Sleep plays an important role not only in recovery, but also in regulating the menstrual cycle. If we rule out pregnancy, active females, can have many factors collectively contributing to lighter or irregular menstraul cycles, all of which are important to understand but also address. Let's recap some of the most common issues that contribute to lighter or delayed periods.

Why Periods May Stop or Become Irregular

High exercise volume or intensity. When training volume or intensity increases, the body may shift priorities and redirect energy away from reproduction and toward survival and performance. In simple terms, the brain tells the ovaries to take a break and periods can become irregular, delayed, or stop altogether. A recent systematic review found that approximately 32.3% of female athletes are impacted in this way.

Nutritional factors. Low energy availability (not eating enough to match output) and restrictive eating are the most common nutritional issues which impact the cycle.  When calorie intake does not match the high energy expenditure of training, the body conserves fuel by slowing reproductive function, and hormones such as oestrogen and progesterone start to decline. While many women boast a quality nutritional profile on the surface, the calorie intake or density can still be insufficient to match the demands of the individual.

Skipping snacks or having lighter meals can easily tip athletes into the red. Prolonged energy depletion can lead to issues such as Relative Energy Deficiency in Sport. Athletes with or without an eating disorder may choose to restrict food intake during a determined window to make weight or enhance performance for a key event. This can impact body fat, hormone signalling and extend the cycle, lighten cycles or stop them altogether.

Emotional stress and anxiety

Emotional stress, travel, competition anxiety, or personal challenges can elevate cortisol and disrupt the hypothalamic-pituitary-ovarian (HPO) axis. The pressure to perform, coupled with life stressors, can compound physical strain, further suppressing hormones that regulate menstruation. Stress of any kind raises cortisol, directly suppresses the HPO axis, and reduces hormones such as progesterone, leading to missed cycles and functional hypothalamic amenorrhea. A condition where the brain suppresses reproductive function due to perceived stress or energy deficiency.

Low Iron

Iron deficiency can indirectly contribute to lighter cycles. Iron deficiency elevates cortisol and inflammatory markers and has effects on the HPO axis as explained above. Estrogen levels may then drop, especially if iron deficiency is paired with low energy availability. The cycle can then start to pitter out. Energy production can also be impacted despite meeting calorie needs.

Poor sleep and recovery habits

Sleep is when the body recalibrates its hormonal systems. During deep sleep, the HPO axis relies on stable circadian rhythms to regulate the release of gonadotropin-releasing hormone (GnRH). This hormone triggers the production of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which are essential for ovulation and menstrual regularity.

When sleep is fragmented or insufficient, cortisol levels rise, melatonin drops, and GnRH pulsatility becomes irregular, disrupting circadian rhythm and impairing ovulation. This vicious cycle contributes to irregular cycles. Poor recovery from poor sleep also dysrupts the HPO axis and cases light or missed periods.

This feedback loop can persist unless addressed through improved sleep hygiene, balanced nutrition, and structured recovery strategies.

Why It Matters

Menstrual irregularities are not just about missed periods. They can affect bone density, cardiovascular health, mood, and fertility. For sportswomen, understanding this connection is empowering. It allows for proactive choices such as adjusting training, improving nutrition, and seeking guidance when needed.

A delayed period is useful feedback. It is the body’s way of saying, “I need more care.” By listening, adjusting, and supporting our hormones, we create space for both strength and sustainability.

At Athlete Sanctuary, we believe that performance and health are not opposing forces. They are partners. If you would like to improve your report card, we are here to help.

In my hometown of Torquay, cold water therapy boomed during COVID lockdowns. Groups such as “Torquay Ocean Waders”  became conduits for community connection through ocean dipping and then coffee sipping outside the local Salty Dog café. This sense of community, based on an ethos of adventure, social connection, and a positive attitude, has grown to 1800 members in just three years, offering a supportive network for all.

The number of local female participants in this group intrigued me. I initially wondered if the group's growing popularity was more about connection than the benefits of cold-water therapy. However, over time, the scientific evidence supporting and validating the health benefits of cold-water therapy has grown, providing reassurance and confidence in its effectiveness.

Cold water therapy and menopause

The menopausal transition adds another layer of complexity to health and fitness. Hormonal changes can affect metabolism, energy levels, and body composition. Despite sound nutrition and plenty of exercise, women in this life stage often complain of central weight gain.

Over 75% of Australian perimenopausal or menopausal women will experience vasomotor symptoms (hot flushes and night sweats). Many women also experience sleep disturbances, mood changes and fatigue, as mentioned in our blog post: Help For Menopause.

