woman running with hands in the air and smile

Have you ever felt a pounding headache after a long run, leaving you drained and discouraged? If so, you’re not alone. Dehydration headaches are a common ailment among endurance runners, and they can significantly impact your performance and enjoyment of the sport.

According to a study published in the Journal of Athletic Training, up to 91% of endurance runners experience dehydration during a training session or competition. Additionally, research from the American Migraine Foundation suggests that dehydration is a known trigger for headaches in female athletes, affecting them more frequently than their male counterparts.

Understanding the link between dehydration and headaches is essential for optimising your performance and overall well-being as an athlete.

What causes dehydration? 

Dehydration occurs when your body loses more fluids than it takes in, leading to an imbalance of electrolytes and a range of symptoms, including headaches. When you engage in endurance activities like running, cycling and long hikes, especially in hot or humid conditions, the risk of dehydration significantly increases.

Why does dehydration affect women more than men?

The answer lies in the complex interplay between hormones and hydration levels in the female body.  Recent research has revealed that women’s hormones, particularly estrogen and progesterone, can affect fluid balance and susceptibility to dehydration.

Estrogen and fluid balance

Estrogen plays a significant role in regulating fluid balance. Studies have shown that estrogen can affect how the body retains and excretes fluids, leading to fluctuations in hydration levels throughout the menstrual cycle. During the follicular phase in the first half of the menstrual cycle, estrogen levels rise, promoting fluid uptake. Higher oestrogen may reduce the risk of dehydration and associated symptoms, such as headaches, during this phase.

Progesterone and fluid excretion

On the other hand, the luteal phase, which occurs in the second half of the menstrual cycle, is characterised by higher levels of progesterone. Progesterone has diuretic properties and promotes fluid excretion from the body. As a result, women may be more prone to dehydration and electrolyte imbalances during this phase, increasing their susceptibility to headaches.

The impact of hormonal changes

Hormonal changes associated with menstruation, pregnancy, and menopause can also impact fluid balance and hydration status in women. For example, menstrual bleeding leads to the subtle loss of blood and fluids, increasing the body’s demand for hydration. Studies show regular adequate water intake can alleviate the severity of period pain, shorten the length of menstrual bleeding and reduce the average number of pharmacological pain medications required during menstruation. Pregnant women experience significant shifts in fluid distribution and metabolism to support fetal development. In contrast, menopausal women may experience changes in thirst perception and kidney function, affecting their ability to maintain optimal hydration levels.

The effect on athletic performance

The implications of these hormonal fluctuations extend beyond mere discomfort; they can significantly impact athletic performance and overall well-being. Dehydration impairs physical performance and affects cognitive function, mood, and thermoregulation. Therefore, female athletes should consider adjusting their hydration strategies to accommodate their unique hormonal profiles and menstrual cycles.

Tips to mitigate dehydration headaches

So, how can female athletes mitigate dehydration headaches? Here are some practical tips:

  1. Track Your Menstrual Cycle: Keep a menstrual calendar to identify patterns in fluid retention and dehydration throughout your cycle. Adjust your hydration plan accordingly, increasing fluid intake during the luteal phase to compensate for increased fluid loss.

  2. Increase Fluid Intake: Be proactive about staying hydrated, especially during hormonal fluctuations. Aim to drink at least 2-3 litres of fluid daily, and increase your intake during intense training sessions or hot weather conditions. Fluid can include water, milk, juices, teas, soups, broths… anything liquid. But what about coffee? As it has a directive effect, I suggest a cup accounts for ½ cup of fluid in your daily tally. We have provided additional details in our blog Hydration the Key to Peak Performance.

  3. Focus on Electrolytes: Electrolytes such as sodium, potassium, and magnesium play a vital role in hydration and muscle function. Incorporate electrolyte-rich foods into your diet to maintain electrolyte balance and prevent dehydration-related headaches. Use sports drinks or electrolyte supplements during prolonged exercise to replenish lost minerals. Foods such as bananas, avocados, and leafy greens are excellent sources of potassium, magnesium, and other essential minerals. We promote magnesium for bone health in another one of our earlier blogs.

  4. Listen to Your Body: Pay attention to thirst cues and early signs of dehydration, such as dry mouth or dark urine. If you experience a headache during exercise, take a break, hydrate, and rest before resuming your activity. Watch out for other signs of magnesium deficiency, such as muscle cramping, restless legs at night, sleep issues, anxiety or menstrual cramps.
  5. Avoid too much caffeine. Caffeine stimulates your kidneys to produce more urine when you drink coffee, leading to increased bodily fluid loss. As a result, frequent consumption of coffee without adequate fluid intake can disrupt your body’s hydration balance. Ironically, in some cases, coffee can help relieve a headache, but too much coffee on a hot day, along with strenuous exercise, can lead to a dehydration headache.

Overall, moderation and balance are key in coffee consumption and hydration. Enjoy your coffee as part of a balanced diet and lifestyle. However, prioritise adequate fluid intake to support your overall health and well-being, especially if you’re an endurance runner or enjoy other strenuous physical activity.

Understanding how women’s hormones impact dehydration can minimise the risk of dehydration headaches. Remember, hydration is not just a quenching thirst; it’s a vital component of athletic success and longevity.

