The Menstrual Cycle & Injury Risk
TL;DR
There’s a lot of noise in the fitness industry around women’s training and their natural cycle - a lot of it encourages caution, but the available research seems to disagree. The fact is, hormones fluctuate and your body is continually adapting to that; that doesn’t make women fragile. There might be small changes in injury risk across the menstrual cycle, but ‘backing off’ training every time, just in case, would do more harm than good.
What the Research Says
Reviews (e.g. Martínez-Fortuny 2023; Herzberg 2017) show possible small increases in injury risk (especially ACL and soft-tissue) around ovulation, when oestrogen peaks. They suggest the mechanism is a slight increase in ligament laxity and neuromuscular variability.
But, the data are tiny, inconsistent, mostly in young footballers, methods used for tracking cycle phase are all over the place and many studies look at laxity or biomechanics, not actual injuries.
So, there’s a biological signal, but it’s weak. There are much larger factors that actually drive injuries (these have far stronger evidence than menstrual-phase timing):
Load spikes - Training volume and intensity should be pretty consistent; be wary of increasing these things too aggressively.
Weakness or poor deceleration control - Train hard and get strong; lift, sprint, jump and land.
Under-fuelling / RED-S - Fuel enough! (RED-S = relative energy deficit in sport; that’ll be another blog entry)
Inconsistent Training - Be consistent (obviously…).
Bottom Line
There may be small shifts in injury risk across your cycle, but consistency beats caution.
Don’t overreact to sensationalist statements like “in this phase in your period you’re more likely to get injured!”; you don’t need to de-load every month and, actually, doing so is probably more risky than training through.
Stay aware - if you know you tend to feel “off” mid-cycle, consider being more mindful of things like your warm-up, landing quality, and your recovery markers.
As usual, check in with yourself every workout - auto-regulate your training intensity based on how you feel.
Track, don’t obsess. Cycle data can help you understand patterns, but it shouldn’t dictate your training.
Keep training hard and build your capacity. Consistent strength training reduces injury risk across all phases.
As usual, your body isn’t fragile - it’s adaptable - train like you believe that!
Thanks for reading! I’d love to hear if you found this useful.
Tom
Key References:
Martínez-Fortuny I. et al. (2023) Menstrual Cycle and Sport Injuries: A Systematic Review. PMID: 36833966
Herzberg SD. et al. (2017) The Effect of Menstrual Cycle and Contraceptives on ACL Injuries and Laxity: A Systematic Review and Meta-analysis. PMID: 28795075
McNulty KL. et al. (2020) The Effects of Menstrual Cycle Phase on Exercise Performance in Eumenorrheic Women: A Systematic Review and Meta-Analysis. PMID: 32661839
Fort-Vanmeerhaeghe A. et al. (2025) Injury Risk and Overall Well-Being During the Menstrual Cycle in Elite Adolescent Team Sports Athletes. PMID: 40427990
