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Augsburg University Augsburg University
Idun Idun
Theses and Graduate Projects
8-9-2024
Cycle Syncing: Optimizing Women's Quality of Life Cycle Syncing: Optimizing Women's Quality of Life
Megan Francois
Follow this and additional works at: https://idun.augsburg.edu/etd
Part of the Obstetrics and Gynecology Commons, and the Women's Health Commons
Cycle Syncing: Optimizing Women’s Quality of Life
Megan Francois, PA-S2
CHEBPP IV
August 9, 2024
Abstract
Background: A woman’s hormones are in constant fluctuation throughout the menstrual cycle.
This 28-day, on average, fluctuation can cause major shifts in mood, cognition, exercise
tolerance, and nutrition needs. Because of this, there is potential to optimize quality of life if each
phase is synced with diet, exercise, and complementary medicine utilizing holistic methods.
Purpose: Physiologically, the menstrual cycle is well understood. The potential effects of
the physiologic changes can have a drastic effect on a woman’s life throughout each phase.
How can nutrition, exercise, and holistic medicine be utilized at each phase of the
menstrual cycle to optimize women’s quality of life?
Methods: This class-based project has been designated IRB-Exempt from Augsburg
University IRB, #2023-06-04. A comprehensive literature review was conducted utilizing
primary, peer-reviewed scholarly journals from PubMed, Medline, Google Scholar, and
secondary sources including WebMD and UpToDate. Many search terms were used
including menstrual cycle, menstruation, follicular phase, ovulation, ovulatory phase, luteal
phase, food impact on hormones, progesterone, estrogen, exercise and women, and woman
holistic medicine. Inclusion criteria were studies that were peer-reviewed and within the
last twenty years. Exclusion criteria were studies that were older than twenty years, non-
peer reviewed, pathologic cycles, and pregnancy. Following the literature review, an
observational research study was conducted on what is being promoted for cycle syncing
on social media apps: Facebook, Instagram, TikTok, and X. Criteria for inclusion is the
source must be credentialed (i.e. registered dietician, naturopathic doctor, athletic trainer, et
cetera) and it must be presented within the last two years. Exclusion criteria include social
media “influencers” without credentials and publishment of more than two years ago
Conclusions: Each phase of the menstrual cycle has its own potential to be harnessed utilizing
diet, exercise, and holistic medicine; doing so would optimize women’s quality of life,
physiologic and psychologic function. Implications for further research include a need for
additional longitudinal and prospective studies. Factors that need to be addressed include further
analysis of the windows of vulnerability over the menstrual cycle according to female hormone
fluctuations, effects of hormonal contraceptives, and effects of pathology on the cycle.
Key Words: Menstrual cycle, cycle syncing, premenstrual symptoms, nutrition, exercise,
menstruation, follicular phase, ovulation, luteal phase, optimizing women’s health, holistic
medicine.
Cycle Syncing: Optimizing Women’s Quality of Life
Megan Francois, PA-S2
Introduction
The hormonal cycle of a woman consists of four phases: menstruation, follicular,
ovulation, and the luteal phase in that order. Each of these phases have unique characteristics,
different durations in length, and greatly impacts a woman’s life in nearly every category
including mood, diet, weight, energy, behavior, appearance, immune system, sleep, skin, and
hormones.1 This list is non-exhaustive and as more research has surfaced, the more it is clear that
the menstrual cycle of a woman greatly impacts their quality of life at different times of the
average 28-day cycle and their life.
To answer how nutrition, exercise, and holistic medicine can be utilized to optimize a
woman’s quality of life, this literature review will first review research and physiology of the
menstrual cycle. Once the entirety of the cycle is better understood, research on each phase of the
cycle and how it affects a woman’s life will be reviewed. Then, research and current literature
surrounding how certain foods are better at certain intervals of the cycle, followed by which
exercises are most beneficial, and then how supplemental/holistic medicine can be beneficial will
be reviewed as well. Following this, a comprehensive discussion analyzing the entirety of the
literature will lead to conclusions, including a proposal for future research and potential next
steps.