Get in touch to learn more and start your journey today.


Casa, D. J., et al. (2015). National Athletic Trainers’ Association Position Statement: Fluid Replacement for the Athlete. Journal of Athletic Training, 50(9), 986-1000.

Munger, B. L., et al. (2018). Female Athlete Headache: A Review of the Literature. Current Pain and Headache Reports, 22(9), 62.

Montain, S. J., et al. (2007). Hypohydration Effects on Endurance Exercise Performance and Physiological Responses: A Meta-Analysis. Medicine and Science in Sports and Exercise, 39(5), 843-849.

Mauskop, A., & Varughese, J. (2012). Why all migraine patients should be treated with magnesium. Journal of Neural Transmission, 119(5), 575-579.

Sawka, M. N., et al. (2015). American College of Sports Medicine Position Stand. Exercise and Fluid Replacement. Medicine and Science in Sports and Exercise, 39(2), 377-390.

Torkan, B., Mousavi, M., Dehghani, S., Hajipour, L., Sadeghi, N., Ziaei Rad, M., & Montazeri, A. (2021). The role of water intake in the severity of pain and menstrual distress among females suffering from primary dysmenorrhea: a semi-experimental study. BMC Women’s Health, 21, 1-9.

Zalcman, B., et al. (2020). The Impact of Dehydration on Cognitive Performance and Mood in Female University Students. International Journal of Environmental Research and Public Health, 17(2), 559.

Woman athlete running with her arms above her head

Let’s face it, pacing is a challenge that most marathoners have grappled with at some point. In fact, a 2021 study revealed that 17% of women and 28% of men tend to “hit the wall” during a marathon.    This struggle is not limited to specific ability levels or age-groups, making it a common hurdle for all of us.

As a fellow marathoner, I’ve had my fair share of pacing struggles. Many of my earlier marathons were approached with a “go for broke” mindset, only to find myself dropping off my initial pace by over 30 seconds per kilometre in the later stages of the race. The final kilometres were a grind to keep my legs moving in the right direction. I understand the frustration and the many factors that can impact your ability to hold a consistent pace for the full 42.2kms.

Inadequate carbohydrate intake and glycogen depletion, dehydration, mindset and mental focus, physiological issues such as gastrointestinal issues or cramping and pacing strategies (or lack thereof) are all factors that can influence your finishing time.

With the right approach and understanding, you can optimise your pacing strategy and run the race of your life.

A well-paced runner outperforms those who start too fast or too slow.

In part one of this blog we explore your target pace using marathon pacing calculators, adjusting pace for race conditions and negative split concepts.

Understand Your Target Pace:

Before embarking on your marathon journey, it’s essential to have a clear understanding of your target pace. Utilise a marathon calculator to determine the pace required to achieve your desired finishing time. By knowing your target pace, you can establish a realistic pacing strategy and avoid starting too fast, which can lead to early fatigue. Some of our favourite marathon pacing calculators include Strava’s Race Pacing Guide and Garmin Connect’s Race Predictor.  Both provide a convenient way to gauge your fitness level and plan your pacing accordingly.

Estimating your target pace will be influenced by your overall health, level of fitness and experience, race conditions, and the marathon course itself. I have always found it useful to base my race pace on the feedback from key long runs and marathon-specific sessions.

Understand the conditions and racecourse:

Studying the racecourse, including undulations and likely race conditions, is always recommended to build confidence in your race pacing strategy. Going over the course prior to race day can be helpful, but if this isn’t possible, seek out videos of the course from previous years and speak to runners who have completed the course.

Practice Negative Splits:

One effective pacing strategy for marathon runners is to aim for negative splits, where the race’s second half is faster than the first. Research published in the International Journal of Sports Physiology and Performance suggests that runners who implement a negative split strategy often achieve faster overall race times and experience fewer performance declines late in the race.

By starting conservatively and gradually increasing your pace, you can conserve energy for the later stages of the marathon, enabling you to finish strong. Don’t forget to consider potential congestion in the first 5km if competing in a big city marathon.  Negatively splitting long runs can be a useful way to practice this strategy. Generally speaking, if you are competing in a flat marathon with limited wind, aim to run the second part of the race 1-2 minutes quicker than the first half.

At the Athlete Sanctuary, we encourage our athletes to listen to their bodies, trust their training, and embrace the journey toward becoming stronger, more resilient athletes.

Whether you’re a seasoned marathoner or preparing for your first race, prioritising pacing can make all the difference in your marathon experience. If you are keen to better understand how to enjoy the thrill of crossing the finish line strong, contact us to discuss your next marathon goal.



Oficial-Casado, F., Uriel, J., Perez-Soriano, P., & Priego Quesada, J. I. (2021). Effect of marathon characteristics and runners’ time category on pacing profile. European Journal of Sport Science, 21(11), 1559-1566.

Renfree, A., & Gibson, A. S. C. (2013). Influence of different performance levels on pacing strategy during the Women’s World Championship marathon race. International journal of sports physiology and performance, 8(3), 279-285.

Photo of a female athlete kneeling down on the ground as she is exhausted.