Cold water therapy is linked to improvements in exercise recovery, hormonal balance, and the management of symptoms such as hot flushes associated with menopause. This knowledge empowers women to take control of their health and well-being.  Additionally, nutritional needs shift during menopause, and iron absorption can be affected by changes in gut health, stress and hormone fluctuations.  Maintaining optimal iron levels is crucial for energy, brain function, and overall vitality.  Incorporating iron-rich snacks and recipes, like those in our Iron-Rich Snacks e-recipe book, can help support your body during this transition.

Cold water therapy can offer many long-term benefits.

1. Regular exposure to cold water can help reduce inflammation.
2. In a study conducted at the University College of London, women reported cold water therapy reduced levels of anxiety, mood swings and depression.
3. Cold water therapy can improve your immunity. Following exposure to cold water, the body releases catecholamines such as epinephrine and norepinephrine, which stimulate the immune system.
4. Cold water immersion post-exercise for active women can aid muscle recovery, reduce soreness, and enhance overall physical resilience.
5. Cold water therapy has also been suggested to reduce the frequency and severity of hot flushes.
6. Regular exposure to cold water therapy may reduce cortisol levels associated with stress.
7. Exposure to cold water is a habit spreading for the selective reduction of adipose tissue, improvement in insulin sensitivity, and is popular with anti-ageing proponents.
8. Cardiovascular risk factors associated with heart disease are also reported to be reduced after just three weeks of cold-water therapy.

The evidence is clear- regular cold-water therapy holds many long-term benefits. The latest research indicates cold water therapy is also beneficial specifically for women experiencing symptoms associated with menopause.

Visit the Athlete Sanctuary for more personalised advice and resources. We support athletes in achieving their best selves through tailored strategies and a compassionate community.

Treatment commonly consists of medical and surgical therapies to remove the endometrial-like tissue. Painkillers and hormonal treatments are frequently offered to sufferers, but unfortunately, up to 50% of women will experience a recurrence of symptoms within 5 years ⁽²⁾. Many find the years before diagnosis extremely frustrating as they seek validation for their symptoms.

The exact causes of endometriosis remain unknown, however, family history, retrograde menstruation, metaplasia (conversion of normal pelvic tissue into endometriosis), alcohol intake, and early onset of periods (prior to 11 years of age) may play a role.

A third of women will be diagnosed after being unable to fall pregnant or inadvertently during an operation.

10 symptoms of endometriosis:

• Abdominal, lower back, or pelvic pain during periods
• Pain during or after sex
• Pain on going to the toilet
• Ovulation pain, including pain in the thigh or leg
• Heavy bleeding or bleeding longer than usual
• Bleeding from the bladder or bowel
• Increased abdominal bloating, constipation, and other digestion issues such as small intestine bacteria overgrowth
• Tiredness or lack of energy
• Anxiety
• Depression

Athletes and endometriosis

Endometriosis impacts athletes at all levels. Olympian Elinor Baker along with many women in sport are working to improve the awareness of endometriosis in sports. If you suffer from this condition it's likely you may be able to relate to Elinor's painful symptoms “as though someone was ringing out my organs as if they were a tea towel”. The fatigue, pain and heavy bleeding can severely impact athletes and their ability to compete and train.  It is not uncommon for athletes to miss competitions due to surgeries, muscle cramps, and debilitating pain.

Natural treatment options

Our understanding of endometriosis is deepening, and holistic treatment approaches are showing promising results. Symptom reduction and improvements in quality of life have been demonstrated through food first and a targeted treatment approach including herbal and nutritional medicines.

By reducing underlying inflammation, improving the immune response, and clearing excess estrogen, women can reduce the severity of symptoms, scarring, and formation of endometrium growths.

Dietary interventions alone have reported reductions in painful symptoms and bowel complaints in up to 75% of women. Increased consumption of essential fatty acids, antioxidants, and a combination of vitamins and minerals have also been shown to have positive effects on endometriosis-associated symptoms. Other nutraceuticals such as resveratrol may improve endothelial wound healing while phytochemicals such as Diindolylmethane (DIM) or calcium-D-glucarate may help support clearance of excess estrogen and relieve pain associated with periods in sufferers of endometriosis.

Our seed cycling blog describes the benefits of using seeds to maintain healthy hormones. purchase your seeds for your cycle here

It can be reassuring to know that with the right self-care and a holistic approach to health, you can continue to achieve life goals and sporting success.  An early diagnosis and understanding of your condition may result in better management of your symptoms.

