Published on 07 May 2025
In recent years, the connection between the menstrual cycle and athletic performance has taken centre stage. Emerging research highlights an intriguing link between the different phases of a menstrual cycle and injury susceptibility in athletes.
Are you more prone to injuries on your period?
Have you ever found yourself getting injured at specific times of the month, but are unable to pinpoint the reason? The answer might lie in your menstrual cycle.
While this insight is relatively new, it’s shedding light on how menstruation might play a significant role in injury risk for female athletes.
How does menstruation affect female athletes?
The menstrual cycle impacts athletes differently depending on the phase they’re in. Hormonal fluctuations play a crucial role, and research indicates that during the pre-menstrual phase, the risk of muscle injuries rises compared to the menstruation phase.
These changes could shape not only how athletes perform, but also how they approach training and recovery.
The effects of menstrual cycle phase on athletic performance
Menstrual cycles typically last between 24 to 38 days, but this can vary for each person and may also change over time. There are four phases of the menstrual cycle:
- Menstrual phase: The first day of bleeding marks the start of the cycle
- Follicular phase: The uterine lining starts to rebuild, making this the longest phase
- Ovulation: The release of an egg from the ovary occurs during this phase
- Luteal phase: The uterus prepares for potential pregnancy by thickening its lining
Research led by University College London (UCL), the University of Bath and St Mary’s University, monitored 26 professional female footballers over three years and a total of 593 cycles were tracked.
Findings revealed a connection between the pre-menstrual phase and an increased risk of injuries. The most common injuries affected the following:
- Muscle
- Joint and ligament
- Tendon
- Fracture and bone stress
Why does this happen?
During ovulation, peak oestrogen levels in the body can influence ligament laxity, increasing the vulnerability to ligament injuries. Elevated oestrogen levels contribute to the weakening of ligaments, which in turn raises the likelihood of injuries such as ACL tears.
After the ovulation phase, progesterone levels increase which leads to greater breakdown of amino acids stored in muscles. This can weaken muscle-building properties and raise the risk of muscle injuries during intense training.
Pre-menstrual hormone withdrawal (as oestrogen and progesterone levels drop) triggers inflammation throughout the body. This can delay recovery and increase injury risk, while menstrual symptoms like sleep problems, mood changes, reduced coordination, and pain further reduce readiness for physical activity.
Tracking your cycle for injury prevention and performance optimisation
Modern technology offers several cycle-tracking apps designed to help you monitor your menstrual cycle and better understand your phases.
For athletes, these tools are particularly beneficial, enabling tailored training plans and optimised recovery strategies.
Coaches, physiotherapists, and sports medical teams are increasingly incorporating menstrual cycle tracking to enhance athlete performance and minimise injury risks.
If you’re also managing a menstrual condition like PCOS or endometriosis, our women’s health and gynaecology services can offer additional support to help manage symptoms that may affect your training or recovery.
Optimise your performance with Benenden Hospital
If you're recovering from a sporting injury and need private Physiotherapy treatment, our experienced and compassionate team can help.
During your initial consultation, our Senior Physiotherapist will take the time to talk to you about your condition, carry out a thorough physical examination and discuss your goals for recovery.
They’ll put together a physiotherapy treatment programme tailored to your needs, ranging from gentle mobilisations and strengthening to therapeutic pain relief and soft tissue techniques.
You can also self-refer to use our on-site physiotherapy gym, featuring specialist equipment to support strength, coordination, and injury prevention across all fitness levels.
Additionally, we offer pelvic floor rehabilitation for those managing conditions like PCOS or endometriosis, which may contribute to pain, fatigue or reduced performance.
Ready to get started?
Book a consultation at our comfortable and discreet private hospital in the heart of the Wealden countryside by contacting our Private Patient Team via Livechat, by completing our online enquiry form or by calling us on 01580 363158.