Training fasted involves exercising without food and/or energy drinks for a period of time. The most common fast lasts for 8/12 hours or extended to 16 hours as an overnight fast. During this period, we tap into fat stores in the form of ketone bodies and stored glycogen.

Runners often train fasted unconsciously as a morning run or gym session before breakfast.

This practice has gained popularity due to its potential effects on fat loss, and overall performance. However, it also comes with its share of pros and cons and is not for everyone. Here’s a list of some of the potential pros and cons:

Pros of Training Fasted:

Weight management: Training fasted may increase the body’s reliance on using stored fat for energy. Over time this aids fat loss and contributes to the maintenance of lean muscle mass, beneficial body composition and weight management.

Weight management: Reduced body fat, contributes to the maintenance of lean muscle mass and beneficial body composition. This can be beneficial for athletes competing in weight categories or sports dependant on body composition such as body sculpting.

Insulin Sensitivity: It can improve insulin sensitivity. When you do eat after exercise, the body absorbs nutrients more efficiently, which is beneficial for overall health and weight management. This assists with blood sugar control, energy levels and management of insulin resistance and diabetes.

Hormonal Responses: Training fasted can lead to increases in human growth hormone (HGH) key to muscle growth. Muscle growth is important to athletes in strength and body sculpting related sports.

Metabolic Adaptation: Proponents will argue that training fasted makes them more efficient at using fat stores for energy. In recent times the belief has gained traction in the endurance running community (especially ultra running).

Cons of Training Fasted:

Performance Impairment: Fasting and then training can lead to decreased performance, especially for high-intensity workouts. Without readily available carbohydrates athletes experience lower energy levels during and post exercise. Recovery, strength, and endurance are also impaired.

A recent review of 46 studies concluded eating before exercise prolongs aerobic performance. The debate becomes clouded in practice as endurance athletes can feel ok during low-to-moderate intensity training when training fasted. A runner can feel good on an easy 6km recovery run but rubbish doing 1km reps.

Muscle Breakdown: Training fasted could potentially lead to increased muscle breakdown due to the lack of readily available energy sources. This is detrimental to muscle gain and repair.

Hydration and Electrolyte Imbalance: Fasting can lead to dehydration and electrolyte imbalances, which can negatively impact workout performance and recovery.

Additional adrenal gland stress: It can increase adrenaline levels and cortisol levels. This is not a great scenario for those athletes with already high levels of stress.

Lower hormones: reduces male sex hormones (androgens) and negatively impacts libido and metabolic health. This is non-beneficial for men but beneficial for women with polycystic ovarian syndrome (PCOS). Training fasted does not appear to have any effect on estrogen or prolactin levels in women.

Training fasted may also reduce thyroid hormones -thyroid stimulating hormone (TSH) and T3- active thyroid hormones. This may contribute further to thyroid hormone imbalances.

Risk of Overeating Post-Workout: Some individuals compensate by consuming larger meals after exercise. Sugar and carbohydrate cravings increase as the day progresses. Poor food choices and excessive sugar intake peaks towards the end of the day. This can then result in disturbed sleep and reduced energy levels the following day.

Lack of Nutrients for Recovery: After exercise, your body needs nutrients for muscle repair, glycogen replenishment, and overall recovery. Fasted training can limit the availability of these nutrients at a critical time and delay recovery.

Individual Responses: Fasted training might be suitable for some individuals but not for others. Factors like genetics, training goals, and personal preferences can greatly influence the effectiveness and comfort of training fasted.

Increased Perceived Effort: For some athletes, training on an empty stomach can make training sessions feel harder. This can impact motivation and adherence to the training routine.

In summary, training fasted can have potential benefits such as increased fat loss and improved insulin sensitivity. However, training fasted also comes with potential downsides like impaired performance and muscle loss. Athletes are also at risk of reduce hormone levels, dehydration and nutrient deficiencies with prolonged fasting.

Your training goals, preferences, and how your body responds to fasted training is important to observe. We always recommend seeking professional help from a sports naturopath or nutritionist to ensure training fasted aligns with your specific circumstances.


Aird, T. P., Davies, R. W., & Carson, B. P. (2018). Effects of fasted vs fed‐state exercise on performance and post‐exercise metabolism: A systematic review and meta‐analysisScandinavian journal of medicine & science in sports28(5), 1476-1493.

Cienfuegos, S., Corapi, S., Gabel, K., Ezpeleta, M., Kalam, F., Lin, S.,  & Varady, K. A. (2022). Effect of intermittent fasting on reproductive hormone levels in females and males: a review of human trials. Nutrients14(11), 2343.

Kim, B. H., Joo, Y., Kim, M. S., Choe, H. K., Tong, Q., & Kwon, O. (2021). Effects of intermittent fasting on the circulating levels and circadian rhythms of hormones. Endocrinology and Metabolism36(4), 745-756.

Hackett, D., & Hagstrom, A. D. (2017). Effect of overnight fasted exercise on weight loss and body composition: A systematic review and meta-analysisJournal of Functional Morphology and Kinesiology2(4), 43.

