Female-Specific Training: Creating Equity in Athlete Care

Of the 113 medals awarded to the U.S. in the 2021 Olympic Games, 66 were won by women (58%). Despite this incredible accomplishment, female representation and female-specific training in sports is still far from perfect. Women make up half the world’s population, and they continue to make great strides in sports performance. Yet female-specific training remains a niche endeavor in athlete management.

What’s holding female-specific training back? Common barriers include:

• Discomfort 
• Lack of knowledge
• Stigma surrounding female biology

As the U.S. women’s overwhelming success in Tokyo indicates, there has never been a better time to invest in female athletes. In her recent webinar, sport scientist Sam Moore argues that creating an equitable training environment doesn’t mean offering women the same training as men. Instead, the key to equitable athlete management is to offer a training environment that’s specifically suited to women and their unique physiology. 

WATCH THE WEBINAR

Learn about challenges facing women in sports and how to provide more equitable care for female athletes, specifically the concept of Menstrual Cycle-Based Training (MCBT).

Moore argues that a better understanding of best practices for strength and conditioning programs for the modern female athlete starts with more comprehensive education. Most women are never taught how their physiology — primarily related to the menstrual cycle — impacts their performance. The “intersection of gender equity” in sports, Moore says, can “revolutionize the training and treatment of women athletes at every [level].” 

COMMON ROADBLOCKS FOR FEMALE ATHLETES

To broach the subject of creating equity for female athletes, it’s important to define the terms surrounding it. In her webinar, Moore defines the term “woman” as referencing gender identity, which may exist fluidly or on a spectrum. She references The Trevor Project’s glossary definition of gender identity: “Our internal understanding and experience of our own gender.”

The term female is referencing biological sex, which can be attributed to several variables. Moore acknowledges that while binary classifications of male and female don’t effectively contain the modern population — “Not all women athletes menstruate, and not all athletes who menstruate are women” — the terms help to remain consistent with current research. 

Entering the discussion about women and female athletes as defined in modern studies, there are several common roadblocks to providing female-specific care.

DISCOMFORT

It can be uncomfortable to talk about the realities of female-specific training. With much of the conversation rooted in topics of physical processes like menstruation and ovulation and the symptoms that come with them, female athlete management can feel like a tricky topic for trainers and coaches — especially male coaches. 

Moore insists that the best way to overcome this roadblock is to tackle it head on. “I encourage you to sit with it, understand why you feel that way and how it doesn’t serve you in order to dismantle the bias. Then move forward past it,” Moore says.

Recently, La Trobe University published a study centered on the challenges of training female athletes. The male subjects of the study, 18 elite soccer coaches, shared their lack of confidence in their knowledge of the menstrual cycle and the way it impacts the athletes. More importantly, they emphasized their discomfort with bringing up the subject with their peers and students. 

While the study pointed to a glaring discomfort with the unknown, it also brought to light an encouraging desire among modern male coaches to learn more.

LACK OF KNOWLEDGE

The insufficiency of understanding around female-specific training reaches far beyond male coaches and peers. It’s also true of female athletes themselves, who are rarely taught about how their unique physiology can have a major effect on their performance and training.

Moore says that the menstrual cycle and training are simply not talked about together. Even throughout graduate school, she recalls understanding her cycle only as it related to reproduction — not her athletic abilities. The solution is to start educating female athletes early so that they can move upward in their careers with a healthy understanding and appreciation of their bodies. 

STIGMA SURROUNDING FEMALE BIOLOGY

When it comes to women in the sports world, one of the most glaring roadblocks is the stigma surrounding female biology. In 2020, The Rally Report indicated that one in every three girls stops playing sports before the age of 15. This disheartening statistic was attributed to a number of factors:

• Low confidence. Many young girls report a persistent lack of confidence that’s amplified in a sports environment. 
• Negative body image. Female athletes are more likely to start comparing their bodies and abilities to those around them at a younger age than their non-athlete peers. 
• Perceived lack of skill. It’s important to note that young girls are discouraged by a perceived lack of skill, rather than one that is verbalized to them. 
• Feelings of being unwelcome or not belonging. Differently abled and underprivileged girls reported feelings of unwelcomeness at a higher rate. 