First, it is important to understand what it means to have a healthy functioning menstrual
cycle. Much like everything else in the human body, a multitude of things can go “wrong”, and
the cycle can have pathology such as endometriosis, unexplained infertility, and polycystic
ovarian syndrome to name a few. For the purposes of this literature review, the research of
potential benefits of syncing phases of the cycle with nutrition, exercise, and holistic medicine
will be underneath the assumption that there is no underlying pathology to the cycle and no
pregnancy occurring.
Second, it will be further analyzed utilizing existing data and research on how the
monthly hormonal changes affects a women’s bodily nutritional needs, ability to exercise, and
how holistic medicine can be supplemented to support these changes as well.
Then, utilizing social media posts from credentialed sources from Facebook, Instagram,
X, and TikTok it will be further analyzed what is being promoted and what is actually working for
women. Following this analysis, general recommendations and implications for further research
will be presented.
Methods
This class-based project has been designated IRB-Exempt from Augsburg
University IRB, #2023-06-04. A comprehensive literature review was conducted utilizing
primary, peer-reviewed scholarly journals from PubMed, Medline, Google Scholar, and
secondary sources including WebMD and UpToDate. Many search terms were used including
menstrual cycle, menstruation, follicular phase, ovulation, ovulatory phase, luteal phase, food
impact on hormones, exercise and women, and holistic medicine. Inclusion criteria were studies
that were peer-reviewed and within the last twenty years. Exclusion criteria were studies that
were older than twenty years, non-peer reviewed, pathologic cycles, and pregnancy. Social media
has become an outlet for health advice far and wide. Good or bad, women’s health is no
exception. Along with the comprehensive review, observational research and analysis of social
media sources (TikTok, Instagram, X, and Facebook) on what is being promoted for cycle
syncing was observed and reviewed. These two methods will assist in further recommendations
as well as implications for further research to optimize a biological female’s quality of life
syncing life with the hormonal cycle. Cycle syncing was observationally analyzed using search
terms of diet, exercise, holistic medicine, and cycle syncing. Criteria for inclusion was that the
source must be credentialed (i.e. registered dietician, naturopathic doctor, athletic trainer, et
cetera) and it must have been published within the last two years. Exclusion criteria included
social media “influencers” without credentials and publishment of more than two years ago.
Women’s health has a paucity of data with lack of information that many other areas in
medicine do not. Because of this, there is a lack of quality and variety in research studies
available. As more studies surface, it is with ambition that the findings in this literature review
and observational research will be further corroborated, and more validity will follow.
Background and Literature Review
A healthy menstrual cycle includes four phases: menstruation, follicular phase, ovulation,
and the luteal phase.1 To better understand what can supplement the cycle, the physiology of the
cycle must be explored. In general, a successful menstrual cycle can be classified into a complex
operation of tissues and hormones. Tissues that help to support, accommodate, and respond to
hormonal signals that promote release of an oocyte and maintain an adequate environment for a
conceptus. Hormones that harmonize functions between cells, structures, and organs to optimize
the environment as needs (implantation, fertilization, pregnancy) change. Hormones that will be
discussed are follicle-stimulating hormone (FSH), estrogen, luteinizing hormone (LH),
progesterone, and gonadotropin-releasing hormone (GnRH). FSH is released by the pituitary
gland and stimulates follicle maturation in the ovary. Estrogen is produced by the maturing
follicle and stimulates the proliferation of the endometrium. LH is also released by the pituitary
gland when estrogen hits a critical level and stimulates the release of the ovum from the follicle.
The gonadotropin-releasing hormone stimulates the pituitary gland to make and secrete both LH
and FSH. The follicle grows to corpus luteum producing progesterone that nourishes and
thickens the endometrium to create a good environment for a fertilized egg. When pregnancy
does not occur, the corpus luteum involutes and decreases progesterone levels, which will
eventually trigger menses.
