Structuring Your Running Programme Around the Menstrual Cycle

A Smart Approach to Performance & Injury Prevention

When working with female runners, it’s becoming increasingly evident that structuring training around the monthly hormonal cycle provides an optimal framework that supports performance, recovery and injury-prevention. As female participation in running continues to rise, understanding how the phases of the menstrual cycle influence neuromuscular control, ligament stiffness, fatigue and recovery is key.

Why the menstrual cycle matters for running and injury risk

The typical 28-day cycle is divided into roughly the menstrual phase (bleeding), the follicular phase (from end of bleed to ovulation), the ovulatory phase, and the luteal phase (post-ovulation until the next bleed). Hormones (primarily oestrogen and progesterone) fluctuate significantly and do more than modulate reproduction: they affect connective tissue laxity, neuromuscular control, fatigue, and recovery. This has been shown to create greater risk for injury, for instance:

• A four-year study of elite footballers found muscle/tendon injuries in the late follicular phase were 88% greater than in the early follicular phase.

• A study of team sport athletes reported that 78.4 % of injuries occurred during the luteal phase, especially joint/ligament (88.4 %) and muscle/tendon (71.4 %) injuries.

• A systematic review found that a clear association between some menstrual phases and higher musculoskeletal injury risk among female athletes.

• 65% of female long-distance runners experience menstrual irregularity, compared to just 2-5% of the general population. A study found endurance runners with absent menstrual cycles had a 2.25x greater incidence rate of bone stress injuries compared to those with regular cycles.

  
  

Why might certain phases carry higher injury risk? Several mechanisms are suggested:

• During the late follicular phase, oestrogen peaks, and oestrogen has been shown to reduce connective-tissue stiffness and increase ligament laxity (for example in the ACL context via hormone relaxin).

• In the luteal phase, increased progesterone and associated changes (such as increased fatigue, poorer sleep, fluid retention) may reduce neuromuscular coordination and prolong recovery.

• Hormonal fluctuations may influence ligament and tendon micro‐structure, muscle contractility, and motor control – all of which mean that the load a runner tolerates safely may vary across the cycle.

In short: tailoring a running programme to recognise these variations can help optimise performance, manage fatigue and reduce injury risk for female runners.

How to structure your running programme around cycle phases

Here is an example 4-week plan (for those with a roughly 28-day cycle) – always individualise based on your individual cycle length, any hormonal contraception, symptoms, training goals and history.

Phase	Approximate Days*	Hormones & Physiology	Training Focus
Menstrual Phase (bleeding)	Days 1-4	Low oestrogen/progesterone; possible cramps, fatigue, altered sleep.	Light aerobic runs (easy pace); focus on recovery, mobility, core and body weight strength work. Avoid high volume and listen to your symptoms.
Early Follicular Phase	Days 5-10	Rising oestrogen; improved energy, neuro-muscular readiness	Gradually increase volume; include moderate runs, technique drills, stability-based strength work (Single leg work, glute strengthening, core).
Late Follicular / Ovulation	Days 11-15	Peak oestrogen; potential ligament laxity; high neuromuscular capacity	Optimal time for: tempo runs, intervals, hills– BUT be cautious of sudden load spikes (given documented higher injury risk). Ensure warm-up and strength/resistance training to support connective tissues.
Luteal Phase	Days 16-28	Progesterone dominates; increased fatigue; possible sleep/energy dips; coordination may reduce	Keep moderate runs, reduce high‐impact or very high volume. Emphasise maintenance aerobic running, mobility, cross-training, and strength. In last 1-2 days before next period, prioritise recovery and lower volume.

Example weekly micro-plan (for a recreational runner, 4-week block)

• Week 1 (Menstruation/early follicular): 3 easy runs (30-40 min), 2 mobility/strength sessions (bodyweight, core, yoga). Swap runs for gentle walks if this feels better.

• Week 2 (Mid-follicular): 1 tempo run (e.g., 20 min at steady moderate pace), 1 interval session (e.g., 5×3 min hard/2 min easy), 2 easy runs, 1 strength session (moderate load, technique focused: Single leg RDL, Step-ups, Lunges, Glute Bridges).

• Week 3 (Late follicular/ovulation): 1 interval run (e.g., 6×4 min hard/2 min easy), 1 hill session, 2 moderate runs, 1 strength session with heavier loads than week 2 (Squats, Deadlifts, Upper Body, Plyometrics).

• Week 4 (Luteal): 2 moderate aerobic runs, 1 easy run, 2 strength/mobility sessions (lighter load, focus on stability), optional cross-training (bike/swim), reduce volume and take additional rest days if needed.

Summary & take‐homes

By aligning the running programme with the menstrual cycle, you help the runner:

• Make use of phases of higher physiological readiness (follicular) for sharper, more effective sessions.

• Mitigate injury risk by reducing high‐load spikes during vulnerable times (late follicular & luteal).

• Support recovery and neuromuscular function when hormones may reduce energy levels and coordination (luteal).

• Maintain consistency, rather than going “all out” every week and risking overload.

It is encouraged to track your cycle (bleeding, ovulation symptoms, fatigue, sleep, soreness) and note running performance/injury or niggles alongside. This can be used as a guide to make load adjustments to your training. Emphasise warm-up, strength (especially hip/glute/hamstring/core), and consistent rest and recovery. A cycle-aware running plan allows for greater longevity in training, reduced injury risk, and supports long-term performance and health.

References

Martin, D., Timmins, K., Cowie, C., Alty, J., Mehta, R., Tang, A., & Varley, I. (2021). Injury Incidence Across the Menstrual Cycle in International Footballers. Frontiers in Sports and Active Living, Vol 3. https://doi.org/10.3389/fspor.2021.616999

Fort-Vanmeerhaeghe, A., Pujol-Marzo, M., Mila, R., Campos, B., Nevot-Casas, O., Casadevall-Sayeras, P., & Pena, J. (2025). Injury Risk and Overall Well-Being During the Menstrual Cycle in Elite Adolescent Team Sports Athletes. Healthcare, 13(10) 1154. https://doi.org/10.3390/healthcare13101154

Martinez-Fortuny,  N., Alonso-Calvete, A., Da Cuna-Carrera, I., & Albalo-Nunez, R. (2023). Menstrual Cycle and Sport Injuries: A Systematic Review. International Journal of Environmental Research and Public Health, 20(4), 3264. https://doi.org/10.3390/ijerph20043264

Parker, E. A., Duchman, K. R., Meyer, A. M., Wolf, B. R., Westermann, R. W. (2024). Menstrual Cycle Hormone Relaxin and ACL Injuries in Female Athletes: A Systematic Review. Iowa Orthopaedic Journal, 44(1), 113-24. PMID: 38919370.