Moore points to the overwhelming pressure that young female athletes face as they shoulder societal gender roles in a competitive environment. Female athletes are more likely to experience disordered eating than their non-athlete female and athlete male peers. Young women often report a desire to remove themselves from the athletic environment, where they’re constantly comparing themselves to the other women around them. 

These pain points grow more prevalent as girls reach puberty and beyond, with the feeling being most pronounced among the surveyed girls between the ages of 16 and 18. 

HOW THE MENSTRUAL CYCLE IMPACTS STRENGTH & CONDITIONING

There is perhaps no greater conflict between female physiology and athletic training than the one that exists between the menstrual cycle and strength and conditioning. In her webinar, Moore discusses the menstrual cycle in its entirety — as “a cyclical and constant fluctuation of hormones.”

Moore addresses multiple key points about a woman’s cycle and her athletic life.

PHASES IN THE MENSTRUAL CYCLE

As you learned in middle and high school, the menstrual cycle is the process by which a woman’s body prepares for the possibility of pregnancy each month. The menstrual cycle lasts between 20 and 30 days and is made up of two phases:

• The follicular phase. This phase begins with the first day of the menstrual period and lasts until ovulation. During this stage of the cycle, estrogen levels steadily rise while progesterone and testosterone levels remain lower. 
• The luteal phase. The luteal phase begins with the first day of ovulation and ends with the menstrual period. It brings about the peak of a woman’s estrogen level, gradually rising progesterone, and a burst of testosterone.

While many people are aware of the menstrual cycle’s existence and its overall purpose, far fewer are attuned to the way it impacts daily health — from mental health to energy levels to cognitive functions.

IMPACT ON MENTAL HEALTH

For many women, certain parts of the menstrual cycle can create significant changes in mood and mental health. “It’s not a matter of toughness,” Moore reiterates. Hormonal fluctuations often cause instability in mood, which can have a major impact on an athlete’s confidence. Many female athletes battle feelings of anxiety and depression in the midst of their cycle. Variations in hormone levels can make it challenging for athletes to effectively communicate their feelings. 

Not all effects are as severe. For example, in the early luteal phase, some women may experience mild brain fog and fatigue, while others may need to slow down significantly. 

EFFECT ON ENERGY LEVELS

During a female athlete’s period, she may experience a severe depletion in her energy levels. Accompanying effects include the following:

• Changes in thermal regulation abilities. Women may experience changes in their ability to cool down or warm up, depending on where they are in their cycle. 
• Unique adaptive training responses. By definition, adaptive training requires the athlete to adjust their training to keep exposing their body and mind to new challenges. A female athlete may need to ramp up or tone down her adaptive training according to her place in the cycle.
• Uterine and muscular cramping. Many women are familiar with the discomfort of uterine and muscle cramps during their period and other times in their cycle. Cramping can range from mild to debilitating.
• Gastrointestinal symptoms. Some women experience gastrointestinal turmoil during PMS and their menstrual periods — to the point that it can impact their training. 
• Significant cravings. It can be a challenge to manage cravings for sugar, carbohydrates, and more at different points in a woman’s cycle. 
• Fluctuation of body composition. Whether they stick to their nutrition plan or not, many women find it difficult to build lean muscle mass during the follicular phase. 
• Lower neuromuscular skills and spatial awareness. Depending on the phase, some women suffer from a decline in tactical skills and coordination during their cycle.

In short, many women suffer from a significant dip in energy, “fuel access,” and various strengths throughout their cycle. It’s important that trainers learn about and acknowledge this very real phenomenon in female athletes. 

Moore argues that tailoring training programs to the menstrual cycle and its effects maximizes a female athlete’s potential and makes her feel more valued, rather than offering a timeout during her cycle — as common misconceptions suggest. 

OVERCOMING ROADBLOCKS FOR THE FEMALE ATHLETE

It’s clear that female athletes face a unique challenge when balancing their menstrual cycle and training programs. So what can you do about it? Moore addresses several ways to elevate the female athlete’s strength and conditioning experience.

