Menstrual Cycle, Period Cramps, and Running


by Pauline Six

Here’s the simple truth on a somewhat taboo subject, running on your period is possible. Training is achievable during periods – though, to be honest – it can be less than enjoyable. Here are some simple tips to help you train… every day of the month.

A beautiful depiction: Uta Pippig

In 1996 Uta Pippig won the Boston Marathon, despite heavy losses of menstrual blood. The press largely ignored the blood, and instead celebrated her tenacity as an athlete. The image of her crossing the finish line, legs dripping in blood, illustrates our point perfectly. Yes, she admitted to experiencing pain and even considered dropping out of the race, but she chose to press on and was rewarded with victory for her determination.

Study on the 2015 London Marathon

Not all women can relate to Pippig’s heroic, if not daunting example of perseverance.

A survey was completed of 1,073 female participants of the 2015 London Marathon. Of these women, around 30% of them expressed that their menstrual cycle had a negative impact on their performance and training.(1)

 Most women runners are affected one way or another, so let’s take a deeper look.

Sports and the cycle phases: when to be careful

Knowledge of your cycle can be a strong ally to optimizing your training. Take extra care in your training sessions from around day 14 until day 28 of your period. During this time there’s up to three times extra risk to ACL injuries (like rupture) to the knee.(2)

Menstrual cycle and performance

There is no formal evidence that says “menstruation is linked to underperformance” in running, or other high endurance sports.(3)However, the hormonal increase in women’s bodies can make it more difficult for the muscles to access oxygen. Other performance measurements are mostly unaffected.

What happens in your body during PMS?

Menstruation is tied to hormonal cycles. Hormone levels drop during the first phase of menstruation, which actually occurs just before the onset of menstruation. This can cause women to have disruptive symptoms that affect certain aspects of women’s training routines. We refer to this as premenstrual syndrome (PMS).

 Symptoms can include:

  • Breast sensitivity
  • Water retention
  • Behavioral changes

Other physical signs can include:

Bone and joint pain, headaches, and digestive symptoms like nausea, constipation, or diarrhea.

Cramping during periods

Cramping is a real… pain. And cramping pertains to all the different pains that occur during menstruation.

From different studies, we know cramping affects between 30 and 50% of all women of reproductive age. This certainly applies to a large number of women runners.

Positive Effects

In good news, estrogen increases can actually have a positive effect on your energy levels, the highest point is during the ovulation phase (around day 14). For high-endurance sports, estrogen promotes energy storage in muscles, as well as the entry of glucose into muscle cells.

Tips for women runners during menstruation

Pharmaceuticals & Alternative Medicine

First and foremost, ask your doctor for advice on taking pain medication during your period. Doctors often prescribe simple pain relievers such as Tylenol, or minute doses of drugs like Ibuprofen. Aspirin increases risk of bleeding, so do not take it during your period.

You may also turn to alternative medicine treatments like homeopathy, phytotherapy, etc.


Most women athletes use contraceptives as they are intended, for birth control. However, contraceptives can be used to control menstrual cycles as well.(4)

The best advice is to talk with your doctor before changing or using a new contraceptive method. Make sure you talk about your running and training routines and get personal advice.

Adapt your training so you can continue running during periods

If you experience painful periods, or if you are more tired before or during your period, listen to your body. Don’t put yourself in a tough situation. However, if you’ve got the urge to burn off some steam, don’t hesitate to lace up.

Running during menstruation is totally possible. Its link to poor performance is not proven. The truth is that everyone experiences their period differently. It is up to each of us to adapt our training approach to our current physical and mental condition.

About the author:

Pauline Six is a sports medicine physician for Running Care. She specializes in the rehabilitation of athletes (from initial diagnosis to re-training). Pauline is a passionate runner; she competes in long distance trail running and triathlons. 


Suggested Posts