Man I feel like a Woman: Understanding your cycle in rehab
Introduction
Have you ever noticed that your gym/recovery sessions differ from one week to the next? Whether it be strength, flexibility or even co-ordination; any changes that seem out of the ordinary may start to raise some questions surrounding why movement can feel so different. Well, a big factor that is often overlooked is the menstrual cycle! Your menstrual cycle impacts more than just your mood, it can impact your joints, muscles and even nervous system and how all of these elements work together. These changes are completely normal and individual to you; not everyone is the same!
In this blog we will break down the menstrual cycle, highlight each phase and discuss how different hormones can impact you from day-to-day and within your recovery.
The Menstrual Cycle in simple terms
Your menstrual cycle comes and goes in 4 different stages (Cunningham et al., 2024):
- Menstruation: shedding of uterine lining (this is where your hormones are at their lowest!) This may lead to cramps, fatigue, and bloating
- Follicular phase: Overlaps with Menstruation; Oestrogen rises, energy and recovery starts to improve.
- Ovulation: surge in luteinising hormone triggers ovulation; progesterone rises after ovulation (in the luteal phase)
- Luteal phase: Progesterone and Relaxin rise; 2 weeks before period. Symptoms such as; irritability, low mood, changes in appetite may be visible here (remember: everyone is different!).
Key hormones to note:
• Oestrogen – literature suggests that this supports muscle activation, recovery, and connective tissue health.
• Progesterone – Findings highlight this may influence temperature, fatigue, and neuromuscular control.
• Relaxin (if relevant) – may affect ligament laxity.
Why they matter: These hormones influence muscle, connective tissue, and the nervous system, which can subtly change how you execute movement.
How Hormones Influence the Body (Chidi-Ogbolu & Baar, 2019)
Strength:
• Oestrogen can support muscle activation and recovery.
• Some women feel strongest in the mid‑follicular to ovulatory phases.
What this means for training:
- Mid-follicular phase -> ovulation phase = high-performance window; heavy strength work and power progressions
- Late Luteal phase may feel lower-energy; prioritise quality over volume and keep load flexible
Flexibility:
• Hormone fluctuations can increase or decrease flexibility and tissue laxity.
• People may feel “looser” or “tighter” depending on the phase.
What this means for training:
- Increased laxity phases = more mobility gains/progressions
- Reduced flexibility phases = warm-ups matter more, avoid forcing range
Stability & Control:
• Changes in laxity, neuromuscular control and fatigue can influence balance, co-ordination and joint stability (Macmillan et al, 2024)
What this means for training:
- Higher laxity + altered neuromuscular control = stability demands change; focus on proprioception and controlled deceleration when laxity is higher
- Fatigue-prone tasks may need reduced complexity = simplify tasks, increase rests and focus on quality of movement
What the Research Says
• Hormone fluctuations may contribute to performance variability (Engman et al., 2025).
• Oestrogen improves muscle repair and contractility (Pellegrino et al, 2022)
• Evidence on injury risk is mixed and highly variable.
• The key message: responses differ widely between people.
Practical Implications for Training & Daily Life Training
• You may feel more fatigued during various days of your recovery
• Flexibility may be higher at certain times.
• Adjust load, intensity or recovery based on how your body feels.
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Communication between you and your physiotherapist/coach is so important! Track elements such as: energy, mood, symptoms so your session can be tailored
Everyday Movement
• Some tasks may feel easier or harder depending on symptoms, i.e fatigue or bloating.
• Small adjustments—pacing, gentler movement, posture, regular hydration—can help without overthinking
How Physiotherapy Can Help
Physiotherapy helps people understand their cycle, adapt their movement, build resilience, and feel confident and capable in everyday life — regardless of where they are in the month
Key Takeaways
• Hormonal changes can influence strength, flexibility and stability.
• Understanding your cycle helps you train and move smarter.
• Physiotherapy can support you in adapting movement and managing symptoms.
These changes are normal and vary widely between individuals!
Bibliography:
Chidi-Ogbolu, N., & Baar, K. (2019). Effect of estrogen on musculoskeletal performance and injury risk. Frontiers in physiology, 9, 421933.
Cunningham, A. C., Pal, L., Wickham, A. P., Prentice, C., Goddard, F. G., Klepchukova, A., & Zhaunova, L. (2024). Chronicling menstrual cycle patterns across the reproductive lifespan with real-world data. Scientific reports, 14(1), 10172.
Pellegrino, A., Tiidus, P. M., & Vandenboom, R. (2022). Mechanisms of estrogen influence on skeletal muscle: mass, regeneration, and mitochondrial function. Sports Medicine, 52(12), 2853-2869.
MacMillan, C., Olivier, B., Viljoen, C., van Rensburg, D. C. J., & Sewry, N. (2024). The association between menstrual cycle phase, menstrual irregularities, contraceptive use and musculoskeletal injury among female athletes: a scoping review. Sports Medicine, 54(10), 2515-2530.
If you would like to know more about how your Menstrual Cycle can affect your rehab, please contact us on 01949 485084
