This article will discuss about
menstrual cycle and the proper exercise during menstrual cycles. Normal women
will have menstuation a sign of puberty. Menstruation is a woman’s
monthly bleeding,
also called a period. When woman menstruate, her
body is shed­ding the lining of the uterus (womb)
(U.S. Department of Health and Human, 2007).
The blood flows out of the opening (called the cervix)
of the uterus, and then out of the body through the vagina (Jean Hailes, n.d.). Girls
usually start having menstrual periods between the ages of 11 and 14. Women
usually start to have fewer periods between ages 39 and 51 (WebMD, 2017). Women in their 40s and teens
may have cycles that are longer or change a lot. If she is a teen, her cycles
should even out with time. If she is nearing menopause, the cycles will
probably get longer and then will stop.

 

Menstrual cycle

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The term ‘menstrual cycle’ refers
to the changes that occur naturally in a woman’s body to prepare it for pregnancy.
The menstrual cycle
starts on the first day of the menstrual period (referred to as day one) and
ends the day before the next period begins. While the length of the menstrual
cycle is often 28 days, it can vary between women and from one cycle to the
next. It is common for women to experience cycles that last anywhere from 20 to
40 days (Women’s
Health Queensland Wide, n.d., (Lamina
et al., 2013) and U.S.
Department of Health and Human, 2007).

Cycles longer than six weeks are
considered unusual. The pattern is different for each woman. The length
of the menstrual cycle can also vary for each woman. Things such as weight loss,
exercise, travelling, body composition, poor nutrition, pregnancy, reproductive
immaturity, psychological stress, acute and chronic endocrine alteration can
affect the length of the cycle (Lamina et al., 2013).

 

Phases of The Menstrual Cycle

 

The menstrual cycle starts on the
first day of one period and finishes on the first day of the next period. After
the first few years of having periods, the cycle gets more regular and is
usually about 21-38 days long. The
menstrual cycle has four distinct phases which are menstruation, the follicular
phase, ovulation, and the luteal phase as shown in Figure 1 (Women’s
Health Queensland Wide, n.d., Oosthuyse
& Bosch, 2010 and Lamina
et al., 2013).

i.                   
Menstruation

Menstruation occurs
when the broken-down lining of the uterus flows out through the vagina.
Menstruation generally lasts from three to seven days. Some women regularly
have periods that are shorter or longer than this. The length can also differ
from one cycle to the next. In addition to blood, menstrual fluid is made up of
several components including endometrial cells, cervical mucus and vaginal
secretions. The amount of menstrual fluid lost varies between women and from
one cycle to the next, but a woman generally loses about 50-100ml of fluid each
time she has a period.

Menstrual flow may be heaviest or lightest at the beginning of
menstruation or may change throughout. The colour can range between black,
brown, dark red, bright red and pink. Menstrual fluid only tends to have an
unpleasant odour after it has been in contact with air for a period of time. In
the first to three days of menstruation, the menstrual cramp (dysmenorrhea)
will occur for certain women (Aronson, 1983).

ii.                 
The
follicular phase

The pituitary gland
releases follicle-stimulating hormone (FSH), which causes between 10 and 20
follicles (cells that contain immature eggs, known as ova) to begin developing
in the ovary. They produce the hormone oestrogen, which causes the lining of
the uterus (endometrium) to become thick in preparation for the possible
embedding of a fertilised egg.

Usually
only one follicle develops into a mature egg. This follicle moves towards the
surface of the ovary, while the others break down and are reabsorbed by the
body. The follicular phase begins on the first day of menstruation and ends
with ovulation. It can vary considerably in length, depending on the time of
ovulation.

iii.               
Ovulation

The term ‘ovulation’ refers to
the release of a mature egg from the ovary. During the follicular phase, the
rise in a woman’s oestrogen levels causes gonadotropin-releasing hormone (GnRH)
to be released from her brain. This in turn causes the pituitary gland to
produce increased levels of luteinising hormone (LH). The abrupt rise in LH,
known as the LH surge, triggers ovulation. Following ovulation, the egg is
swept into the fallopian tube and moved along towards the uterus. If
fertilisation does not occur, the egg disintegrates within 6-24 hours.

