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Last month, on the day my period started, I had a few cramps, felt a little bloated, was slightly irritable, and noticed a lovely little pimple just to the left of center on my forehead. On most days, making all that go away (except the pimple) would be as easy as going out for a run. But on that day, lacing up my sneakers was too daunting. I felt exhausted, and gearing up for a workout seemed incredibly difficult. So I skipped the run—and didn’t feel better until the next day.

Why So Tired?

I didn’t think much about why I felt too tired to exercise that day, but if you have ever experienced something similar, there may be an explanation. A study from the University of Adelaide in Australia suggests that the phenomenon is quite real and probably related to hormone levels, which vary dramatically throughout the course of the menstrual cycle.

According to the study, exercise is most difficult from approximately three days prior to beginning the menstrual period to ovulation. During this time, two of the principle menstrual cycle hormones, estrogen and progesterone, are low.

Researchers believed that these hormones may influence the body’s energy metabolism at rest and during exercise. They suggested that when these hormone levels are low, women may end up contending with more waste products—such as lactic acid and carbon dioxide—from the metabolic consumption of carbohydrates. This can contribute to muscle soreness and premature fatigue.

Testing Their Theory

In the study, a group of women went through the same exercises at different points during their menstrual cycles. Although the women completed the same exercise test in both phases of the menstrual cycle, the exercise test conducted at the beginning of the month took longer to complete and the women reported feeling more physically and mentally fatigued at this time point.

Exercise Could Help (If You Weren’t So Tired)

The fact that hormone levels may lead to difficulty with exercise during the menstrual period is unfortunate. Exercise is a good remedy for the symptoms many women encounter before and during their periods. Exercise can improve your mood, increase your metabolism, and help reduce bloating. In addition, the American College of Obstetricians and Gynecologists advises women to exercise to help alleviate menstrual cramps.

According to the 2008 Physical Activity Guidelines for Americans, all adults need at least 150 minutes of moderate intensity aerobic physical activity each week, which amounts to 30 minutes a day.

What About Your Diet?

If period fatigue is in fact a result of low levels of estrogen and progesterone leading to poor metabolism of carbohydrates, then limiting your intake of simple carbohydrates like refined sugars just before and during your period may help combat the fatigue. Also, limiting salt may help reduce bloating and limiting caffeine might help with irritability.

There are also nutritional supplements that may help with premenstrual syndrome symptoms:

  • Calcium can reduce pain, cramping, and mood swings
  • Magnesium can reduce headache, fluid retention, and mood changes
  • Vitamin E can help with breast tenderness

Talk to your doctor before you begin taking any vitamins or supplements.

Medication May Help

Every woman's menstrual cycle is different. Track your symptoms over time to learn your specific patterns and share them with your doctor if you are concerned. If you have severe symptoms and fatigue before and during your period, even after incorporating lifestyle changes, there are medications that might help. Talk to your doctor about your options.

Resources:

American Congress of Obstetricians and Gynecologists
http://www.acog.org

American College of Sports Medicine
http://www.acsm.org

CANADIAN RESOURCES:

The Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org

Women's Health Matters
http://www.womenshealthmatters.ca

References:

2008 physical activity guidelines for Americans. US Department of Health and Human Services website. Available at: http://www.health.gov/paguidelines/default.aspx. Accessed July 23, 2014.

Calcium. Office of Dietary Supplements website. Available at: http://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/. Updated November 21, 2013. Accessed July 23, 2014.

Premenstrual syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 8, 2014. Accessed July 23, 2014.

Redman L. Effects of phase of the menstrual cycle on exercise capacity in young, sedentary women. European College of Sport Science Annual Conference. Athens, Greece; July 2002.

Vitamins and supplements for menstrual relief. Epigee website. Available at: http://www.epigee.org/vitamins.html. Accessed July 23, 2014.

Your first period. The American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq049.pdf?dmc=1&ts=20120830T1947542351. Updated December 2012. Accessed July 23, 2014.



Last reviewed July 2014 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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