Menstruation, also known as the early follicular phase, is a complex interaction of
molecular signaling from tissues and hormones through a positive and negative feedback loop.
Day one of the cycle is characterized as the onset of menstrual flow. At this time, hormone levels
are low, and production of estrogen and progesterone is low. There is an increase in FSH two
days before the onset of flow which stimulates pre-granulosa cells to convert to active hormonal
granulosa cells which begin their secretion of estradiol. Estradiol begins a self-propagating
process by stimulating LH which increases secretion of androgen precursors who ultimately will
be converted to estradiol. At Day 4-5, this rise in estrogen begins to shut off menstrual bleeding
and kickstarts endometrial regeneration.
After cessation of flow, the late follicular phase begins. Through the continued
production of estrogen and progesterone paired with the suppression of the hypothalamus by the
ovary and follicle, GnRH production is decreased which decreases the release of FSH and
increases release of LH. As FSH decreases, follicular development is slowed, and other emerging
follicles are halted from maturing and releasing their eggs. This self-limitation is why there is
only one egg released each month to be fertilized. Proliferation of the endometrium is continued
and reaches its maximum thickness 1-2 days before ovulation.
About 24 hours before ovulation occurs, progesterone production begins, and a surge of
LH triggers ovulation and an oocyte is released. Estrogen levels drop. Progesterone’s negative
feedback begins on the pituitary secretion of both FSH and LH and causes a second period of
endometrial fluid retention to prepare for a fertilized, implanted ovum.
The luteal phase marks the beginning of the end of the menstrual cycle and in the absence
of an implanted ovum, the corpus luteum begins to degenerate and estrogen and progesterone
levels continue their drop. This drop will trigger an output of pituitary gonadotropins which will
again stimulate release of FSH to begin follicular growth and a new cycle will begin.1 Below is
graph depiction of hormonal changes throughout a 28-day cycle.
Figure 1. Graphical depiction of hormonal fluctuations on a 28-day scale33
Undeniably, this summary is an oversimplification of the process, but does the work of
illustrating that an abundance of changes that are always occurring in a biologically female’s
body. Now that the physiological framework has been demonstrated, next is a deeper dive into
each of the phases to explore how they affect the daily life of a woman’s cognition, performance,
and mood and if it is possible to supplement lifestyle to optimize quality of life during each
phase.
Starting with menses (early follicular phase), progesterone, estrogen, FSH, and LH are
low. Besides the obvious obstacle of bleeding during this time, the impact on daily life can be
severe. Schoep et al. (2019) surveyed 42,879 women to analyze the impact of menstrual
symptoms on everyday life, it was concluded that 1/3 women quit daily activities owing to
menstrual symptoms such as abdominal pain, heavy bleeding, headache, back pain, and
tiredness.2 The authors found following dysmenorrhea, psychological complaints were the
second highest prevalent complaint including depression, anger or irritability, and trouble
concentrating. Another comprehensive review on the fluctuations of psychiatric disorders and
symptoms including addictive behaviors, psychosis, suicidality, anxiety, and posttraumatic stress
disorder across the menstrual cycle showed increase in psychosis, mania, depression,
suicide/suicide attempts, and alcohol use during late luteal and menstrual phases.3 Because of this
potential trend of increase in physical or psychiatric symptoms, clinicians have the opportunity to
predict worsening of symptoms and better prepare patients by offering coping strategies and
tools to improve this time of the cycle.
The late follicular phase was less studied in comparison to the other phases of the cycle.
At this phase, there is a steady increase in estrogen and the beginning of the increase in
progesterone. In a survey utilizing Moos Menstrual Distress questionnaire, it was found that
significantly more adverse symptoms were reported during the luteal and menstrual phases
compared to the late follicular phase.4 Most of the literature is comparing the late follicular phase
with the late luteal phase which just continues to trend that the luteal phase has significant
increase in dysphoric mood and impaired cognitive performance in relation to the follicular
phase.5 Due to estrogen levels rising to their highest, energy levels, mood, and strength are
elevating at this time in preparation of the next phase.