Hansen, D., De Strijcker, D., & Calders, P. (2017). Impact of endurance exercise training in the fasted state on muscle biochemistry and metabolism in healthy subjects: can these effects be of particular clinical benefit to type 2 diabetes mellitus and insulin-resistant patients?. Sports Medicine47, 415-428.

Vieira, A. F., Costa, R. R., Macedo, R. C. O., Coconcelli, L., & Kruel, L. F. M. (2016). Effects of aerobic exercise performed in fasted v. fed state on fat and carbohydrate metabolism in adults: a systematic review and meta-analysis. British Journal of Nutrition, 116(7), 1153-1164.

Zouhal, H., Saeidi, A., Salhi, A., Li, H., Essop, M. F., Laher, I.,   & Ben Abderrahman, A. (2020). Exercise training and fasting: current insightsOpen access Journal of sports medicine, 1-28.

Want to know more? Contact the Athlete Sanctuary and learn how we can help you to increase health, wellbeing and performance. 

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.

Photo of a female athlete wearing a hoody on a dark gloomy day

Seasonal Affective Disorder (SAD), also known as seasonal depression or seasonal mood disorder, can have many impacts to your way of life, including your athletic performance. While SAD’s prevalence in Australia may differ from other regions, it is still important to explore the experiences of female athletes living with SADs. In this blog post, we will delve into the symptoms and unique challenges faced by female athletes in relation to SAD, and strategies to navigate through it.


It’s vital for female athletes to recognise the intersection between their mental health and athletic performance, and acknowledge that working on mental health can positively impact their overall performance and condition.

SAD is suggested to be linked to the circadian rhythms (‘body clock’) adjustments at certain times of the year and in response to variations in exposure to sunlight. This is thought to impact the hormones melatonin and serotonin, which affect sleep and mood.

Those most at risk are younger females, those with a family history of depression, bipolar disorder, or SAD. The risk increases the further away from the equator. Vitamin D deficiency is also linked to SAD and people with SAD may produce less Vitamin D. As Vitamin D plays a role in serotonin activity, Vitamin D deficiency and insufficiency have been associated with depressive symptoms.

SAD frequently co-occurs with other disorders including attention-deficit hyperactivity disorder (ADHD), addiction, and eating disorders.


Awareness of Seasonal Patterns
Athletes experiencing SAD may notice seasonal patterns to their moods.

Common observations over winter include:

  • Decline in mood, sadness and depression
  • Fatigue without explanation
  • Reduced motivation
  • Hopelessness
  • Social withdrawal
  • Overeating and carbohydrate cravings
  • Excessive sleeping

In summer SAD may look more like sleep issues, not feeling hungry, losing weight and feeling agitated and anxious.

By recognising these patterns and symptoms, athletes can better anticipate and prepare for the potential impact on training and performance.


Athletes and coaches may need to modify training schedules to accommodate SAD symptoms. This could mean adjusting the timing of workouts to coincide with optimal sunlight exposure in the middle of the day, incorporating more indoor training during the darker months, or allowing for flexibility in training intensity to accommodate fluctuations in mood and energy levels.


Openly communicate with coaches, supporters, friends and family about your experiences with SAD. By sharing your challenges and seeking understanding, you can foster a supportive environment that promotes positive mental health and helps alleviate the burden of SAD symptoms.

Seek Out a Mental Health Professional
Support from a mental health professional who specialises in sports psychology can be incredibly valuable. These professionals can provide tailored strategies to manage SAD symptoms, including cognitive-behavioural techniques, mindfulness practices and stress management tools.

In some cases your doctor may recommend light therapy.


Sunlight Exposure
Spend time outdoors during daylight hours, as sunlight exposure has a positive impact on vitamin D levels, sleep, mood and energy levels. Including outdoor activities, such as training sessions, walks and other outdoor hobbies, can help combat the effects of SAD.

Rest and Recovery
Prioritise sufficient sleep and establish consistent sleep routines to support your mental health and physical wellbeing.

Stress Reduction
Implementing stress reduction techniques, such as meditation, deep breathing exercises, or taking time with hobbies, people etc that bring joy, can help to alleviate SAD symptoms and promote overall mental wellbeing.

Vitamin D
We recommend athletes who suffer from SAD check their vitamin D levels every 6 months. Maintaining regular sunlight exposure and intake of vitamin D rich foods is essential to the prevention of deficiency. In many cases vitamin D supplementation is required.

Managing Seasonal Affective Disorder requires a comprehensive approach that integrates mental health and performance considerations. By recognising the unique challenges you face and implementing strategies such as adjusting training schedules, tapping into support networks and prioritising self-care, you can affectively navigate SAD while maintaining fitness and performance.


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 our website.


1. Armstrong, S. L., & McVeigh, D. (2019). A systematic review of athletes’ experiences with self-talk. Frontiers in Psychology, 10, 1518.
2. Fenton, G., McPherson, A., & Kinnafick, F. (2019). Qualitative inquiry into the lived experiences and coping strategies of female athletes with eating disorders. Psychology of Sport and Exercise, 42, 100-108.
3. Gulliver, A., Griffiths, K. M., & Christensen, H. (2012). Perceived barriers and facilitators to mental health help-seeking in young people: A systematic review. BMC Psychiatry, 12.
4. Pargman, D., & Wiese-Bjornstal, D. M. (2003). Examining links between emotional states and physical activity among individuals with high physical activity levels. Journal of Applied Sport Psychology, 15(4), 300-317.
5. Melrose S. Seasonal Affective Disorder(2015): An Overview of Assessment and Treatment Approaches. Depress Res Treat. doi: 10.1155/2015/178564.
6. Murray, G. (2004). How common is seasonal affective disorder in temperate Australia? A comparison of BDI and SPAQ estimates. Journal of affective disorders, 81(1), 23-28.

