Monday, November 23, 2015

Training "On Cycle", Done Right - Women See Much Better Results When Periodization is in Line W/ Menstrual Cycle

Yes, I could have exploited the ambiguity and called this article "Training 'On Cycle', Done Right - Women See Much Better Results When Periodization is in Line W/ Their Period", but let's be honest: This is a science website and that's neither scientific, nor actually funny, is it?
As a man, I have to admit to being at best well-read, yet not experienced in all things "menstrual cycle". So, while I do only know the (very different) things I've heard from (ex-)girlfriends about how they feel during the different phases, I do know that the hormonal differences in the luteal phase, with high levels of progesterone and estrogen, and the follicular phase with low progesterone and eventually increasing estrogen levels are pronounced enough to cause much more than just mood disturbances.

For many trainers, however, the estrous cycle is still a closed book. "Can you train, or not!?" Especially male trainers are not just insensitive when they ask their protégées this question, they may also be missing out on a chance to maximize their clients' training progress. That's at least what a recent 4-months study from the Umea University in Sweden (Wikström-Frisén. 2015) suggests.
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According to Wikström-Frisén and colleagues, "high frequency periodized leg resistance training during the first two weeks of the menstrual cycle is more beneficial to optimize training, than the last two weeks" (ibid. 2015). Now, "beneficial" is obviously a very loosely defined term. When I am telling you, though, that power, strength and lean body mass gains all benefited from the right timing of the workouts (in the first two weeks of the estrous cycle), I will hopefully have every women's and every trainers' attention (even though, I guess I will lose even more of the male bros, now).
Figure 1: Relative changes in lean mass (DXA data), measures power and strength (torque) in 59 trained women in response two weeks of frequent leg-training in the first or second two weeks of their estrous cycle (Wikström-Frisén. 2015).
While all the aforementioned increases in the women who trained in the first two weeks of their estrous cycle were statistically significant (for all, but the quad torque test | +4.4% the statistical significance also survived the Benferroni corrections), the women in the group for whom the periodization scheme had a focus on the second two weeks of their menstrual cycle, saw no significant changes in lean mass and power and a significant reduction in quad strength (see Figure 1). Since the latter lost its statistical power, after Benferroni corrections, though, one could say that the changes the Swedish researchers observed in the 2nd weeks group were practically meaningless.
What about women on oral contraception? The scientists recruited 32 young women on oral contraceptives and 27 women who didn't use oral contraceptives and a re-analysis of the data in Figure 1 didn't show significant inter-group differences between the two groups. In other words, the data in Figure 1 and thus the main findings are relevant for "all" resistance training young women, irrespective of whether they're taking contraceptives, or not. The only difference is that you go by the contraceptive (CC), instead of the estrous cycle and place the high frequency training period in the first, not the last two weeks of the CC cycle.
"Meaningless changes", however, are not meaningless results. In fact, the exact opposite is the case. These results tell trainers and female trainees, alike, that abandoning their protégées / their own
  • regular non-periodized training, i.e. three leg training workouts per week that consisted of leg presses and leg curls (3x sets @ 8-10RM, 1-2 minutes rest between sets; progressive increase of weight by 2-10% whenever the subjects could perform 3x10 reps with a given weight) 
for 4-months and switching to a periodized 2-week high- vs. 2-week low-frequency training, where they would perform the same 48 workouts in either
  • high-frequency first cycles, i.e. 5 workouts per week in the first two weeks, 1 workout per week for the last two weeks of each menstrual / contraceptive cycle, or
  • high-frequency last cycles, i.e. 1 workout per week in the first two weeks, 4 workouts per week for the last two weeks of each menstrual / contraceptive cycle,
would have beneficial effects on their progress only if they increase the frequency during the early phase of the cycle. 
Figure 2: Comparison of the relative changes in the periodization group (high frequency in the first two weeks of the menstrual / CC cycle) vs. control group (three workouts per week for 4 months | Wikström-Frisén. 2015).
Ok, if you compare the periodization group to the control group which kept the regular "three workouts per week"-frequency (see Figure 2, green bars) was maintained, the "advantages" of periodizing "correctly" are not as pronounced as they are in comparison to doing it the "wrong" way. Even though, only the hamstrings appear to benefit to a large extent from periodization, though, benefits exist.

What's even more important, though, is the simple, but really important revelation (or for the few of you who have read about this before e.g. in Reis et al. (1995) "confirmation") that a woman's menstrual and similarly her contraceptive cycle must be aligned to her training schedule. Obviously, the implications will have to be further explored in future studies. Studies, of which I hope, that they will be using smarter periodization schemes which acknowledge that training only once a week is simply not enough... ;-)
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Bottom line: Before I try to put things into perspective, I should mention that the participants of the study who were recruited at local gyms, were not jut healthy, non-smokers and had regular menses, they were also experienced trainees. All of them had been doing leg presses and leg-curls for several months - in fact, on average for 3.5 years. Against that background, even non-statistical significant inter-group differences as they were observed between the periodization (5 per week, 1 per week) and the control group (3 per week) may be practically relevant, because they may help experienced trainees to break through plateaus.

With that being said, I personally think of this study as one study in a series of studies that will hopefully elucidate how women can adapt their training regimen to the repetitive changes in the hormonal milieu of their bodies.

If we are honest with ourselves, the fact that Wikström-Frisén's results come as a surprise to most of us is only further evidence of how wantonly exercise scientists and trainers, alike, have hitherto neglected the peculiarities of the female physiology and endocrinology | Comment on Facebook!
  • Reis, E., U. Frick, and D. Schmidtbleicher. "Frequency variations of strength training sessions triggered by the phases of the menstrual cycle." International journal of sports medicine 16.8 (1995): 545-550.
  • Wikström-Frisén, L., C. J. Boraxbekk, and K. Henriksson-Larsén. "Effects on power, strength and lean body mass of menstrual/oral contraceptive cycle based resistance training." The Journal of sports medicine and physical fitness (2015).