Training Female Athletes Means Understanding Female Physiology

Mother’s Day feels like a good time to talk about something that still doesn’t get handled well in training environments—female physiology.

Even if this doesn’t apply directly to you, if you coach or train female athletes, it’s something you should understand.

Last week, FIFA announced funding for a new research study examining the relationship between ACL injuries and the menstrual cycle.

The response online was predictable: “We’ve known this forever.”

They’re not wrong. Research dating back to the late 1990s has suggested a connection between hormonal fluctuations and ACL injury risk.

But here’s the uncomfortable truth: We still don’t have clean answers.

Most studies are short-term, involve small sample sizes, or show conflicting results. And despite decades of interest, we still lack clear, evidence-based training protocols that reliably reduce injury risk across the menstrual cycle.

So while more funding is welcome, we’re not there yet.

What we can do is understand the physiology—and make smarter, more flexible decisions because of it.

Hormones Run on a Schedule

The menstrual cycle isn’t just a period. It’s a roughly 28-day hormonal rhythm that influences energy, coordination, recovery, thermoregulation, and possibly injury risk.

Estrogen and progesterone rise and fall throughout the month, and those shifts matter for training.

Follicular Phase (Days 1–14)

This phase starts on the first day of menstruation and lasts until ovulation.

• Estrogen rises

• Progesterone stays low

For many women, this is a physical and mental sweet spot. Strength improves, recovery feels easier, and motivation is higher. It’s often a great window for heavy lifting, sprinting, and pushing intensity.

Ovulation (Around Day 14)

Estrogen peaks and testosterone gets a brief bump.

Many athletes feel fast, strong, and coordinated—but this phase is also associated with increased joint laxity, which is suspected (not proven) to elevate ACL injury risk.

Luteal Phase (Days 15–28)

Progesterone rises while estrogen drops.

Core temperature increases, sleep can suffer, and high-intensity work often feels harder. Training isn’t broken—but it may feel like more of a grind.

Menstruation (Start of the Next Cycle)

Hormones drop to their lowest levels.

Some women feel a reset. Others deal with fatigue, cramping, or low motivation. Like everything else in the cycle, responses vary widely.

The Hard Part: What Do You Do With This?

This is where things get tricky.

Symptoms vary dramatically between athletes—and even month to month within the same athlete. Competitions don’t pause for hormone fluctuations. And not every dip in performance is cycle-related.

Still, understanding these shifts helps athletes and coaches make better decisions.

1. Start With Tracking

Cycle tracking—whether through apps, wearables, or a simple calendar—can be eye-opening.

Log:

• Energy

• Sleep

• RPE

• Recovery

• Soreness

• Performance metrics

Over time, patterns often emerge. Not rules—but tendencies.

2. Fluctuations Are Normal

If training suddenly feels harder despite consistent programming, hormones might be part of the picture.

That’s not an excuse. It’s physiology.

Knowing hormones can influence heart rate, perceived effort, and neuromuscular coordination can relieve a lot of unnecessary self-blame.

3. Not Everyone Follows the Same Script

Some women feel good all month. Others experience large swings.

Many athletes—those on hormonal birth control, with irregular cycles, amenorrhea, or low energy availability—aren’t well represented in research at all.

It’s also critical not to blame everything on the menstrual cycle.

Conditions like RED-S and PCOS can disrupt hormones, increase injury risk, and lead to serious health consequences like bone loss or metabolic dysfunction. Those aren’t things to “push through.” They’re medical issues.

4. Should Training Align With the Cycle?

Maybe.  Many athletes report feeling strongest during the follicular phase and more fatigued in the mid-luteal phase. Since deloads are already a best practice, aligning them with lower-energy windows can make sense.

That doesn’t mean eliminating training. It might mean:

• Slightly reducing intensity

• Prioritizing skill work

• Pulling back on peak power demands

And for coaches—especially male coaches—this is not about micromanaging or tracking someone’s cycle.

It’s about creating space for communication and flexibility without judgment.

5. Plan Around Potential Risk Windows

For athletes who are hypermobile or prone to soft-tissue injuries, extra precautions during ovulation or the mid-luteal phase may help.

Bracing, taping, and conservative progressions can be useful—but this is exactly where better research is still needed.

Train for Chaos

Competitions won’t line up with ideal hormonal phases.

That’s why long-term strength, power, and resilience matter. The higher the baseline, the less impact hormonal fluctuations tend to have.

When it comes to ACL injuries, well-designed prevention programs—those combining dynamic warm-ups, strength training, and plyometrics—have consistently reduced injury rates across populations.

Every woman is different. But awareness plus tracking leads to patterns. And patterns lead to better decisions.

The best coaches don’t ignore these factors.  They build them into the plan.