Photo of a bowl of pumpkin and ginger soup with a spoon.

We all know that winter weather calls for delicious, heart warming soups. This delicious pumpkin soup recipe has the added bonus of ginger – an ingredient that aids digestion and is packed with antioxidants that help prevent arthritis, inflammation and various types of infection. There are so many health benefits of ginger!


1kg pumpkin, peeled, seeds removed and cut into 4cm pieces

75g ginger, roughly chopped

2 garlic cloves

2 tbs extra virgin olive oil

1L (4 cups) vegetable or chicken stock

2 tbs finely chopped dill

1/3 cup (50g) toasted hazelnuts, chopped


Preheat your oven to 180 degC.

Place your pumpkin, ginger and garlic on a large baking tray and drizzle with oil. Season, then toss to coat. Roast for 30 minutes or until the pumpkin is soft (don’t let the garlic burn).

Puree mixture in a blender or food processor with 2 cups (500ml) of stock, then season. If there are lumps then strain through a fine sieve. Place the soup in a large saucepan with remaining 2 cups (500ml) of stock and warm over a medium-low heat.

Divide the soup between 4 bowls and serve with dill and toasted hazelnuts and what ever other toppings you love on your soup – if you wish a dollop of marscapone.

Enjoy x

Photo of a female lying down on the ground with her hands to her head in discomfort.

Premenstrual Dysphoric Disorder (PMDD) is a health concern best described as a form of severe premenstrual syndrome (PMS). PMDD affects 3-8% of women worldwide but is not well understood or researched.

What are the symptoms?

PMDD symptoms include anger, irritability, depressed mood, anxiety, lack of pleasure, a sense of overwhelm, difficulty concentrating, fatigue, changes in appetite or food cravings, sleep changes, and physical symptoms such as breast tenderness, bloating or headaches.

These symptoms emerge in the luteal phase of the menstrual cycle, one to two weeks before periods commence, and typically subside within a few days of bleeding.

Over 64% of women experience some kind of mood changes a few days before the onset of menstruation. For women with PMDD these changes are more extreme. Despite having normal hormonal fluctuations during the menstrual cycle, women with PMDD experience an abnormal mood response to these fluctuations. Rage, anger, irritability, intolerance to others, anxiety and depression are commonly reported in women with PMDD. Our patients with PMDD sometimes say extreme statements along the lines of ” I get so mad I feel like I want to kill my husband before my period.”

It is suggested these more extreme changes in mood may be attributable to the effect estrogen and progesterone have on the serotonin, GABA and dopamine systems. These can also alter the renin-angiotensin-aldosterone system, which could explain some of the bloating and swelling that occur during the luteal phase.

Conventional intervention typically involves the contraceptive pill, anxiety medications and anti-depressant medications. For some women this relieves problematic symptoms but may also contribute to other side effects which become more of an issue than the PMDD itself. For those women, considering complementary solutions may be a good option. In traditional medicine practice, herbal medicines have been used to manage PMDD. Some of these natural medications support GABA levels, reduce extreme emotions, reduce depression, minimise physical symptoms and promote relaxation.

Other options often included in a herbal prescription such as withania , ginseng and rhodiola are considered serotonergic – i.e. they support level of serotonin in the brain. Nutrients such as vitamin E, vitamin D, zinc, vitamin B6, 5-HTP, calcium or inositol may be prescribed to help support healthy mood, reduce pain and support hormonal balance.

In naturopathic medicine we consider the individual’s unique presentation and symptomatic picture, rather than the diagnosis. Therefore, our treatment plans are also always tailored to the individual and consider their health history and current lifestyle demands. For some women anger is their key concern, while for others their depression is debilitating.

It helps to be realistic about what changes you can expect and appropriate timeframes. To get the best results we recommend an in-depth assessment and consultation for women with PMDD along with regular reviews to allow for modifications and adjustments of formulas and dosages.

Always seek medical care if you think you may have PMDD.

Want to know more? Contact the Athlete Sanctuary and learn how we can help you.

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


Hantsoo, L., & Payne, J. L. (2023). Towards understanding the biology of premenstrual dysphoric disorder: From genes to GABA. Neuroscience and biobehavioral reviews, 149, 105168.

Hofmeister, S., & Bodden, S. (2016). Premenstrual Syndrome and Premenstrual Dysphoric Disorder. American family physician, 94(3), 236–240.

Kashanian M, Mazinani R, Jalalmanesh S. Pyridoxine (vitamin B6) therapy for premenstrual syndrome. (2007) Int J Gynaecol Obstet;96(1):43-44.

