has ignored women when it comes to sports science.
It is often shown that sports science has ignored women when it comes to sports science. A casing point is the inequality in prizemoney, the time it took before women were “permitted” to race a marathon, the ongoing debate on tennis sets, cross-country distances and a woman’s Tour de France. Many of the “classic” training approaches for “athletes” haven’t been truly tested for women. As a result, it is fair to suggest that women have been given a disservice when it comes to training and coaching, with nearly all of the science being based on men. I believe we can and should do better. Thankfully, we are at a point when things are changing.
Approaches like fasted training, nutritional guidelines, periodisation all fail to allow for the sex differences within physiology. Over recent months there has been more media attention on these differences. The current literature highlights that there is simply not enough data to come to any conclusions indefinitely. We know that there are sex differences, and that should make us question everything that we do or have done when it comes to training female athletes because, at the moment, we don’t know the full extent of these implications.
Firstly, we need to understand what some of the fundamental differences are, and it all begins with an understanding of how the menstrual cycle interacts with physiology. Typically the menstrual cycle is said to take 28 days, with ovulation on the 14th day. Immediately we come across a limitation: very few women have a 28-day cycle (not one of my current athletes have a 28-day cycle); the hormone changes are not fixed within that cycle, and they are unique to every woman. After ovulation, where there is a spike in follicle-stimulating hormone, oestrogen and progesterone rise and then fall before menstruation, impacting the body in several different ways.
As a brief overview, high oestrogen and progesterone impact the body’s ability to utilise carbohydrate, use protein and remain hydrated. There may be cognitive differences through the high hormone phase, which is noticeable in ball sports but may also impact cyclists. Interestingly, performance markers like VO2MAX and Lactate threshold seem to remain constant throughout the cycle, but the other changes may influence how an athlete feels at those efforts. The theory is that high-intensity and strength training should occur in the first ‘half’ of the cycle, and more endurance-focussed training in the second. It has also been demonstrated that reducing weights in the gym in the luteal phase will improve strength gains but lessen the injury risk.
There are differences between men and women in fat percentage, heart size, lung capacity, lean muscle mass, to
name a few. However, biomechanically, due to the widening of a woman’s hips through puberty, they have what is known as a Q angle. This essentially is where the knees are narrower than the hips. This Q angle can be responsible for many musculoskeletal injuries, and as a result, female athletes should ensure they are always focussing on excellent core control and hip stability. For cyclists, this means controlling the knee track under load while pedalling.
Interestingly, during the low hormone phase, when a woman is on her period, her physiology is most like a man’s, and sport science’s “rules” are most appropriate. However, this is when most women step back from sport due to the stigma, the effects or the practicalities of being on their period. This begins at puberty, and the associated body changes are shown to contribute to a significant drop-off in female sport participation under 18 years old. The leaner, stronger, testosterone-fuelled teenage boy improves at his sport. Whereas an adolescent girl will change their centre of mass, lose coordination skills, gain fat and struggle with a sport they loved. Coaches should do more to nurture young female performers through this phase so they come out stronger and more capable than before they began puberty. This is only just starting to be recognised.
Hydration requirements and the woman’s ability to tolerate heat, changes throughout the menstrual cycle. Oestrogen is responsible for water storage, and progesterone elevates the core body temperature. Added to the fact that more electrolytes will be shed during menstruation, a female athlete will have different fluid and electrolyte requirements at other points in their cycle. When planning for a race, knowing this subtlety will make a difference in performance. As such, we need to know sweat and electrolyte rates throughout her cycle.
For endurance athletes, GI issues and managing fuel for endurance events may be the difference between a podium or a DNF. The presence of oestrogen leads to increased fatty acid availability and improve the body’s
ability to burn fat as a fuel source. Therefore, a nutrition strategy will need to take this into account. Furthermore, in the pre-menstrual phase, they will burn about 5-10% more calories. For eumenorrheic endurance athletes, where energy availability is critical for training adaptions, a regular period is a sign of good overall health. It has often been a way of identifying that a woman is eating enough (avoiding what was previously known as the female athlete triad and is now known as Relative Energy Deficiency in Sport (RED-S)). An increase of 5-10% calorie requirement could be enough to put an ordinarily healthy athlete into a state of Low Energy Availability. Even after only four days, detrimental health effects can be observed, especially if coincided with a big training block and the athlete could be on the path to RED-S. Front-loading nutrition before exercise is advised in order to avoid training fasted. Training on empty only produces more cortisol as the body is stressed, and this has been shown to promote fat storage, which is usually the opposite of what endurance athletes want to achieve! Nevertheless, training fasted is often a deliberate training method used by coaches and athletes, which has been demonstrated to have a negative impact on female athlete performance and health.
Finally, in the luteal phase (high hormone phase before menstruation), elevated progesterone levels increase muscle breakdown and make it harder for protein synthesis. Taking protein after a session is critical. Sports nutritionists talk about the golden hour after exercise to take onboard protein. For women, it can be much more reduced (less than 20 minutes). In the high-hormone phase, taking some protein before a workout can help maximise the adaption to training, where protein uptake is likely to be reduced due to the elevated progesterone levels. Leucine (one of the critical Branch Chain Amino Acids) can reduce progesterone’s impact on the nervous system and is advised to be taken through this phase.
Just as an athlete begins to understand their menstrual cycle and the impact on training, they enter a perimenopausal stage which can last anything from 5-10 years. Here a decline in oestrogen and progesterone means that what worked before simply doesn’t anymore as the athlete gets older. I won’t go into this here. However, a lot can be done to reduce the classic impacts of menopause on endurance athletes.
Unfortunately, women often see their menstrual cycle as a limiter to their performance. In fact, it means they are better suited to perform at certain times, and if monitored and understood, this can be an unfair opportunity for them to use their physiology to gain advantages in training that can be realised in competition.
What can female athletes and coaches of female athletes do to improve the situation? Firstly we need to be communicating these differences to athletes and coaches. The number of female athletes I work with who are first surprised that I am willing to talk about their hormones’ impact on performance, and secondly, had limited knowledge of what those impacts are. By normalising the dialogue, we can be more effective in our training.
Secondly, coaches have to treat athletes as individuals. Training is not equal. If a coach works with a team, then the female athletes shouldn’t be given the same training schedule; the coach should work with the individual and get the most out of them and not apply a simple training plan.
Thirdly, the program should be built around a woman’s cycle. We know that a woman’s menstrual cycle is unlikely to fit the theoretical 28-day model, so we cannot use a 3:1 periodised training structure. When the training plan is confirmed, a nutrition or fuelling plan can be built around both their cycle and training.
Finally, coaches and athletes should be open to the idea that this is new.
The knowledge we have now isn’t a known fact and may evolve with time. Therefore, athletes and coaches should engage in dialogue, work out what is best for them and let the literature inform but not rule them.