Ovulation marks the peak of LH and the release of the ovum from the follicle.
Schleifenbaum L et al. (2021) facilitated an online diary study finding that women report feeling
happiest, most attractive, and sexual desirable during and right before ovulation.6 The authors
found robust evidence in an increase in sexual desirability, self-perceived attractiveness, positive
mood, and self-esteem during ovulation. Lund A et al. (2016) completed research focusing on
stress management with the use of a functional Magnetic Resonance Imaging (fMRI) to compare
activity in the hippocampus while solving difficult mathematical problems on two occasions:
when estrogen levels were high (during ovulation and just before) versus when estrogens levels
were low (luteal phase and menstruation).7 It was concluded that there was more activity in the
hippocampus during times of high levels of estrogen, interpreted as better stress management.
This is illustrated once more in a study examining women’s mood responsiveness at work during
different phases of the menstrual cycle that shows estrogen to be linked to better production of
general arousal and reactivity in stressful environments.8
To mark the end of the cycle, the luteal phase begins. The increase in progesterone in this
phase can cause bloating, constipation, fatigue, and fluid retention.1 Bhargavi L et al. (2023)
conducted a study on the impact of the menstrual cycle on college aged girls, it was shown that
some women may experience the worst of the monthly symptoms with low affect, motivation,
high anxiety, tension, fatigue and weakness, depression, and hostility especially late in the luteal
phase.9 63.4% of the participants noted an impact of quality-of-life by reporting premenstrual
symptoms such as abdominal pain, nausea, mood swings, food cravings, and dizziness during the
luteal phase with an increase in negative moods and distress. In another study on patterns of
mood changes throughout the cycle, there is evidence of a significant increase in psychological
symptoms related to neuroticism and depression in the late luteal phase.10 Earlier, a research
study about stress management was analyzed, noting the increased ability to manage stress
during times of increased estrogen (ovulation), the opposite was also true. During times of low
estrogen in the luteal phase and menstruation, hippocampus activity was diminished showing
decreased ability to manage stress.7
In conclusion, during and right before ovulation women are feeling happiest, most
attractive, and have better stress management. During menstruation and late luteal phase, there is
shown to be increase in tiredness, moodiness, abdominal and back pain, and trouble
concentrating. The question remains if there is an answer to help mitigate the negative symptoms
and consequences of those symptoms using nutrition, exercise, and holistic medicine.
Nutrition
The basal metabolic rate (BMR) is defined as the number of daily calories the body needs
to accomplish its most basic life-sustaining functions such as blood circulation, cellular growth,
regulation of body temperature, and hormone production. Each individual’s BMR is different
and dependent on a multitude of factors including but not limited to age, biological sex, level of
physical activity, genetics, and health conditions. There are several equations to estimate an
individual’s BMR including Ravussin and Cunningham equation, Harris-Benedict equation, and
Schofield equation, Katch-McArdle Formula, and the Mifflin-St Jeor equation. There is
variability on which formula is most accurate. An analyzation of the validity of predictive BMR
values was completed by the Journal of Nutritional Science in 2020, it was concluded that the
Mifflin St. Jeor equation was most accurate for females with varying Body Mass Index (BMI).11
The Mifflin-St. Jeor Equation for women is as follows: (10 x weight in kg) + (6.25 x height in
cm) – (5 x age in years) – 161.
It can be hypothesized, given the hormonal effects of the menstrual cycle in other aspects
of the physiology of women’s bodies, that there is an effect on BMR depending on where a
woman is in her cycle. A study examining resting energy metabolism and sweet taste preference
illustrated that BMR is lower in follicular phase versus luteal phase and that there is lower
consumption and preference to sweet foods during the follicular phase compared to luteal
phase.12 This is supported in another narrative review that shows an increase in energy intake in
the luteal phase compared to the follicular phase with the lowest intake in the late follicular and
ovulatory phases.13 Additionally, in studying variations in energy intake and energy expenditure,
the luteal phase, again, is increased.14
Given this clear association, it can now be explored if there are certain foods that can be
consumed that will benefit and optimize women’s energy and overall feeling of wellness. Souza
L et al. (2018) performed a cross-sectional study to evaluate food intake and cravings during the
menstrual cycle.15 It was observed that there’s not only a change in variation of food preferences,
but also consumption throughout the different phases. The study showed an increase in foods
rich in sugar, salt, and fat such as desserts, pastries, and chocolates in the premenstrual period.