Tartagni, M., Cicinelli, M. V., Tartagni, M. V., Alrasheed, H., Matteo, M., Baldini, D., De Salvia, M., Loverro, G., & Montagnani, M. (2016). Vitamin D Supplementation for Premenstrual Syndrome-Related Mood Disorders in Adolescents with Severe Hypovitaminosis D. Journal of pediatric and adolescent gynecology, 29(4), 357–361.

Cerqueira, R. O., Frey, B. N., Leclerc, E., & Brietzke, E. (2017). Vitex agnus castus for premenstrual syndrome and premenstrual dysphoric disorder: a systematic review. Archives of women’s mental health, 20(6), 713–719.

Photo of jars of watermelon and orange in glass jars ogf water with straws.

Most athletes consider the balance of electrolytes when thinking about hydration and recovery, especially over endurance events.  But are salt tablets and electrolytes really necessary?

Before we answer this question, let’s recap on electrolytes and the role they perform in the body.

Sodium is the key electrolyte responsible for controlling extracellular fluid balance while potassium controls the fluid within the cells. Potassium also helps with muscle contraction and supports blood pressure. Electrolytes such as potassium can also impact iron absorption. Potassium (along with other nutrients such as zinc and B vitamins) is essential for hydrochloric acid (HCL) production in your stomach. Without adequate HCL a condition known as achlorhydria can develop where your ability to absorb dietary iron and the successful coordination of iron uptake, export, and iron storage as ferritin is reduced.  This can lead to iron deficiency and anaemia as explained in this article.

Magnesium is well known for its role in nerve function, heartbeat regulation, energy metabolism and blood sugar stabilisation. Your muscles, brain and heart rely heavily on magnesium to do their job. As an electrolyte, magnesium sits both inside and outside cells and binds to water and interacts with other electrolytes.   Calcium is well known for its role in bone health, heart and nerve function and less recognised as an electrolyte. Calcium sits within both intracellular and extracellular spaces. Other electrolytes include phosphates, chloride and bicarbonates.

Sodium and chloride are the two electrolytes lost in large quantities through sweat. The losses of these electrolytes are regulated in response to the balance of sodium consumed in the diet and recent sweat and urine losses.

So is the ingestion of electrolytes or salt tablets really necessary to enhance performance? Well yes and no. Confusing hey!

Why you should consider electrolytes.

Research suggests sodium added to drinks before exercise may improve the amount of that fluid retained, rather than lost through urination and potentially reduce the risk of dehydration. Sodium can also improve the flavour of drinks and encourage consumption when consumed during exercise. This could be handy in warmer conditions and when exercising for two or more hours. Sodium during exercise can also reduce the potential risk of developing hyponatraemia. It is suggested sodium can assist with fluid and carbohydrate absorption from the gut.  If you are a heavy sweater with above average sodium loses (>1g/L) identified through sweat testing, then you may benefit from sodium ingestion during exercise if you are exercising for several hours.

The good news is that most sports drinks and gels contain sodium so it is unlikely the majority of athletes will need to take on additional electrolytes in the form of tablets. Ultra runners and ironman participants may be an exception to this rule.

Keep in mind the body has large stores of sodium that are released into the bloodstream as needed so it is unlikely you will ever run out of sodium unless severely dehydrated. The key reason why sodium is included in sports products is to balance out fluid intake and losses and maintain an appropriate osmolality, while improving the taste and increasing the palatability and consumption of the product, rather than preventing an actual sodium deficit.

And what about cramping?

Cramping is caused by multiple factors that can lead to changes in the nerves that control muscle contraction and muscle fatigue. Therefore, it is a little simplistic to suggest a single nutrient such as sodium or magnesium will prevent cramping.  Further scientific research is required to give us clear guidance around cramp prevention. Many athletes do respond well to magnesium and a suitable hydration protocol.

Don’t forget you can also obtain electrolytes through wholefoods nutrition.

  • Sodium is easily found in most processed foods such as crackers, sardines, smoked foods, pickled foods, roasted seeds and nuts, cheeses, table salt and sauces.
  • Magnesium is found in pumpkin seeds, chia seeds, almonds, spinach, cashews, black beans, peanuts, oats, brown rice, and yogurt.
  • Potassium-rich foods include potatoes, sweet potato, dried apricots, and raisins, beans lentils, spinach, broccoli, avocado and bananas.

So before you reach for more artificial sports products consider if this is really necessary and if there are alternative ways you can provide your body with the electrolytes it requires.

Need specific guidance?  We would be delighted to help.

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 www.https://



Miller KC. et al. An Evidence-Based Review of the Pathophysiology, Treatment, and Prevention of Exercise-Associated Muscle Cramps. J Athl Train. 2022; 57(1):5-15.

Lau WY. et al. Water intake after dehydration makes muscles more susceptible to cramp but electrolytes reverse that effect. BMJ Open Sport Exerc Med. 2019; 5(1):e000478.

Maughan RJ. & Shirreffs SM. Muscle Cramping During Exercise: Causes, Solutions, and Questions Remaining. Sports Med.2019; 49(Suppl2):115-124.

Photo of a female runner with sunglasses on running in the Zurich marathon.

