Not sure if you can exercise during your period? Here's what the experts say
Exercise may help with the cramps and Premenstrual Syndrome symptoms. But if you're into yoga inversions, spinning or HIIT, should you carry on?
Back in primary school, I couldn’t understand how my classmate Peggy could get our teacher to let her off physical education lessons. Did her mother write the PE instructor a note to excuse her every week? Did she suffer from a mysterious ailment? Whenever we asked, she’d blush and look down.
It was an ailment all right – and the mystery was solved when I hit puberty myself. It was Aunt Flo visiting and bearing unsolicited gifts of menstrual cramps and heavy periods.
Now, even as a middle-aged woman, I am still bowled over by Aunt Flo’s extravagance on some months.
“You shouldn’t have,” I’d say through gritted teeth as I curl up into a foetal position in bed from the throbbing, abdominal pain – all while worrying about the torrential blood-letting staining the sheets.
The lethargy also bothers me. There is only so much lying in bed I can do, but mustering the energy to step outside for a walk and take my mind off the cramps feels like wading through chest-deep mud.
Even if I do manage to put on my running shoes, can those feel-good exercise hormones help to counter period cramps and other menstrual symptoms?
WHY THE CRAMPS AND PERIOD FATIGUE?
First, the lowdown on menstrual cramps. Every month, hormone-like prostaglandins cause the uterus to contract and expel its lining. When prostaglandin levels are higher than usual, your cramps feel more severe, according to the Mayo Clinic’s website. Very high levels can even cause nausea and diarrhoea.
As the lining is shed, the prostaglandin levels taper off, which explains why menstrual cramps typically subside after the first few days of the period.
Endorphins help to elevate your mood, make you feel better, and does not impact the severity of the symptoms experienced during menstruation.
As for the period fatigue affecting your energy level before and during your period, it could be your fluctuating oestrogen levels. Oestrogen production rises during the first half of the menstrual cycle and drops during the second half, according to Medical News Today’s website.
As it dips, oestrogen also brings down your serotonin levels. It is this reduced level of serotonin that can lead to low mood and decreased energy levels.
The same website also noted other possible causes of period fatigue, including low iron levels (or anaemia), food cravings that lead to spikes and dips of your blood sugar levels, as well as disturbed sleep brought on by period pains and mood changes.
SHOULD YOU OR SHOULD YOU NOT EXERCISE DURING YOUR PERIOD?
My mother didn't write me an excuse letter from PE, and I haven't refrained from exercising while menstruating. Nor have I fainted from period-induced anaemia that the aunties have warned me about. But should other women follow suit?
There are some truths to the anaemia part, “especially during the first few days when the menstrual flow can be heavier”, said Dr Zhang Huipei, a family physician and one of the medical directors of Paddington Medical Clinic.
“For women who have excessive bleeding from their menstruation, this can cause not only low energy levels, but may also cause giddiness and fainting spells,” she said.
Furthermore, the low oestrogen levels when you start your menstrual cycle “can contribute to mood swings – though for some women, the irritability, anger, anxiety, depression, headaches, breast tenderness and back pain from Premenstrual Syndrome (or PMS) may get slightly better after the menstruation starts”, said Dr Zhang.
CAN EXERCISE COUNTER PERIOD BLAHS?
It is very tempting to use your period as an excuse to get out of many things, including skipping a workout or two. But should you? And what about those exercise hormones that you’ve read about? Can they help you get out of your period funk?
The endorphins or “feel-good chemicals produced by the nervous system to cope with pain or stress” might actually help you, said Dr Kevin Chua, a medical advisor with Zoey, a health digital platform for women.
“Endorphins help to elevate your mood, make you feel better, and does not impact the severity of the symptoms experienced during menstruation,” he said.
However, when it comes to strength training, you may notice “a perceptible loss in muscular strength” if you’re hitting the weights in the first few days of your period. This can be caused by the low mood or slight anaemia in women who experience excessive bleeding, said Dr Zhang.
Furthermore, muscle soreness may be more pronounced after exercising, possibly due to the “lower effect of endorphins”, she said.
Even without exercising, there are already changes in endorphin levels as a result of the menstruation cycle.
This is because endorphin levels, or more specifically, beta endorphins (there are 20 types of endorphins produced in the hypothalamus and pituitary gland), “peak 24 hours before your next period, whereupon the levels decline again”, said Dr Lee Joon Loong, who is also a medical director of Paddington Medical Clinic, citing a study published in Gynecological Endocrinology.
“Which means that even without exercising, there are already changes in endorphin levels as a result of the menstruation cycle,” said Dr Lee.
WHAT SHOULD WOMEN TAKE NOTE OF WHEN EXERCISING DURING THEIR PERIODS?
If you're keen to maintain your fitness routine during the time of the month, carry on. "There’s no scientific reason you should skip out on your workouts during your period," said Dr Chua.
In fact, it is a good idea to continue with your fitness activities – but reduce the intensity during the first few days of the menstrual cycle. “The best forms of exercise during your menstruation are the ones that you are accustomed to and enjoy participating in,” said Dr Zhang.
But what if your regular workout consists of high-intensity exercises such as CrossFit, high intensity interval training (HIIT), high-intensity spinning, or hardcore weight training? Consider temporarily swapping them for low-intensity yoga or "light to moderate aerobic activities such as brisk walking or running", recommended Dr Lee.
The above is advisable, especially if your motivation to exercise isn't high, or you're feeling lethargic or not as strong as your usual self on the first day or two of your period.
But since no two women experience the same menstrual symptoms, do what you feel is appropriate for yourself. "Exercise in moderation and do not over-exert. Listen to cues from your body and be sensible about the exercise that you choose to do," said Dr Chua.
A good tip to ease yourself into your menstrual cycle, fitness-wise, is to include gentle stretching exercises such as yoga, Pilates or tai chi before Aunt Flo visits. These exercises may be beneficial in alleviating PMS symptoms, said Dr Zhang.
But hold off yoga inversions during your period, especially if you have "a low blood count and borderline anaemia", she advised. "Doing inverted poses in any form may result in fainting spells and falls."
As your period comes to an end, by all means, resume your usual intensity. "Listen to your body and increase the level of intensity gradually," said Dr Chua.
No matter what exercise you're performing, stop when you experience giddiness, severe breathlessness, severe pain and/or the sensation of near-fainting, said Dr Lee. “See a doctor as soon as possible if these symptoms don’t self-resolve within five to 10 minutes.”
He added: “Pain is another good indicator of whether a workout is suitable. Stop when it feels too painful”.
At this point, it is also important to focus on your nutrition. Consider consuming iron-rich foods such as red meat and spinach to boost haemoglobin production, suggested Dr Lee.
And don't be embarrassed, like my classmate Peggy, to exercise while menstruating. There's nothing an effective sanitary pad, tampon or even period panties can't solve.
Nor should you feel bad for sitting out on the sidelines if your cramps just aren't cooperating with you. Do whatever feels right to you and not what some old wives' tales dictate.