Additionally, a higher intake of carbohydrates, protein, fiber, and calcium during the luteal phase
as well.
Unfortunately, there is lack of research if this is a beneficial change in diet for the
physical and psychological wellness of the woman. If optimizing fertility is the goal, it is
recommended to avoid alcohol, refined carbohydrates, processed sugary foods, reducing red
meat consumption, and considering eliminating dairy.16 Another study confirms this, concluding
that if unbalanced, dietary fatty acids, carbohydrates, and proteins may impair metabolic
homeostasis and fertility.17
Exercise
It is a common recommendation the physical training can be used to positively influence
menstrual symptoms.18 Due to the physiological fluctuations illustrated earlier, the menstrual
cycle is known to cause alterations in muscular strength, endurance, body temperature, and blood
flow which all affect physical training performance.19 Based on that article, it is said that if the
exercise load is intense enough, it can be harmful and cause irregular or even the absence of
menses. Therefore, types of exercise and levels of intensity should coincide with phases of the
menstrual cycle.
In a critical and systematic review of the menstrual cycle phase on elite athlete
performance, it was illustrated that performance and responses to physical training can be
improved in female athletes when adjusted to their menstrual cycle through a notable change in
endurance, power resistance, ligament stiffness, decision making skills, and competitiveness.20
Endurance performance increased during follicular phase and maximal strength produced is
shown post-menstruation mid-follicular phase. Additionally, maximal voluntary contraction is
significantly increased during follicular phase compared to late luteal phase.21
During the luteal phase, exercise is complicated. While some literature does not suggest
effect to physiological processes because of the menstrual cycle, there is a clear change in
psychological response during luteal phase especially during exercise at high intensity. This
psychological response is shown through rate of perceived exertion being increased despite same
level of intensity.22 Although it may be difficult to start exercising and during the workout,
women displayed higher anxiety, tension, depression, hostility, and lower arousal affect and
motivation before exercise compared to after. Illustrating that working out has a positive effect.
However, there’s evidence of a deterioration in balance and an increase in asthma attacks in
those with asthma during this phase and the dangers of that should be considered.
Holistic Approach
Holistic medicine is an approach to wellness that assimilates physiological,
psychological, and spiritual components of health. Examples of holistic health are dietary and
herbal supplements, yoga and meditation, acupuncture, psychotherapy, diet, and exercise.
Kashani L et al. (2015) conducted a study on complementary and alternative herbal medicine in
women’s health, it was found that there are many successful treatments that could play a role in
treating premenstrual symptoms, post-natal depression, and menopausal symptoms.24 There is
evidence that due to the drastic drop in progesterone at the end of the luteal phase, a large change
in serotonergic conductivity in the CNS occurs. Authors suggested that although the
pharmacological first line would be a selective serotonin reuptake inhibitor (SSRI), Saffron has
shown to be an effective treatment of premenstrual related mild to moderate depression.
Furthermore, Gingko Biloba was found to provide relief in premenstrual symptoms such as fluid
retention and breast tenderness. Evening Primrose oil, a plant oil containing omega-6 essential
fatty acid, has a potential role in regulating pain and inflammation in the body as well, but was
found to be no more effective than the placebo.