With any goal or challenge, a holistic approach to race preparation can help. It is never too early to start planning. Training for a key event is no different, and you may just be surprised at what else you learn about yourself along the way.

As discussed in an episode of “On Purchase” podcast (with Jay Shetty), growth comes through the process of becoming uncomfortable in situations which challenge and stretch us. Being comfortable with being uncomfortable is a skill everyone needs to work at in order to achieve any goal. It isn’t the goal that satisfies our thirst necessarily but rather what we become as a person in the process of working towards a goal.

Jay suggests being too comfortable or casual may lead to complacency and “crashing”. The opposite is also true.

Building curiosity around new experiences and challenges that take you out of your comfort can lead to competence. When speaking to retired elite athletes, 99% suggest it was building the competence in their chosen sport, inner strength and resilience that paved the way to a fulfilling career, not the medals or accolades they received for their achievements.

 “You don’t have to be great to start but you have to start to be great”  Zig Ziglar

In our Holistic Health and Performance Women’s Mentoring Program we ask the hard questions – what are you willing to consider that will take you out of your comfort zone? What are you curious about but haven’t acted on just yet?

There’s so much more that goes into race preparation, and the earlier you can start the better. A holistic approach ensures all the building blocks are in place ahead of time.

So, what do you need to think about? A holistic approach will consider your overall mental and physical health, work/life balance, nutrition, training and much more. Let’s break it down:

Start by examining your nutrition

This is a great place to start. Time to be self-reflective.

Through our diet, we are either feeding inflammation or fighting it. We are also either eating for performance or inhibiting performance through poor food choices.  There are some great online food diaries to help you track your nutritional profile such as My Fitness Pal, or Cronometer. Some of the key questions to ask yourself are:

  1. Are you getting enough quality protein, carbohydrate and fats in your diet?
  2. Is your overall energy intake adequate for your training requirements?
  3. Are you lacking in any food groups e.g. dairy. If so how are you compensating for this?
  4. Are you restricting or overeating food intake or lacking overall balance in your diet?
  5. Are you taking note of how you feel after consuming different foods? e.g bread makes you feel tired

Work/Life Balance

This is always key. Training for big events can involve a lot of sacrifice, not only for you but for those around you. It takes time and energy, and the physical demands are high. Finding work/life balance can be incredibly tricky -particularly when you’re trying to fit your training and prep around a busy work and family life.

Some key points to help you navigate this and keep stress levels as low as possible include:

  • Communicate your goals and plan openly with your family and friends,
  • Try to be flexible with your training regime to meet other commitments that you may have,
  • Avoid being obsessive with your training and event performance, include flexibility in your mindset and focus on progress over perfection
  • Factor in adequate downtime for yourself. This may be as simple as rest time, an hour with a good book or some time with friends.

Work on preventing illness

Our immune system is equipped with a multi-tiered response to do battle with foreign invaders 24/7 but a poor diet, stress and overtraining can significantly reduce our immune system’s ability to fight infection. This leads to more frequent colds and missed training and racing opportunities.  There are many ways to keep your immune system robust.

(Read our blog > How Robust is Your Immunity?)

Manage your mental health

This one is vital. Training for a big event can becoming all consuming, especially when you’re juggling multiple demands of your time. Stress can be compounded if you’re dealing with unexpected disruptions to your training plan, such as illness or injury.

It’s so important for you to master ways to manage the stresses of each of the elements of your life – including your training regime. Some days that means accepting you simply can’t do everything you’d like to in a day.

Build resilience

Let’s get real- some days will be hard. Working on building resilience and perseverance are key elements of meeting those long, sometimes hard, training sessions – and the road to meeting your goals.

“Resiliency is the ability to face setbacks, failures, crises, and pain (both emotional and physical) with confidence and courage. It is the ability to quickly bounce back from our trials and tragedies. It’s the quality that keeps us from giving up, even when the going gets rough. It’s the ability to stick with something through thick and thin and the power to overcome the temptation to bail out when things stop being easy.” (from “Building Your Resiliency”)

Perseverance is the continued and steadfast effort towards a goal despite difficulties and setbacks. Resilience is what makes you pick yourself up; perseverance is what keeps you moving forward.

Are you ready to take on a holistic approach to performance?

Our Women’s Holistic Health and Performance Mentoring Program designed for endurance runners encompasses all of the elements that align for success – whether it be your next main event or life. Want to know more about this? I’d be really happy to have a chat with you in readiness for the second half of the year.

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 www.https://


There are many benefits of blueberries for improving overall health. Of particular interest for our athletes is how blueberries reduce inflammation.

Delayed onset muscle soreness (DOMS) can cause significant discomfort after a race or hard session. This discomfort and heaviness in the muscles are thought to be due to micro tears in muscles and exercise-induced inflammation. Increasing your nutritional intake of anthocyanin flavonoids the antiinflammatory agents found in berries may help to reduce inflammation.

How do you blueberry?

