Our Run Mummy Run Community Run Club in association with ASICS strength and conditioning expert Lucy Hurn brings us this exclusive blog. She explores why we need to focus on women’s health and specific issues that can affect our training. These blogs are exclusive to RMR CRC members for a few months before being made public, so if you do want to get expert advice on your running, as well as a training sessions, expert Q&As, access to exclusive kit and much more, find out more about the club today! Lucy gives us an introduction to the menstrual cycle and perimenopause.

Some stats:

• 1 in 3 women have missed work as a result of their menstrual cycle and the majority of women feel that their menstrual cycle negatively affects their performance or training.
• Menopause: Around 80% of women have symptoms (25% severe symptoms) and 25% of women say they have considered leaving their job (and 1 in 10 actually do) because of perimenopause symptoms. 30% of women are less physically active post menopause. Yet almost 80% of women did not realise their symptoms were because of the menopause.

These are clearly issues that affect women’s quality of life and training and activity levels, but they are rarely talked about, and often seen as taboo, making it harder for women to access information.

In addition, the majority of medical and sports research has traditionally been carried out on men.

Until relatively recently, women of ‘child bearing age’ were not allowed to be included in medical research, and it’s only since the turn of the century that research funding organisations are now asked to consider gender/sex in their research or have to justify only looking at a single sex. Even more shockingly, it’s only recently that doctors are covering the menopause in their training, despite the fact that it affects almost 50% of the population!

By discussing these issues, the intention is not to give women anooooother thing to have to worry about, or an ‘excuse’ not to train, but to arm them with information, so they know what they are dealing with and to find ways to maximise their training.

The menstrual cycle

While we often see our period as a bad thing, getting our period is a sign that everything is in order – if things are out of balance, our body protects against pregnancy. But, of course, the cramps and other side effects can get in the way of our training.

My primary suggestion is to track your cycle for a few months, noting how you feel through the whole month. As well as cramps, include energy, mood, how your training feels, any injury flare ups. Often we don’t realise the effect that our cycle has on us until we track things. For example, maybe we keep struggling to get through a certain workout because we’re feeling low in energy, or get upset over something trivial because we’re feeling more sensitive, or slept worse than normal.

But it’s not until we track it that we realise it keeps happening at a certain phase of the cycle.

Knowing these things doesn’t necessarily mean we can change them but we can plan for them, just as a weather forecast allows you to plan accordingly. You may sleep badly just before your period because you are hotter than usual, and simply changing the heating for those days can help you sleep better. Or if you know you’ll find certain workouts harder at certain points of the cycle, then just avoid them on those days.

I add a rest week every 3 to 4 weeks to all my clients’ training plans to allow for recovery and for them to come back stronger the following week. For many clients we simply schedule this rest week around their period (that may be the week before when PMS is worst, for others it will be 3 days before to 3 days after). It doesn’t mean they’re doing less training, we’re just working with their body to work harder when they feel at their best, and take the rest when they need it most, and maybe more importantly, they spend less time beating themselves up for ‘failing’ a workout.

Menstrual dysfunction

I don’t have space to do justice to these issues, but I do want to at least flag them up, because for too long women have just accepted more severe impacts around their period. Issues such as endometriosis or PMDD (pre menstrual dysphoric disorder) mean many women are losing days of their life each month due to the impacts of their period, but society’s taboos mean they’re rarely discussed. If you feel this could be you then speak to your GP.

Perimenopause

Menopause marks the point at which it’s a year since your last period; the average age for this to occur is 51, but commonly ranges from 45-55.

Perimenopause is the phase before that when hormones start changing, with all sorts of knock-on effects. It lasts on average 4 years, but can be up to 10-15 years, and so could start as early as your early 30s.

Symptoms vary widely, with 80% of women having some symptoms, and 25% experiencing severe symptoms. These can include more irregular periods and changes to flow, increased PMS, mood changes (usually increased anxiety, depression and anger), issues sleeping, increased fatigue, headaches, poor memory and brain fog, tender breasts and bloating, unexplained weight gain, hot flushes and night sweats, increased joint and muscle pain, vaginal dryness, bladder changes and much more.

Sounds fun doesn’t it! Yet despite the potentially significant impact on the life of almost half the population, it rarely gets talked about (thankfully this is changing) and many GPs have had no training on the issue (again, this is changing).

If you think you’re experiencing symptoms, again the first thing is to start tracking your symptoms. Write down everything, not just menstruation dates. This will help with diagnosis but also help you to start to spot any patterns in your changing cycle and symptoms so you can start to plan for the good and bad days (with your training, as well as other areas of life) and note anything that triggers worse symptoms (sorry to say, alcohol is often one) or improves things.

There’s too many possible solutions to the different symptoms to list here, but the main one is HRT, or hormone replacement therapy. Whether it’s right for you, and in what form, will depend on a variety of factors that you will need to discuss with your GP. But so many people discount it without looking into properly, so here’s a quick defence of HRT.

HRT has a bad reputation (again, thankfully changing), mostly due to The US Women’s Health Initiative in the 90s which reported that women taking HRT had a significantly increased risk of breast cancer, heart attacks and strokes, and resulted in a massive decline in the use of HRT. However subsequent analysis of the study shows there were many issues with the study, including that the evidence for the claims was not statistically significant and that many of the women in the study should have been excluded.

Far from carrying an increased risk, for the vast majority of women, if begun early enough (before 60) HRT can actually bring many potential health benefits. As well as helping to reduce the negative impacts experienced during perimenopause and therefore increasing quality of life and supporting training, it can also help reduce the risk of osteoporosis, cholesterol, heart disease and potentially dementia. If you’re worried about the risk of cancer or blood clots, or over 60, your GP should be able to advise on the best options for you.

There are also a range of lifestyle changes which can help reduce symptoms of perimenopause, including diet (moving away from unrefined carbs to more wholefoods and veggies), stopping smoking and reducing alcohol, sleep hygiene, and practicing relaxation and meditation techniques.

In terms of training, as oestrogen declines, bones become more at risk (about 1 in 2 women compared with 1 in 5 men over 50 will break a bone because of osteoporosis) and so it’s vital to look after them – running is great, but also adding in some side to side low level hopping will help, as well as getting enough recovery between sessions so the bone can rebuild, and sufficient calcium along with vitamin D. We also start to lose muscle mass as we get older, so protect muscle through weight training (building up to fairly heavy weights where you can do around 10 reps), as well as checking you’re getting enough protein

About Lucy

Lucy is an endurance athlete, PT and run and triathlon coach. She coaches athletes of all abilities – from those working up to their first 5K through to Ironman and beyond, as well as those wanting to build fitness or reduce their risk of injury. As well as writing bespoke training plans, she delivers triathlon and run-focused strength and conditioning sessions. She works with her clients to ensure the training works for them, fits their life, and ensures they get to the start line happy and healthy. She’s passionate about working with women as women, working with their bodies and menstrual cycle rather than just treating them as ‘small men’, and working towards a world where women equal the number of men on the start line by working with women to overcome barriers and to gain confidence.!

For more Lucy’s online strength and conditioning, and personal training, as well as bespoke training plans, visit www.feelfitwithlucy.co.uk