How Female Hormones Affect Exercise — at Every Age

During the teenage years, the young female body has already undergone puberty, and the menstrual cycle is becoming more predictable due to monthly fluctuations in estrogen and progesterone levels (1).

What’s happening physiologically

This is an important time to be physically active. Doing so enhances bone mineral density and helps maintain a healthy balance between body fat and lean muscle mass.

Studies show that 80–90% of female bone mass is accrued by age 16, with the development of lean muscle helping to stimulate bone density augmentation (2).

Exercise recommendations

Sports and athletics provide an opportunity for growth in many areas, especially when it comes to refining physical skills, increasing strength and endurance, and establishing perseverance to exercise.

While being physically active has numerous benefits, balance is key when it comes to regular exercise and recovery.

It’s important not to overly tax the teenage body with too much intense exercise, as this can result in the loss of regular menstrual cycles, hormonal dysregulation, and a deterioration in bone density.

Adequate sleep, recovery days, hydration, and — most importantly — a healthy diet are imperative to a thriving teenage body, with food intake supporting the amount of exercise performed (in other words, no calorie restriction!) (1).

Beyond that, impact and weight bearing exercises, plyometrics, and resistance training are ideal for increasing bone mineral density (2).

These are the years that the female body is governed by its monthly opportunity for impregnation.

The menstrual cycle begins on day one of your period, with very low levels of hormones during the first half of the month. After mid-month ovulation, estrogen and progesterone begin to rise and continue to climb throughout the second half of the cycle until the next one begins (2, 3).

What’s happening physiologically

Because hormone levels are at their lowest on day one of your period, this is when your body is most resilient and ready to work hard. Following mid-month ovulation, progesterone gradually rises, increasing your body temperature, heart rate, and respiratory rate (3, 4).

Exercise recommendations

At this stage of life, it’s important to coordinate your workout intensity with your menstrual cycle.

Hormone levels are low at the beginning of the month, so this is the time to prioritize intense exercise like high intensity interval training (HIIT), plyometrics, powerlifting, heavy weightlifting, hill repeats, and other rigorous exercise, with at least 1 day of recovery between hard workouts.

Also, due to low estrogen levels during the first half of the menstrual cycle through ovulation, women are at a higher risk of anterior cruciate ligament (ACL) injuries (5).

Activities that require quick changes in direction or side-to-side cutting, including soccer or downhill skiing, should be pursued with caution during this phase, and it’s critical to mind proper knee placement during squats, lunges, jumps, and repetitive cardio.

After mid-cycle ovulation, hot exercise environments should be avoided, and moderate intensity, gentle movement is most beneficial. Great options include easy cardio, yoga, Pilates, walks, bike rides, and hikes.

The first trimester is marked by increases in progesterone, estrogen, and relaxin.

Both progesterone and estrogen levels continue to increase throughout pregnancy, with progesterone levels lessening in the last 4 weeks before labor. Relaxin reaches its highest point within the first trimester and remains present beyond birth (6).

What’s happening physiologically

The most common hormonal symptoms during the first trimester of pregnancy are increased body temperature, nausea, fatigue, and constipation.

The prenatal body also experiences an increase in blood volume of over 1 liter throughout pregnancy, and several symptoms result, including increases in respiratory rate, heart rate, and the amount of blood moving through the heart with each pump (7, 8).

Exercise recommendations

The following are exercise suggestions for uncomplicated pregnancies, but guidance from a healthcare professional is recommended before making changes to any prenatal exercise regimen.

Given a pregnant person’s increased body temperature and developing babies’ inability to dissipate heat, it’s essential to take all steps to prevent overheating (no hot yoga until after baby arrives!).

Moderate level cardio provides healthful benefits to the mother and baby, significantly decreasing your risk of birth complications, a life threatening diagnosis, and postpartum depression (8, 9).

That said, breathlessness during cardio should be avoided.

Prenatal yoga is a wonderful way to fend off lower back pain while staying mindful of the increase in your joints’ laxity.