iv.               
The Luteal Phase

During
this phase, the remnants of the follicle that released the egg (now called the
corpus luteum) release large amounts of the hormone progesterone as well as
some oestrogen. These hormones contribute to the further thickening and
maintenance of the uterine lining. If fertilisation does not occur, the corpus
luteum breaks down and progesterone levels decline, leading to the
disintegration of the uterus lining. During the luteal phase, women may
experience physical and emotional changes including tender or lumpy breasts,
fluid retention, bloating, mood swings, tiredness or anxiety.

Figure 1: Phases of Menstrual Cycle

Source: Women’s Health Queensland
Wide, n.d.

What Kinds of Problems Do Women Have with Their Menstruations?

 

Women can have a range of
problems with their periods, including pain, heavy bleeding, uterine bleeding, skipped
periods and PMS. Dysmenorrhea or period
pain or menstrual cramp is painful periods, including severe cramps. When
menstrual cramps occur in teens, the cause is too much of a chemi­cal called
prostaglandin. Most teens with dysmenorrhea do not have a serious disease even
though the cramps can be severe. In older women, a disease or condition, such
as uterine fibroids or endometrio­sis, sometimes causes the pain. For some
women, using a heating pad or taking a warm bath helps ease their cramps. Some
pain medicines available over the counter, such as ibuprofen (for instance,
Advil®, Motrin®, Midol® Cramp), keto­profen (for instance, Orudis® KT®), or
naproxen (for instance, Aleve®), can help with these symp­toms (U.S. Department of Health and Human, 2007). If pain is not
relieved by these medicines or the pain interferes with work or school, they
should see a doctor. Treatment depends on what is causing the problem and how
severe it is.

                Second
problem is hypemenorrhea or abnormal
uterine bleeding. vaginal bleeding that is different from normal menstrual periods.
It includes very heavy bleeding or unusually long periods, periods too close
together, and bleeding between periods. In both teens and women nearing
menopause, hormonal changes can cause long periods along with irregular cycles.
Even if the cause is hormonal changes, treat­ment is available. These changes
can also go along with other serious medical problems such as uterine fibroids,
polyps, or even cancer. You should see a doctor if these changes occur.
Treatment for abnormal bleeding depends on the cause.

            Third problem is
heavy menstrual bleeding. Heavy
menstrual bleeding is defined as excessive menstrual blood loss which
interferes with the woman’s physical, emotional, social and material quality of
life. Heavy bleeding can be caused by many things, including hormonal
imbalance, endometriosis and uterine growths such as polyps and fibroids.
Sometimes a woman will bleed so heavily that she eventually becomes anaemic.
Treatment will depend on the cause of the bleeding.

            Another problem
is amenorrhea. This is the medical name given when a woman has no
periods. Some women have never had a period – this is called primary amenorrhoea
and is very rare. Primary amenorrhoea is usually due to a genetic or physical
abnormality. If a young woman has not had a period by the time she is 16 it is
important that she sees a doctor to make sure there are no medical problems
delaying the period (Family Planning NSW,
2012).
A woman may also have had periods in the past but they have stopped. This is
called secondary amenorrhoea and the most common cause is pregnancy. If a woman
is not pregnant it is usually caused by a hormonal disturbance. These are often
temporary and can be caused by such things as stress, weight changes,
over-exercise, travel and emotional upsets. Sometimes periods will stop when a
woman is in her thirties or forties because of early menopause. This sometimes
runs in families. When the periods do not stop completely but where there are
long spaces of time between them, it is called oligomenorrhoea. Women who have
no periods for more than six months or who have only three or four periods in a
year should talk to their doctor.

            Lastly is PMS. Premenstrual
syndrome (PMS) is an array of predictable physical, cognitive, affective and behavioural
symptoms that occur cyclically during the luteal phase of the menstrual cycle (Vishnupriya & Rajarajeswaram, 2011 and Tsai, 2016).  PMS is not a single condition but a set of interrelated
symptom complexes with multiple genotypes, phenotypes or subtypes and several
different patho physiologic events that begin with ovulation. Premenstrual
symptoms occur in 90% of all women of reproductive age and about 10% are
diagnosed as having premenstrual dysphoric disorder (Tonekaboni, Peeri, & Azarbayjani, 2012).

