That first day of your period can gloriously signal the end of some horrible PMS symptoms but unfortunately can still bring some pesky annoyances that interfere with training. If you missed it, you can read my post about minimizing PMS symptoms here. Read on below to learn about tricks to minimize period symptoms to maximize your training.
Cramping and/or diarrhea
How it affects performance:
Other than the obvious distracting pain in your lower belly, episodes of diarrhea can come on with only short warning causing distracting anxiety.
It is usually decently easy to ignore these distractions but one thing that should not be ignored is dehydration. If you do suffer from diarrhea during your period, be on the lookout for signs of dehydration: darker urine, faster heart rate, dry mouth.
Training while already dehydrated is likely to make you more dehydrated which can cause lightheadedness, dizziness, poor coordination, and loss of consciousness. These symptoms when moving heavy weights can lead to poor form or dropping weights on yourself, causing actual musculoskeletal injury.
Why it happens:
During your period, your uterus is shedding the lining it built up in case of a pregnancy that month. In order to do that, the muscle contracts forcefully to push that lining out. The dying cells of the lining release a hormone called prostaglandin which causes smooth muscle in your body to contract.
The smooth muscle of your uterus contracts but when too much is release, other smooth muscle contracts, most notably that in your intestines.
This causes the food you’ve eaten to be pushed along your digestive tract too fast, not allowing the body to absorb the water it needs, resulting in diarrhea and dehydration.
What to do about it:
NSAIDs (non-steroidal anti-inflammatory drugs) are the best medicines for these symptoms because
- They help with the pain of cramping
- They inhibit the the hormone prostaglandin which causes the diarrhea.
There are two options within the class of NSAIDs:
- All the other NSAIDs
Aspirin is uniquely helpful in that it inhibits prostaglandin irreversibly, which means its effect on the hormone doesn’t go away (until your body makes more of it by shedding more lining). One downside to aspirin though is that it can make it slightly harder for your blood to clot (which is why it is used to prevent heart attacks) and therefore may make your period heavier.
I would only recommend taking aspirin if you do suffer from moderate or worse diarrhea AND if you have really light flow periods.
Of note: DO NOT take aspirin if you are under the age of 16. You are at risk for a severe neurological disease called Reye Syndrome.
Otherwise, go ahead and take any other NSAID (ibuprofen, Advil, Motrin, Naproxen, Aleve, etc.) These also inhibit prostaglandin but they do so reversibly and therefore less effectively. But they also don’t cause the same blood thinning effects that aspirin does.
How it effects performance:
This hardly needs explaining but obviously you can’t train to your max when you don’t feel you have the energy to give 100%.
Why it happens:
The major cause of lower energy during this time is blood loss. Especially if your periods are heavier, you are actually losing a good amount of red blood cells that carry oxygen and also a decent amount of fluid, which dehydrates you.
Losing red blood cells means you aren’t able to get as much oxygen to your muscles to use to make energy. This is what is known as anemia.
Dehydration also means you have less blood getting to your tissues for energy and waste removal.
What to do about it:
For the dehydration component, as expected, it is important to drink more water than you normally would. Especially if you’re also dealing with diarrhea, as above.
For the loss of red blood cells, it can help to increase your intake of iron during this time. All of the other nutrients that go into making more red blood cells are in plentiful in your body but the iron is the limiting factor.
For those that are curious, yes, you are also losing all the other components of your blood such as white blood cells, plasma, clotting factors. Your blood and body has a large excess of these components so that the amount lost in this case doesn’t usually cause any problems.
Foods that are high in iron are shellfish, spinach, broccoli, liver, legumes (beans, peas, chickpeas, etc), red meat, turkey, quinoa, and dark chocolate.
You can also take an iron supplement. It is very common for young women to develop iron deficiency anemia because of monthly blood loss from menstruation and they are often advised by their physician to take an iron supplement daily, even outside the time of their period.
The daily recommended intake of iron for adults is 40mg. You may be advised by your doctor to take more if your periods are causing iron-deficiency anemia.
Normal, healthy adults can consume much more than the daily recommended amount of 40mg of iron (up to 1400mg usually without symptoms) and your GI tract is able to only absorb what it needs. It is actually quite difficult for your GI tract to absorb some sources of iron, particularly tablets and plant-based sources.
It is important to keep iron supplements out of reach of children as iron overdose can often be fatal in children. Because children are much smaller and iron supplements usually appear and taste similar to candy, children can unintentionally consume large amounts, causing deadly liver failure.
For blood loss causing fatigue and low energy, emphasizing hydration and increasing iron intake can help significantly.
Here’s a table to quickly summarize what we learned:
|Cramping & Diarrhea|
|– NSAIDs or Aspirin (for light periods and >16 years old)|
|Low Energy & Fatigue|
|– Maintain hydration|
– Increase iron intake
If you suffer from any of these annoying symptoms during your period, hopefully some of this will help you get through it and be able to train just like any other day.
Be sure to check out my post on how to minimize PMS symptoms to maximize your training for next go around.
Dr. Elle, MD