Nutrition & The Menstrual Cycle

Article by Namrata Ashok

Given that almost half the world’s population experience the menstrual cycle in their adolescent and adults lives, this is still such a taboo topic that isn’t spoken about enough. Whilst good quality evidence exploring how diet influences menstruation and period pain is limited, what we do know is that there are certain nutritional considerations to be aware of which may help to alleviate your symptoms.

The infradian rhythm

Every individual that possess female physiology has a unique biological rhythm during their menstrual years. Distinct from the 24-hour circadian rhythm, the infradian rhythm changes according to the hormonal changes throughout the menstrual cycle, affecting the brain, metabolism, immune system, microbiome, stress response system, and reproductive system.

Phases of the menstrual cycle

The menstrual cycle is comprised of four phases

The follicular phase
The ovulatory phase
The luteal phase
The menstrual phase.

The follicular phase - this is the 7 to 10 days after the period ends, where oestrogen and progesterone are at their lowest levels. As oestrogen levels begin to rise, the lining of the uterus thickens and the ovaries prepare to release an egg.

The ovulatory phase - the second phase marks the three to four days in the middle of your cycle, where oestrogen increases rapidly and the egg is released.

The luteal phase - this the 10-14 days before the next bleed, where oestrogen, progesterone, and testosterone peak, and then begin to drop.

The menstrual phase - the final phase is the three to seven days during the bleed when oestrogen and progesterone decrease rapidly.

Nutritional considerations for each phase

In the follicular phase, the rate of metabolism and resting cortisol levels decline (4,5). Nutritional recommendations suggest a well-balanced diet, high in fruits and vegetables (8). As menstruation is an inflammatory process, a diverse range of vitamins, phytochemicals, and minerals will support the immune system and offset excess inflammatory signaling (24). Oestrogen appears to liberate fatty acids, increasing fatty acid availability for energy and reducing carbohydrate utilization (5, 25). However, because oestrogen levels remain quite low, insulin sensitivity is high (26). Therefore, including the following as part of a healthy and balanced diet may be beneficial:

Follicular phase

Cruciferous vegetables (broccoli, cauliflower, Brussel sprouts, cabbage) support oestrogen detoxification by maintaining optimal levels of oestrogen and ridding excess (19)
Sweet potato, olive oil, nuts, seeds, and green leafy vegetables as sources of Vitamin E (22)
Complex carbohydrates, such as grains which contain B vitamins and legumes
Anti-inflammatory spices, e.g. ginger, turmeric (23)

Ovulatory phase

Foods high in water and fibre, like colourful fruits and vegetables, to regulate water retention (18).
Moderating intake of highly salty foods (18).
Vitamin B-rich foods (grains, meat, eggs, dairy, nuts, and seeds)

In the luteal phase, insulin sensitivity is low and resting metabolic rate increases significantly, making fat utilization predominant (1,2,9,25,26). Furthermore, low levels of serotonin during this phase have been associated with increased cravings (26). As a precursor of serotonin, foods high in tryptophan can help manage cravings (27). With low insulin sensitivity, consuming fiber-rich carbohydrates, complex carbohydrates, and carbohydrates combined with sources of fat or protein can support blood sugar levels (8). Moreover, progesterone appears to break down protein (1,2,9). Therefore, eating an adequate amount of quality proteins and fats support the body with oestrogen and progesterone peaking (28).

Quality fats (sunflower seeds, flax seeds, tahini) contain compounds that increase progesterone production and rid excess oestrogen (21)
Magnesium-rich foods (spinach, cacao powder, avocado, banana, berries, salmon and tuna, and legumes) support pre-menstrual symptoms (15).

Whilst bleeding in the menstrual phase, supporting energy levels and the loss of blood is vital.

Iron (red meat, fortified cereals, cacao powder, dark leafy greens) (12)
Vitamin C (red pepper, kiwi, citrus fruits, and vegetables) increases the bioavailability of iron (12).

Finally, to support the menstrual cycle, considering the following vitamins and minerals may be beneficial:

Vitamin C intake in conjunction with iron can prevent anaemia in menstruating individuals (12).
Vitamin B6 contributes to serotonin production, supporting pre-menstrual symptoms and mood (13,20).
Vitamin D supports fertility health, menstrual cycle irregularities, and menstrual cramps (14).
Magnesium helps to reduce menstrual migraines, cramps, and premenstrual symptoms (15).
Probiotics regulate oestrogen production by supporting liver detoxification to rid excess oestrogen (16).
Omega 3 fatty acids can support the regulation of inflammation and pre-menstrual symptoms (17).
Zinc supports the immune system and alleviates symptoms of premenstrual symptoms (29).

Therefore, resting energy requirements change throughout the cycle as body temperature and the basal metabolic rate change. Research suggests that hunger begins to elevate as levels of progesterone increase. Consuming slightly more during the luteal phase may support the increased metabolism and physiological changes that occur (26).

Summary

The four phases of the menstrual cycle require different metabolic requirements and energy demands.

Higher carbohydrate foods and foods that support liver detoxification are supportive of the follicular phase.
Modulating salt intake, and consuming water-rich foods, and complex carbohydrates support the ovulatory phase.
Consuming quality fats, protein, and magnesium-rich foods supports the luteal phase.
An adequate intake of iron-rich foods with vitamin C-rich foods supports the menstrual phase.
For specific nutrition needs, please seek dietary recommendations from an accredited Dietitian or GP.. Other resources available to you include the NHS, British Nutrition Foundation and British Dietetics Association websites.

This blog post was written by Namrata Ashok, a Sports Science and Nutrition BSc student at University of Glasgow. Currently involved in two internships, work experience, podcasts, and further reading, alongside her studies, Namrata is enthusiastic about helping individuals heal and restore from the inside out, honing in on approaching the root cause. She is determined to explore the world of health, nutrition, and movement by combining research, theory, and practical experience.

References:

(1) https://pubmed.ncbi.nlm.nih.gov/33502701/

(2) https://www.tandfonline.com/doi/abs/10.1080/09291016.2018.1526496

(3) https://pubmed.ncbi.nlm.nih.gov/9221991/

(4) https://pubmed.ncbi.nlm.nih.gov/16690766/

(5) https://pubmed.ncbi.nlm.nih.gov/34281146/

(6) https://pubmed.ncbi.nlm.nih.gov/11160041/

(7) https://pubmed.ncbi.nlm.nih.gov/34134602/

(8) https://pubmed.ncbi.nlm.nih.gov/22865231/

(9) https://pubmed.ncbi.nlm.nih.gov/7943222/

(10) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5698353/

(11) https://pubmed.ncbi.nlm.nih.gov/14644065/