Begum M et al. (2016) supported the use of medicinal plants and home remedies for
management of menstrual cycle symptoms including essential oils, hot compresses, self-
acupressure, and supplements.25 Essential oils such as lavender, sweet marjoram, sweet fennel,
and German chamomile had benefits. Lavender oil to relieve anxiety, depression, and pain during
menstruation, sweet marjoram to reduce menstrual cramps, sweet fennel to assist in promoting
menses and regulating monthly discharge, and German chamomile to reduce inflammation,
promoting calmness, reducing anger, irritability, and depression. Self-acupressure for menstrual
pain was also explored, noting that certain pressure points on the abdomen, back legs, and arms
can relieve discomfort, cramps, back pain, reduce bloating, and regulate menses. Authors
suggested supplements such as Vitamin A, magnesium, Omega-6 fatty acids, fermented cod liver
oil, and gelatin were shown to reduce premenstrual symptoms such as pain, irritability, mood
swings, and fluid retention.
Research Proposal
As of April 2024, there are 5.07 billion social media users worldwide; this number
amounts to 62.6% of the global population.26 Social media apps such as Facebook, Instagram,
TikTok, and X are frequently used for news, socializing, and information on topics from fashion
to politics to literature.27 Facebook is ranked the most commonly used social media app
worldwide, Instagram is ranked third, TikTok is ranked fourth, and X is ranked sixth.28 Because
of this easily accessible outlet for education, this observational research study will investigate
what is being promoted on social media for cycle syncing with diet, exercise, and holistic
medicine and if there is overlap between the four sites.
A common obstacle the population faces is sorting deceptive sources from accurate
ones.29 Falsified information can easily be spread especially when a person has a large platform
of followers. For the purposes of this observational research, inclusion criteria for results were
sorted to ensure a credentialed sources rather than a social media or “fitness” influencer. While
there may be some validity to what influencers say, marketing, promotions, and the desire to gain
more followers causes a conflict of interest with the information that is exhibited.
To respect the privacy of the content creators, the names have been altered as follows:
Facebook sources will be listed as Source 1A (diet), Source 1B (exercise), Source 1C (holistic
medicine), Instagram sources will be listed as Source 2A (diet), Source 2B (exercise), Source 2C
(holistic medicine), TikTok sources will be listed as Source 3A (diet), Source 3B (exercise),
Source 3C (holistic medicine), and X sources will be listed as Source 4A (diet), Source 4B
(exercise), Source 4C (holistic medicine). Cycle syncing trend promotions using diet, exercise,
and holistic medicine on each of the four platforms (Facebook, Instagram, TikTok, X) was
observed to identify if the data can be reflected on the literature presented and if there is potential
for it to work.
Research Results
Facebook
Source 1A, an integrated functional medicine doctor, promotes a plan for women’s cycles
to “revitalize your roots, harmonize your hormones, and elevate your energy” by cycle syncing.
The first step being “revitalizing roots” is by having a diet that supports every phase of the cycle.
Source 1A focuses on battling nutrient deficiency and suggests adding leafy greens, nuts, seeds,
and lean proteins.
Source 1B, a homeopathic practitioner, suggests an exercise plan following each of the
four phases of the cycle. It is recommended that during the menstrual phase to try gentle yoga,
light walking, and stretching supports the body while it conserves energy. During the follicular
phase, it’s encouraged to embrace higher energy with cardio, strength training, and HIIT. Next,
the ovulatory phase is time to “go all out” with high intensity because of peak energy. Finally,
during the luteal phase it’s recommended to shift to moderate intensity cardio and Pilates while
slowly incorporating more rest and recovery as the menstrual phase approaches.
Source 1C, a women’s health holistic coach and practitioner, discusses the importance a
well woman not starting with diets or supplements or “biohacking” the cycle, but rather the
psyche. Supporting regulation of the nervous system and living in alignment of the feminine
cyclical design rather than a masculine approach to wellness is key to having more energy,
clarity, and intuitive connection with the body. Source 1C recommends herbals such as red
raspberry tea, light exposure, castor oil packs at night, and keeping the womb warm.