About the Author: Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit https://athletesanctuary.com.au/kate-smyth

References

Endometriosis in Australia: prevalence and hospitalizations. VIEW

Hickey M, Ballard K, Farquhar C. Endometriosis BMJ 2014; 348:g1752 doi:10.1136/BMJ.g1752

Hui, E., & Nap, A. (2020). The effects of nutrients on symptoms in women with endometriosis: a systematic review. Reproductive BioMedicine Online, 41(2), 317-328. https://www.sciencedirect.com/science/article/abs/pii/S147264832030225X

Marziali M, Venza M, Lazzaro S, et al. Gluten-free diet: a new strategy for management of painful endometriosis related symptoms? Minerva Chirurgica. 2012 Dec;67(6):499-504. http://europepmc.org/article/med/23334113

Moore, J. S., Gibson, P. R., Perry, R. E., & Burgell, R. E. (2017). Endometriosis in patients with irritable bowel syndrome: the specific symptomatic and demographic profile, and response to the low FODMAP diet. Australian and New Zealand Journal of Obstetrics and Gynaecology, 57(2), 201-205. https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/ajo.12594 

Jean Hailes www.jeanhailes.org.au

Oregon State University (2022).Resveratrol www.https://lpi.oregonstate.edu

Endometriosis Australia www.endometriosisaustralia.org 

BBC Sport www.bbc.com/sport/56276626 

If you’re training hard, but don’t feel like you’re improving your athletic performance, then enriching your gut health through choosing the best probiotics to complement your gut microbiome could be the missing ingredient.

What are probiotics?
Probiotics are live microorganisms, mainly bacteria, and yeasts, that naturally reside in your gut (microbiome) and convey a health benefit. Your microbiome typically contains over 1000 different organisms, both beneficial and pathogenic.

Because a healthy gut microbiome strengthens your immune system and enhances your recovery from fatigue and overtraining, taking care of your gastrointestinal system is vital. This will enhance your general health and help to improve your athletic performance.

We consume probiotics via gut-friendly fermented foods such as yogurt, kefir, kimchi, kombucha, and sauerkraut, and commercially produced supplements.

Probiotics shouldn’t be confused with prebiotics. Prebiotics are carbohydrates and fibres such as inulin and other fructo-oligosaccharides found in foods like artichoke, bananas, and asparagus. The microorganisms in your gastrointestinal tract use prebiotics as fuel.

Supplements called ‘synbiotics’ contain both prebiotic molecules and probiotic organisms.² Synbiotics offer a dual-action strategy for even greater health benefits. A diet rich in pre and probiotic foods support your gut to develop a robust immunity.

Understanding probiotics for runners

As the popularity of ‘gut health’ supplements for athletes increases, a basic knowledge of the assortment of beneficial probiotics in your supplement is helpful.

Probiotics are classified by their unique microorganism strain, which includes the genus, species, subspecies (if applicable), and an alphanumeric strain designation.

The seven core probiotic genera are Lactobacillus, Bifidobacterium, Saccharomyces, Streptococcus, Bacillus, Enterococcus, and Escherichia.

Lactobaccillus rhamnosus, Lactobaccillus acidophilus, and Saccharomyces boulardii are common commercially produced probiotic and yeast species. This ‘probiotic tree’ diagram highlights several commercially available probiotic strains.

Research on specific probiotic strains has expanded our knowledge of the health benefits and targeted treatments of probiotics for athletes. However, probiotic supplementation may not be appropriate or necessary for all athletes.

Probiotics for Runners

Certain probiotic species impart significant anti-inflammatory effects within your gut. In particular, Lactobacillus strains produce lactate, which is then converted into short-chain fatty acids by your gut bacteria. Butyrate is a pivotal short-chain fatty acid for intestinal homeostasis due to its anti-inflammatory properties and beneficial effects on intestinal cells, gut barrier function, and permeability.

Over thirty years of research supports the widespread use of Lactobacillus rhamnosus GG (LGG) for common gut-related issues such as diarrhoea, antibiotic use, infections, e.g., Clostridium, irritable bowel syndrome, inflammatory bowel disease, respiratory tract infections, and allergies in athletes.

Studies also show certain probiotics can improve vitamin D levels in athletes.

LGG along with L. acidophilus, and B. bifidum improve exercise-induced gastrointestinal symptoms. In fact, almost 60%of runners and endurance athletes who train intensely experience gut microbiome upsets and unwanted symptoms. Probiotics offer relief by supporting immune function and intestinal cell proliferation and function, as well as shortening the duration of gastrointestinal symptoms.⁵

Probiotic strains interact favourably with other probiotic species in the microbiome to improve the overall balance and composition of beneficial bacteria in your gut. For example, Lactobacillus fermentum (PCC) can increase the Lactobacillus genus seven-fold after 11 weeks of supplementation.

