Nutritional considerations across the menstrual cycle and for hormonal contraceptive use 📝
A guide for all female athletes.
Menstrual Cycle and Hormonal Contraceptives in Female Athletes: Should Symptoms and Nutrition Matter More than Cycle Phase? A Narrative Review
Study Details
This new review highlighted the key scientific literature on nutrition for female athletes…
…distinguishing important differences between eumenorrheic menstrual cycles and hormonal contraceptive users 🔍
Here are the key takeaway points ⬇️
Key Findings
ENERGY INTAKE 🔥
🩸 Eumenorrheic
Intake may increase in the luteal phase (+100–300 kcal/day)
Target: >45 kcal/kg FFM/day
💊 Hormonal Contraceptive Use
Energy intake may appear more stable but remains individualised
Target: >45 kcal/kg FFM/day
CARBOHYDRATE 🍞
🩸 Eumenorrheic
Possible luteal-phase alterations in glycaemic regulation
Post-exercise: ~1.2 g/kg; During exercise: 30–60 g/hour to compensate for reduced gluconeogenesis in luteal phase
💊 Hormonal Contraceptive Use
Glucose handling may vary by formulation
Prioritise low-GI carbohydrates where appropriate during active pill weeks to mitigate transient insulin resistance
PROTEIN 🥩
🩸 Eumenorrheic
No meaningful phase-dependent differences in MPS
Target: 1.4–2.2 g/kg/day; Post-exercise: ~0.32–0.38 g/kg
💊 Hormonal Contraceptive Use
No clear differences between active and pill-free phases
Target: 1.4–2.2 g/kg/day; Post-exercise: ~0.32–0.38 g/kg
INFLAMMATION / SYMPTOMS 💥
🩸 Eumenorrheic
Luteal phase may increase fatigue, cravings, and discomfort
Vitamin D, zinc, and curcumin may support symptom management
💊 Hormonal Contraceptive Use
May reduce symptom severity in some individuals; responses vary
HYDRATION💧
🩸 Eumenorrheic
Progesterone-related fluid retention and bloating may occur
💊 Hormonal Contraceptive Use
Fluid shifts and bloating may vary by individual and formulation
GI TOLERANCE 💨
🩸 Eumenorrheic
GI symptoms may fluctuate across the menstrual cycle
💊 Hormonal Contraceptive Use
GI tolerance may improve or worsen depending on individual response
IRON STATUS 💉
🩸Eumenorrheic
Menstrual blood loss increases iron deficiency risk
Estimated requirement in endurance athletes: ~30 mg/day
💊 Hormonal Contraceptive Use
Reduced bleeding may lower deficiency risk
Supplement based on biomarkers; some formulations provide iron
Conclusion
OVERALL PRACTICAL IMPLICATIONS ✅
🩸 Eumenorrheic
Align nutrition with training load, energy availability, and symptom presentation rather than phase-based assumptions
💊 Hormonal Contraceptive Use
Does not guarantee metabolic stabilisation; individualised monitoring remains essential
Reference
https://pubmed.ncbi.nlm.nih.gov/41978194/
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