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Understanding the Menstrual Cycle

In the third resource in a series, the Welsh Institute of Performance Science’s Natalie Brown explains the biology of the menstrual cycle and why a greater knowledge and awareness of the cycle is important to consider when working with female athletes

The menstrual cycle is not something that is frequently discussed within the coaching environment but building a greater awareness of the cycle and its implications for the people you coach can transform your sessions, ensuring that you are providing a comfortable and safe environment for all.

Biology of the menstrual cycle

The menstrual cycle is controlled by two hormones released from the brain, specifically the pituitary gland which releases follicle stimulating hormone (FSH) and lutenising hormone (LH).

This causes an egg cell located in the female reproductive system to grow and mature. 

In response, follicles release oestrogen and cause eggs to grow. This inhibits the production of FSH and increases the release of LH, eventually causing the release of the egg, otherwise known as ovulation. 

Meanwhile the empty follicle releases progesterone to promote the uterus lining to develop, ready for a fertilised egg.

If the egg is fertilised, this equals pregnancy. However, if not fertilised, there is a drop in both oestrogen and progesterone and the uterus lining breaks down, which causes a period.

Then the process starts again! 

What does this mean for coaches?

When it comes to coaching, it is important to remember that the endocrine system controls the hormones, and to consider this along with other biological processes in training and performance. The four hormones FSH, LH, oestrogen and progesterone fluctuate and can influence other physiological processes within the body, such as gastrointestinal disturbance and mood changes.

The fluctuations in oestrogen and progesterone are associated with phases. The follicular phase includes the period when the female is bleeding up to ovulation, during which there is an increase in FSH, LH and oestrogen. After ovulation this is the luteal phase, incorporating the increase in progesterone and subsequent decline in both oestrogen and progesterone during the premenstrual phase. Note that this cycle only occurs for females who have a natural cycle.

Women take hormonal contraceptives for a variety of reasons. There are different types, including hormonal and non-hormonal, and only hormonal contraceptives affect hormones and function based on synthetic hormones being released in the body.

This creates a very different response, preventing ovulation or build-up of the uterus lining to avoid pregnancy.

There is no change in FSH or LH: the synthetic hormones inhibit the production of FSH and prevent egg cells from maturing.

This graph highlights a combined pill containing the synthetic hormones oestradiol and progestin taken for 21 days with a 7-day break. At this point, the absence of synthetic hormones can result in premenstrual symptoms.

However, females may experience bleeding. This is not a period but is known as a withdraw bleed. Progestin hormones frequently prevent bleeding when taken continually, and when ovulation occurs the control of progesterone prevents the build-up of the uterus lining to allow for a fertilised egg to implant. Lower levels of progestin exist in comparison to a combined pill.

Key learning points

  • There are 4 hormones involved in regulation of the menstrual cycle released from the brain and reproductive system: follicle stimulating hormone (FSH) and lutenising hormone (LH), oestrogen and progesterone. 
  • Hormonal contraceptive users do not experience the same fluctuations in hormones and may experience withdraw bleeds, which are not the same as a natural period.
  • Hormones can influence and interact with other physiological processes and systems in the body, making it important to consider when coaching.

More from Natalie Brown

This is the third resource in a series on menstrual health developed with Natalie Brown


Related Resources

  • Coaching Female Participants

  • Menstrual Cycles and Participation

  • The Menstrual Cycle: Female Athletes' Experiences and Perceptions


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