Probiotic supplements can help regulate blood sugar levels and maintain energy for training and performance. Also, yeast probiotics such as Saccharomyces cerevisiae are widely used to suppress the overgrowth of Candida or thrush fungal infections.

Lastly, new research demonstrates that probiotics can enhance sports performance. Runners taking Bifidobacterium longum (OLP-01) for five weeks significantly increased their running distance in a timed test. Bifidobacterium longum (OLP-01) also provided other health benefits such as increasing the abundance of gut microbiota in the runners.

There are a few final points to keep in mind before you add probiotics to your diet.

First, the quality of your probiotic supplement may vary significantly. Be careful about your choices as the label "probiotic" doesn't necessarily mean this option will be suitable for your microbiome.

Second, a probiotic combination or an inappropriate supplementation duration may exacerbate unwanted symptoms in some situations. Therefore, it’s vital to consume high-quality, well-characterised live probiotics that deliver a therapeutic dose over an effective length of time.

Finally, the best probiotics for endurance athletes are selected case by case to improve your performance, recovery, immune and gut health. Be sure to seek professional advice for the most suitable probiotic therapy for your training and health circumstances.

Unsure if a probiotic supplement could help you?
Speak with Athlete Sanctuary’s sports naturopath and nutritionist about your health and sports performance goals today.

About the Author: Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit https://athletesanctuary.com.au/kate-smyth

References

1. Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, et al. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol 2014;11:506-14.
2. World Gastroenterology Organisation. Probiotics and prebiotics. 2017.
3. Capurso, L. (2019). Thirty years of Lactobacillus rhamnosus GG: a review. Journal of Clinical Gastroenterology, 53, S1-S41. doi: 10.1097/MCG.0000000000001170
4. Leite, G. S., Student, A. S. R. M., West, N. P., & Lancha Jr, A. H. (2019). Probiotics and sports: A new magic bullet? Nutrition, 60, 152-160. https://doi.org/10.1016/j.nut.2018.09.023
5. Salarkia, N., Ghadamli, L., Zaeri, F., & Rad, L. S. (2013). Effects of probiotic yogurt on performance, respiratory and digestive systems of young adult female endurance swimmers: a randomized controlled trial. Medical Journal of the Islamic Republic of Iran, 27(3), 141. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3917487/
6. West, N. P., Pyne, D. B., Cripps, A. W., Hopkins, W. G., Eskesen, D. C., Jairath, A., ... & Fricker, P. A. (2011). Lactobacillus fermentum (PCC®) supplementation and gastrointestinal and respiratory-tract illness symptoms: a randomised control trial in athletes. Nutrition Journal, 10(1), 1-11. https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-10-30
7. Gaziano, R., Sabbatini, S., Roselletti, E., Perito, S., & Monari, C. (2020). Saccharomyces cerevisiae-based probiotics as novel antimicrobial agents to prevent and treat vaginal infections. Frontiers in Microbiology, 11, 718. https://doi.org/10.3389/fmicb.2020.00718
8. Lin, C. L., Hsu, Y. J., Ho, H. H., Chang, Y. C., Kuo, Y. W., Yeh, Y. T., ... & Lee, M. C. (2020). Bifidobacterium longum subsp. longum OLP-01 Supplementation during Endurance Running Training Improves Exercise Performance in Middle-and Long-Distance Runners: A Double-Blind Controlled Trial. Nutrients, 12(7), 1972. doi:10.3390/nu12071972 
9. Probiotic professionals

Sporting clubs, associations, and teams such as Australia Triathlon, AFL teams, USA Triathlon, Ironman US, USA Track and Field,  British Gymnastics, Belgian Cycling, American Cycling, USA Hockey, Ireland Hockey, and the Boston Ballet are just some of the crew ahead of the curve using Normatec recovery.

We have been so impressed with Normatec recovery we've made it accessible to athletes of all levels through our exclusive hire service. We also sell the Normatec recovery systems to those who like to take their training and recovery a bit more seriously.

What is Normatec?

Normatec is an evidence-based recovery system with proven results and research supporting its claimed benefits.

Normatec is a form of active compression therapy (peristaltic pulse dynamic compression) with a sophisticated massage pattern. Studies show reduced muscle soreness and fatigue, enhanced blood flow to the treated areas, decreased inflammation, improved clearance of waste products, and increased range of motion. Studies also demonstrate that the peristaltic compression process may deliver positive adaptive responses to exercise and improve artery endothelial function systemically, making it useful for individuals with circulation and lymphatic drainage issues.

Normatec Recovery boots can also be used post-surgery and to enhance injury recovery.