A blueberry smoothie is a convenient post-training choice. In a randomized crossover study, participants were asked to consume either a smoothie with 1.5 cups of frozen blueberries, a banana, and apple juice or a smoothie that substituted berries for dextrose and vitamin C powder to match the calorie and antioxidant content of the blueberry smoothie. The participants consuming the blueberry smoothie demonstrated significantly reduced exercise-induced oxidative stress over the next 24 hours. The consumption of the blueberry smoothie also resulted in a recovery of peak strength far exceeding that of the substitute smoothie. These findings are particularly relevant to athletes in multi-day events and endurance athletes with high mileage over successive days.  Cherries, spinach, ginger, turmeric, oily fish, and watermelon have all been shown to help reduce muscle soreness.

Quercetin is another anti-inflammatory flavonoid found in foods. Capers, dill, broccoli, tomato, asparagus, green capsicum, red onions, apple, and grapes all contain quercetin as highlighted in our previous blog here 

Regular intake of blueberries can also reduce period pain.

Improvements in cognitive function with the consumption of blueberries have also been well documented. The brain-enhancing metabolites of anthocyanins peak in the bloodstream within an hour and are accessed by the body as blueberries are digested by our gut microbiome and colon.

The natural prebiotic and probiotic action of blueberries occurs as the bacteria in the gut breaks down the berries and absorbs the active compounds back into the body.  Blueberry consumption may help our youngsters with brain development and also our mature athletes. The consumption of one cup of blueberries a day has been shown to delay cognitive decline by over two and a half years in middle age and in seniors, reduced artery stiffness, osteoarthritis, and improve immune defense against viral infections. In studies looking at children consuming blueberries, the improvement in cognitive performance was seen within hours of just a single meal with blueberries.  Now that is powerful stuff!

In the southern parts of Australia, fresh blueberries can become expensive and reduced in quality due to storage and seasonality. Frozen berries provide a good alternative. While fresh is typically best, there are exceptions to this rule.

Several studies have found that frozen berries contain the same nutritional elements as fresh berries that have just been harvested. According to studies conducted by John Hopkins University, recently harvested frozen berries maintain their optimal nutrition levels for several months. Freezing berries makes it possible to easily access these superfoods year round.

Otway chemical-free blueberries are a great choice. Their berries are plump, juicy, and always very fresh as they are locally grown, picked daily when in season, and frozen.  Their berries are superb in summer but you will always find a packet in my freezer as a backup supply.

If you find smoothies containing frozen berries too cold in winter, add warm milk or a teaspoon of ground turmeric or ginger to the smoothie. You can always thaw the berries and allow them to come up to room temperature before adding them to your smoothie.   For a creative way to enhance your recovery, check out our Beet berry smoothie bowl.

Sound nutritional advice is key to sports performance. Our holistic female-centric approach gets results! Find out how we can help you here


Connor, A. ,  Luby, J.,  Hancock, J, Berkheimer, S., and Eric J. Hanson, E..  (2002). Changes In Fruit Antioxidant Activity Among Blueberry Cultivars During Cold-Temperature Storage,.  Journal of Agricultural and Food Chemistry, 50(4), 893-898.

Du, C., Smith, A., Avalos, M., South, S., Crabtree, K., Wang, W., & Juma, S. (2019). Blueberries improve pain, gait performance, and inflammation in individuals with symptomatic knee osteoarthritis. Nutrients, 11(2), 290.

Hein, S., Whyte, A. R., Wood, E., Rodriguez-Mateos, A., & Williams, C. M. (2019). Systematic review of the effects of blueberry on cognitive performance as we age. The Journals of Gerontology: Series A, 74(7), 984-995.

Kalt, W., Cassidy, A., Howard, L. R., Krikorian, R., Stull, A. J., Tremblay, F., & Zamora-Ros, R. (2020). Recent research on the health benefits of blueberries and their anthocyanins. Advances in Nutrition, 11(2), 224-236.

Sucharita, G., Revathi, K., Venkatesh, P., Kalarini, D. H., & Prema, R. A Review on Benefits of Blue Berries.

Tarazona-Díaz, M. P., Alacid, F., Carrasco, M., Martínez, I., & Aguayo, E. (2013). Watermelon juice: potential functional drink for sore muscle relief in athletes. Journal of agricultural and food chemistry, 61(31), 7522-7528.

Whyte, A. R., Rahman, S., Bell, L., Edirisinghe, I., Krikorian, R., Williams, C. M., & Burton-Freeman, B. (2021). Improved metabolic function and cognitive performance in middle-aged adults following a single dose of wild blueberry. European Journal of Nutrition, 60(3), 1521-1536.

Benefits of Blueberries for Artery Function.

Lohachoompol, V., Srzednicki, G., & Craske, J. (2004). The change of total anthocyanins in blueberries and their antioxidant effect after drying and freezing. Journal of Biomedicine and Biotechnology, 2004(5), 248.[/vc_column_text][/vc_column][/vc_row]

10 symptoms of Endometriosis

Endometriosis is a painful condition impacting over 830,000 Australian women and girls and over 176 million women worldwide.  With endometriosis, inflammation and estrogen dominance impacts tissue similar to the uterine lining and encourage growth in other areas of the body outside the womb such as in the pelvic cavity, the ovaries, fallopian tubes, intestines, or bowel.

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 www.https://


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.

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.

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. 

Jean Hailes

Oregon State University (2022).Resveratrol www.

Endometriosis Australia 

BBC Sport