Instagram
Source 2A is a registered dietician that focuses on women’s hormone balance. Source 2A
not only gives recommendations for cycle syncing and diet, but also common habits that may be
messing with the hormonal balance. Some of these suggestions include drinking coffee with a
meal to avoid cortisol spikes, incorporate protein during breakfast, stop intermittent fasting,
avoid going low carbohydrates, and eating enough calories. Intermittent fasting is a common
method for weight loss, however, Source 2A suggests that most studies on intermittent fasting
have been done on men, which do not have the same hormonal fluctuations as women.
Therefore, intermittent fasting is not supportive of the hormonal balance for a woman.
For cycle specific recommendations, easily digestible, anti-inflammatory foods rich in
iron, vitamin C, and magnesium such as dark leafy greens, legumes, strawberries, beans, and
dark chocolate are suggested for the menstrual phase. For the follicular phase, gut supportive
foods and foods that support estrogen balance such as kimchi, asparagus, oats, flaxseeds,
edamame are favored. During the ovulatory phase, supporting the liver and estrogen
detoxification is recommended through consumption of cruciferous veggies and fiber like sweet
potatoes, avocado, Brussel sprouts. Lastly, the luteal phase can be supported with complex
carbohydrates and foods high in potassium, calcium, magnesium, and zinc to help optimize
progesterone production such as chickpeas, bananas, beans, salmon, turmeric.
Source 2B has a master’s in science and is a cycle syncing strength coach. This source
promotes that during the menstrual phase patients will feel more lethargic and less tolerant to
heat, therefore, moderate volume and load during lifting and keeping cardio low volume. During
the follicular phase, training efficacy and motivation increases leading to more challenging
workouts, better heat tolerance, and higher volume loads for lifting and cardio. The ovulatory
phase is recognized as the “peak week” and the time for highest volume, load, and longest lifting
and cardio sessions. Finally, it is suggested that the luteal phase is a time for de-loading which
means slowly cutting down on repetitions and time for lifting and cardio. Additionally, new
plyometric movements should be limited due to decreased coordination. Rather than suggesting
that women are “weak” during their menstrual phase, Source 2B suggests that there is incredible
strength and power outputs during bleeding.
Source 2C, a nutritionist, has several holistic medicine suggestions to optimize the
women’s hormonal cycle and fertility. The source advocates for maca root, magnesium, and red
light therapy to boost mood and energy levels because of increased cellular energy production.
For cycle specific menstrual symptoms, Source 2C proposes ginger to eases cramping, rose to
help irregular menstruation, and ginseng that fights fatigue and stress, improves mood and
metabolism. In addition, omega 3’s are advised to support the woman’s hormonal cycle by
relieving menstrual pain due to anti-inflammatory processes, harmonizing hormone regulation,
enhancing mood stability, optimizing fertility potential, and supporting cervical mucous quality.
TikTok
Source 3A is a dietician that promotes cycle syncing for both diet and exercise. The use
educates the followers by discussing the importance of supporting the basal metabolic rate
(BMR) during each phase. It is stated that not eating enough and overexercising with the loss of
the menstrual phase of the cycle causes injury to bone density. For recommendations, it is said to
focus on carbohydrates with vegetables and protein at every meal to balance blood sugar and mix
in healthy fats daily.
Source 3B, a health coach and certified personal trainer, promotes healthy hormones by
cycle syncing exercise. The important distinction that women have a 28-day hormonal cycle, and
men have a 24-hour hormonal cycle is emphasized on the source’s page. Because of this
difference, it is said that men can wake up any day of the month and do a high intensity interval
workout, whereas a woman may feel strong one day and not so strong the next day. For the
menstrual phase, light movement is advised such as rest, walking, yoga, stretching, body
weightlifting. The follicular phase transitions to more intense cardio like running and Pilates.
Next, the ovulatory phase is the best time for high intensity circuits such as running, weight
training, HIIT. Finally, the luteal phase is the time to begin high intensity for the first half and
lower intensity for the second half. For example, HIIT, weightlifting and running turning into
hiking, Pilates, yoga, and stretching as the menstrual phase approaches.