Key benefits of Normatec recovery

1. REDUCES PAIN: Journal of Strength and Conditioning 2015  - dynamic compression may accelerate and enhance recovery by reducing muscle tenderness from pressure stimuli.

2. INCREASES RANGE OF MOTION:  Journal of Strength and Conditioning 2014 -Peristaltic pulse dynamic compression rapidly enhances acute range-of-motion with less discomfort and time and has been shown to be more

3. REDUCES DOMS (DELAYED ONSET MUSCLE SORENESS), PAIN, and SWELLING: Journal of Athletic Training 2016  - a 30-minute treatment of pulse compression increases blood flow in the lower extremity, making Pulse compression a viable option in the management of exercise-induced muscle damage (DOMS). In general, DOMS-related swelling, range of movement limitations, and pain ratings were lower and returned to baseline faster while using NormaTec when compared to continuously-worn compression sleeve options  International Journal of Exercise Science 2018.

4.DECREASES MUSCLE FATIGUE AFTER ACUTE EXERCISE: PLOS One Medical Journal 2017. External pneumatic compression increases flexibility and reduces select skeletal muscle oxidative stress and proteolysis markers during recovery from heavy resistance exercise.

5. PASSIVELY CLEARS WASTE AND METABOLITES FROM BODY: Journal of Athletic Enhancement 2013 This form of compression significantly lowers blood lactate concentrations when compared to a passive recovery group.

6. IMPROVES ENDOTHELIAL FUNCTION: European Journal of Applied Physiology 2015. A single bout of peristaltic pulse compression improves artery endothelial function systemically and improves blood flow in the compressed limbs.

7. IMPROVES EXERCISE ADAPTATION AND GENE EXPRESSION: Journal of Experimental Physiology 2015. A 60-minute bout of whole-leg, peristaltic pulse compression transiently upregulates PGC-1α mRNA, while also upregulating eNOS protein and NOx concentrations in biopsy samples.

Clinical Physiology & Functional Imaging 2016. Peristaltic pulse compression may upregulate rps6 and downregulate Stat1, which may facilitate positive adaptive responses to exercise.

8. ENHANCE LYMPHATIC SYSTEM FUNCTION: Journal of Strength and Conditioning Research  Muscle stiffness, tenderness, strength loss, and oedema have been linked to exercise-induced muscle microtrauma.  Enhancement of lymphatic flow and clearance of waste may accelerate recovery.

"A goal of dynamic compression is to reduce lymphatic obstruction and thereby enhance the removal of the protein- and debris-rich fluid that accumulates in the interstitial spaces after exercise-induced inflammation". Maintaining an anti-inflammatory diet can also speed up your recovery time. Ginger is one natural remedy that may help reduce inflammation. Read our blog on how easy it is to use ginger.

Normatec features

• Individualised programs for rehab, recovery, and injury treatment to suit your needs.
• Normatec can be set to focus on key problem areas of the body such as the quads or calves through a “zone boost” allowing extra attention where needed. There is also an option to deactivate zones of the body.
• Setting can be set to varied pressures to suit you and your comfort
• Portable in a durable case, battery powdered for remote use, and lightweight
• Versatile- single control unit is compatible with leg, arm, and hip attachments. The calibration phase ensures a personalised fit for all body types.
• Super easy to use- set up takes less than a minute, giving you more time to relax
• Made from highly durable material
• The Normatec app allows you to integrate Normatec use seamlessly with your training plan

HOW TO USE NORMATEC 

Typically, 20-30 minutes once a day is sufficient for most athletes. Athletes in heavy training may consider using it after each training session.

Normatec boots and hip attachments are popular with athletes preparing for and recovering from events. Committed athletes use the system daily as an ongoing recovery tool.

Normatec Hire - TRY BEFORE YOU BUY

Normatec Pulse 2.0 boots (upper and lower legs and feet) are available for hire from our Torquay clinic. Take a look at our Normatec Hire and Purchase page for more information.

BUY YOUR NORMATEC RECOVERY SYSTEM:

*Normatec pants 3.0 includes compression for the legs, ankles, and feet

*Normatec lower leg (includes attachments for the feet, ankles, legs, and hips)

*Normatec Full Body Recovery System - includes attachments for the legs, ankles, arms, and hips for the ultimate recovery experience

*Normatec Arms - great for swimmers, rowers, adventure racers and canoeists

*Normatec Hips- a great addition to the lower leg attachment

We recommend purchasing a Normatec carry case or backpack to keep your Normatec protected, and secure during transport and at home.

Visit the Athlete Sanctuary online shop to view the Normatec recovery systems we stock.