TRACKING THE MENSTRUAL CYCLE

The fluctuation of hormones from stage to stage can create a truly wide range of symptoms from person to person. This, Moore argues, is why it’s imperative that female athletes track their cycles.‌

One of the most common responses she has received from the athletes she’s worked with is, “Oh, I didn’t track that symptom because it’s not related to my period.” However, Moore emphasizes that the opposite is true: “Everything is related to your period.”‌

Because of this, it’s essential that female athletes make note of the symptoms they experience — and understand that these changes are not simply in their head. Tracking symptoms can help athletes better understand their cycle and the way it uniquely affects their performance

‌As a coach, it’s up to you to create a safe space and system for tracking your athletes’ cycles. Moore suggests surveying athletes daily. Instead of asking, “When did you start your last period?” she recommends asking, “Did you start your period today?” The simplified, consistent format eliminates errors in tracking. She also recommends tracking sleep time and quality. 

PLANNING PARALLEL TO THE MENSTRUAL CYCLE

Creating a training program that tailors its progression to the female menstrual cycle can maximize the athlete’s efficiency and progress. You can amass the most benefit for your athletes by dividing your program into two phases that run parallel to the menstrual cycle:

FOLLICULAR PHASE

The follicular phase is characterized by an increase in estrogen, steady testosterone, and decreasing progesterone. In this phase, Moore suggests focusing on:

• Strength training
• Hypertrophy
• Lactic conditioning
• High-intensity interval work

Ultimately, in this anabolic-focused time period, Moore recommends “max testing of your power.” Thinking of estrogen as building blocks that collect over time, training during the follicular phase should ramp up from the end of the menstrual period and onward. 

‌LUTEAL PHASE

The luteal phase is characterized by fluctuating estrogen, peak progesterone, and unstable testosterone. During the dips in energy of the luteal phase, Moore recommends dialing back training. Pushing over-fatigued or under-motivated athletes can lead to injury. Female athletes can anticipate these drastic drops in energy directly after ovulation. 

On the other hand, women often experience training maximums in the two days leading up to ovulation. During high-energy times, Moore recommends focusing on functional movement, working on new skills, and engaging in aerobic workouts. The luteal phase is often the perfect time to home in on reteaching or honing specific movements or skills. 

Ultimately, a woman’s cycle is characterized by peaks and valleys of energy — some intense and some mild. As a trainer, it’s up to you to truly listen to your athlete and craft a strength and conditioning program that aligns with their physiology.

MOVING FORWARD: MAKING FEMALE-SPECIFIC TRAINING THE STANDARD

Despite its obvious importance, female-specific training remains novel in the sports world — not unlike equity. “But women are not niche,” Moore says. “They are the majority, and the dominant athletic majority at that.” In her webinar, Moore brings up several tips for creating a space that nurtures female-specific training:

ADDRESSING PAST SHORTCOMINGS

One of the most important points Moore brings up is the importance of addressing past misunderstandings and transgressions in order to move forward. 

“It’s OK if you said that you’re more likely to tear your ACL on your period because that’s genuinely what you were taught,” she says, as long as you acknowledge that you were wrong. The next step is making an open, tangible effort to continue your education. 

BEING VULNERABLE AND APPROACHABLE

It’s essential that leaders in sports not only take steps to grow but also take them in front of their student athletes. Coaches and trainers must demonstrate a certain level of approachability and vulnerability to gain the trust of their female athletes. This process may start by admitting to past errors, but it continues with consistent openness.  

To open the door to constructive conversations about female physiology and training, you should start with the following:

• Avoid and own up to dismissing female symptoms and fatigue. 
• Create a safe space for female athletes through validation and compassion.

‌HOLDING ATHLETES ACCOUNTABLE

Moore advocates for holding female athletes accountable for their potential through education. While all athletes should maintain the option to opt out of surveys, effective athlete management includes educating women about the importance of tracking and communicating their symptoms. They should understand that while they’ll still receive quality training regardless, their experience will only be elevated by looping their coaches into their status. 

CREATING A SENSE OF EMPOWERMENT

The bottom line is that women and girls are empowered by understanding their cycle and how to train in a way that aligns with their physiological state. 

“They came here to play their sport and to grow as a human,” Moore emphasizes, “and our job is to make sure that they are informed and empowered — and they’re equipped so that when they leave the weight room and they go out into the world, they know who they are and they know what they deserve, and they feel ready to handle the situations that life throws at them.”