 

Is It Okay to Exercise During Menstrual Cycle?

 

Many
research  had been carried out to study
the relationship between exercise and menstrual cycle. Some findings suggest
that 60 minutes of strenuous exercise at an intensity of higher than 75% AT may
induce inflammation in sedentary females, especially during the menstrual phase
of the menstrual cycle (Hayashida, Shimura,
Sugama, Kanda, & Suzuki, 2016). Some researchers also said behavioural interventions
such as exercise may not only reduce dysmenorrhoea, but also eliminate or
reduce the need for medication to control menstrual cramps and other associated
symptoms (Amanda, 2008). Some study also said regular stretching exercises
combined with the usual menstrual care were effective for reducing the pain
intensity of primary dysmenorrhea and premenstrual symptoms (Aboushady & El-saidy,
2016).

            Some study find out the relationship
of yoga interventions and menstrual. Some studies used a combination of Asana,
Pranayama, and other yogic relaxation or meditation techniques (Oates, 2017). All included studies reported some change in their
outcome measures, suggesting reduced symptoms of menstrual distress following a
yoga intervention; however, the heterogeneity and intensity of the
interventions and outcome measures meant that findings have limited
generalizability and applicability in practice settings.

            Some research find out that overtraining
or exercise stress can cause other problems besides missed periods (National Institutes of
Health Osteoporosis and Related Bone Diseases National Resource Center, 2016 and Vladimir & William,
2006). It is not just exercise that can cause menstrual
abnormalities. Other factor involved with menstrual abnormalities incuded
inadequate caloric intake (Bonen, 1994). Many sports in which lower body weight appears to
enhance performance (e.g., gymnastic and cross country running) or that have
body weight classification (e.g., weighlifting) may in fact promotes with
menstrual cycle normality. In addition, high volumes of intense training
accompanied by low levels of caloric intake may exacerbate such problems (Deidre, Jonathan, &
Joe, 2000). If they do not take in enough calcium and vitamin D
(among other nutrients), bone loss may result. This may lead to decreased
athletic performance, decreased ability to exercise or train at desired levels
of intensity or duration, and increased risk of injury.

            Few data also exist regarding the
role of the menstrual cycle in strength training. While highly variable, it has
been observed that a decrease in normal premenstrual symptoms such as breast
enlargement, appetite cravings, bloating and mood changes occurs in trained
individuals. This has led to a general concept that active have fewer problems
with premenstrual sysmptoms than sedentary women (Vladimir & William,
2006 and Mcmahon, Zijl, &
Gilad, 2015).

            Besides that, high intensity interval training or HIIT can be the best
workout during menstruations. This is so because, during menstruations, there
is a drop in estrogen and progesterone level and because of this hormonal drop,
the best time to access carbohydrate or glycogen more easily as compared to the
high estrogen time periods. So, it can be said that this hormone shift makes
fuel more accessible to the body and this in turn allows you to push harder and
get more of short and fast paced workouts during periods than other times of
the month (ePainAssist, 2017).

Some study said doing regular physical exercises and
continuous sport can be effective in preventing PMS (Zhang, Zhu, Song, &
Kong, 2014 and Safarzadeh, Zare,
& Arbabisarjou, 2016). The elevation of endorphin levels before menstruation
may be a significant factor and regular exercise may stabilise or prevent
extreme variation in endorphin levels and thus decrease the effects of PMS (Scully, Kremer, Meade,
Graham, & Dudgeon, 1998 and Lamina et al., 2013). Some study also encourages the employment of regular,
moderate intensity aerobic exercise as a potential intervention for PMS (Vishnupriya &
Rajarajeswaram, 2011 and Tonekaboni et al., 2012).

 

What Exercise is Best During Menstrual Cycle?