Strength training at a low to moderate intensity can also be included in a prenatal exercise routine, with a focus on exhaling with challenging movement and bracing the belly so the abdominal muscles do not protrude out.

During childbirth, a mother’s progesterone levels fall dramatically, and as soon as the placenta has exited the body, a subsequent drop in estrogen ensues (9).

What’s happening physiologically

Because of the drastic change in hormones following childbirth, as well as the loss of sleep that comes with having a baby, those who have just given birth are at a heightened risk of developing anxiety and depression (9).

Weakness of the pelvic floor and urinary tract musculature is also very common following pregnancy, and some joint laxity may still be present due to relaxin (10).

One study showed significant knee joint laxity persisted up to 23 weeks postpartum (11).

Exercise recommendations

Weekly, moderate-level strength training and cardiovascular exercise can reduce symptoms of postpartum depression and increase energy and feelings of happiness (9).

Pelvic floor exercises inclusive of deep breathing have been proven to tone the pelvic floor and deep abdominal musculature, as well as reduce urinary incontinence (10).

Working with a physical therapist who specializes in pelvic floor physical therapy and can assess your abdominals to check for diastasis recti is often the best first step before resuming your traditional exercise routine.

A postpartum person should gradually move back into a weightlifting routine that’s thoughtful of their energy level.

It’s important to make sure that the abdominals are not being overly stressed with any kind of lifting (even picking up your baby), with a focus on an inward contraction and not pushing the abdominals out.

Furthermore, consider working out in a group to give your endorphins an extra boost. New moms who exercise in group settings have reported decreases in depressive and anxious feelings (9).

During perimenopause ovarian function declines, resulting in a decrease in estrogen and progesterone levels and subsequent menstrual cycle irregularities (12).

Menopause is considered to be the point at which a woman does not have a menstrual cycle for 12 consecutive months.

What’s happening physiologically

During the transition between perimenopause and menopause, bone density can decline rapidly, increasing susceptibility to osteoporosis and bone fractures (13).

A decrease in lean muscle and an increase in fat can lead to negative metabolic changes, including weight gain, and a higher risk of developing diabetes and heart disease.

Hot flashes, night sweats, insomnia, and depression are some of the most common symptoms at this stage of life (14).

Exercise recommendations

Resistance training and impact exercises are proven to slow declines in bone density (15).

Still, it’s important to have a workout program that also includes flexibility work — yoga, Pilates, static and dynamic stretching, and foam rolling — to prevent poor movement patterns that could compromise joint health.

Recovery days must be taken between hard workouts, especially if they include jumping or running, to avoid any overuse injuries and give your body time to adapt.

Regular cardiovascular training plays an essential role in maintaining heart health and body weight, and it can support mental health and combat sleeplessness (11).

Estrogen is very low during the post-menopausal period. As a result, there are some specific things to consider.

What’s happening physiologically

Along with being at higher risk of osteoporosis and heart disease, you may experience weight gain and muscle loss during and after menopause (16, 17).

Exercise recommendations

Moderate intensity cardio and interval training have both been shown to decrease arterial stiffness and increase aerobic fitness for women in this stage of life (18).

Combining resistance and weight bearing exercises has proven to be most effective at maintaining bone density, and these forms of training are helpful when trying to prioritize lean muscle maintenance and a healthy metabolism (19).

Balance work should also be a part of your regular exercise routine, as it helps prevent falls and lowers your risk of bone fractures.

Women of all ages can benefit from a better understanding of the intricate hormonal changes they face throughout their lives.

Exercise programs must be respectful of the hormonal symptoms of the female reproductive system, adapted appropriately to provide therapeutic and general health benefits, and ultimately give women a sense of connection to their bodies.

Alexandra Rose began her career in New York as a professional modern dancer and personal trainer. After receiving a master’s degree in exercise physiology from Columbia University, Alexandra has worked within clinical exercise settings and commercial gyms, as well as with preprofessional dancers and clients in their homes. Alexandra is a certified personal trainer and fascial stretch practitioner, providing clients of all athletic endeavors with bodywork that helps restore healthy movement patterns, improve strength and performance, and prevent overuse injuries.