 

It
does not have to be a hard core cardio workout to experience the benefits of
working out during menstruation. Simply a walk in the park or a couple of
jumping jacks in living room are also fine. Here
are some recommendations on the best ways to work up a sweat during that time
of the month.

 

1.     
During menstruation (Days 1 to 7)

Figure 2: The best workouts for days 1*-7 of period cycle

Source: (Cosmpolitan, 2017)

 

This cycle
begins on the first day of menstruation. Because the body kicks things off with
cramping and bleeding, the first few days can be the hardest time to train
(refer Figure 2). If you feel perfectly fine, proceed with your scheduled workout.
But if you are particularly uncomfortable, you might want to skip your cardio
dance class or long-distance run. Push yourself to do some low-key yoga or a
light-cardio workout like walking planking exercises, aerobics, dance, zumba or
an easy bike ride (Cosmpolitan, 2017 and Leanka, 2017).

If you’re working
out on your own, include some exercises that entail lying face down, which can
alleviate cramping and give you a gentle lower belly massage. A disposable heating
pad can also help. Just apply it before you hit the gym. Another smart move:
Drink a little extra water. Women with heavy periods lose extra fluids, which
can make you feel light-headed when you stand up quickly, like during a yoga vinyasa.

 

2.     
The week after
mensturation (Days 8 to 14)

Figure 3: The best workouts for days 8-14 of period cycle

Source: (Cosmpolitan, 2017)

 

When
the period lets up, the testosterone and estrogen levels begin to rise (refer
Figure 3). Because testosterone can help to sculpt lean muscle mass and
estrogen builds connective tissues that bind the muscles to bones, this is the
ideal time to tone up (Cosmpolitan, 2017). Try a hard core workout like indoor cycling,
high-intensity interval training or boot camp, rowing, CrossFit, cardio kickboxing
or strength training.

 

3.      The third week of menstrual cycle (Days 15 to 21)

Figure 4: The best workouts for days 15-21 of period cycle

Source: (Cosmpolitan, 2017)

 

After day 14, estrogen levels
tank and the same goes for energy (refer Figure 4). This can make any workout
feel even more strenuous, and could make you extra susceptible to ligament and tendon
tears and other injuries (ePainAssist, 2017).  

If you typically hit up fitness classes, slow
things down with a self-paced solo workout. Because stamina is on your side this
week, slow-and-steady cardio, like a long run or elliptical session, is also
ideal. Or you can always play it safe with a couple rest days.

 

4.     
The week before menstruation (Days 22 to 28)

Figure 5: The best workouts for days 15-21 of period cycle

Source: (Cosmpolitan, 2017)

 

Your body is revving up for your period with a surge in
progesterone and, for some, crazy cramps, along with moodiness, tender breasts,
and fluid retention, all which make you feel markedly unhot even in your most
flattering yoga pants. It can also boost your body temperature up to 1 degree. The
best thing you can do is push through it all the way to the gym.

Because exercise gives you a natural
endorphin high, it can elevate your mood and actually make you feel better
(refer Figure 5). Another bonus, while PMS might make you feel bloat, sweating
can help you get rid of extra fluids. Go for generally lighter exercises such
as yoga, but take a more hard core class like vinyasa or power yoga, which will
get your heart rate up. And if you have the energy, an indoor cycling class can
help you break a serious sweat.

 

Conclusion

 

Menstruating is not a barrier to do exercise. In fact, exercises
give a lot of benefit. Perform the best workout at the right time. This is not
only helps the individual to build the dream body but it can reduce the rate of
injury. If you work out regularly and do not want to lose
a training day that is fine. Be sure to adjust your training plan and work with
your menstrual cycle, not against it.

            Exercising
or workouts helps in having regular periods and also aids you in experiencing
less cramps and reduced heavy flow while your periods. As you sweat by working
out, water leaves your body which can help you relieve uncomfortable belly
bloat. Apart from this exercise also releases the mood enhancing endorphins
which can at least take your mind of discomfort and pain while periods.

            You can
go for the light exercises and keep yourself moving even during periods. This
will at least help you not to take a break from your fitness routine that helps
in your overall health.

 

(2936 words)

 

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