Source 3C, a clinical herbalist and integrative health practitioner, suggests several herbs
for hormone health and optimizing the menstrual cycle. Several herbs are promoted including
raspberry leaf as uterine tonic, chate tree to support ovulation and regulate the cycles, and ginger
rhizome as a powerful anti-inflammatory that eases period discomfort and cramps. Also, it is
suggested to wake up naturally with a wake light to promote best sleep especially during the
luteal and menstrual phases along with getting sunlight on the stomach in the morning.
X
Source 4A, PhD, recipe developer, and writer, prioritizes nutrition with cycle syncing.
Dark leafy greens, berries, oily fishes, ginger, carrots, beets are advised during the menstrual
phase. Next, pumpkin seeds, lettuce, lentils, oranges, eggs, fermented foods are suggested for the
follicular phase. Then, bell peppers, Brussel sprouts, asparagus, salmon, flaxseed, coconut,
quinoa are recommended for the ovulatory phase. Finally, consumption of cabbage, cauliflower,
bananas, apples, dates, ginger, mint, mushrooms are instructed for the luteal phase. Source 4A
also has recommendations for how the food should be prepared for each phase. It is suggested to
steam or sauté during the follicular phase, to consume steamed or raw foods for the ovulatory
phase, roast or bakes for the luteal phase, and stews or soups for the menstrual phase.
Source 4B, a children sports MD, and Source 4B1, MD work for a research program that
stresses the importance of the effects of the female cycle and exercise. Many young females lose
their period during bouts of heavy training. Sources draw to the importance of despite the
decades of increased female participation in sports, there remains a large gap in sports medicine
and exercise research studying female athlete’s performance and well-being. Source 4B posts
that losing the period during training is not a normal response, meaning that the fueling is not
matching the exercise efforts. In an article republished on source 4B’s page, Source 4B1 speaks
on the nuances of training during the menstrual cycle. The article promotes strength training
during the late follicular phase due to estrogen levels being the highest and the fact that estrogen
plays a role in muscle synthesis. During the luteal phase, since the body conserves carbohydrates
and relies on fat as fuel, this phase is best to have steady state cardio activities compared to HIIT
which require more access to carbs for quick bursts of energy. Recovery may be slower in this
phase as well.30
Source 4C, Doula and childbirth educator, promotes the importance of holistic pregnancy,
preconception health, and cycles. Source stresses the importance of blood building herbs and
supporting progesterone and estrogen levels. Vitamin C, nervous system regulation, zinc,
magnesium, and selenium are suggested for progesterone production. To support estrogen levels,
it is suggested to not utilize birth control pills and use glass containers rather than plastics.
Nervous system regulation is also promoted through practices such as emotional freedom
technique tapping and breath work.
Overlap of Social
Media
Recommendations
Menstrual Phase Follicular Phase Ovulatory Phase Luteal Phase
Diet
leafy greens, dark
chocolate, berries,
iron-rich foods,
support BMR
fermented foods,
seeds, lentils,
support BMR
bell peppers, Brussel
sprouts, support BMR Bananas, support BMR
Exercise yoga, light walking,
stretching, rest
higher volume
lifting and cardio
like running or
Pilates
HIIT, heavy
weightlifting, running
Higher intensity
(weightlifting, running)
to lower intensity (yoga,
stretching)
Holistic Medicine
raspberry leaf tea,
ginger, nervous
system regulation,
magnesium
nervous system
regulation,
magnesium
nervous system
regulation, womb
warmth, magnesium
nervous system
regulation, magnesium
Figure 2. Table depicting the consistency across social media platforms for cycle syncing recommendations
Overlap of
Literature and
Social Media
Recommendations
Menstrual Phase Follicular Phase Ovulatory Phase Luteal Phase
Diet
iron-rich foods
(leafy greens),
Vitamin C (berries,
citrus), dark
chocolate
complex
carbohydrates,
seeds (healthy
fats), fermented
foods, BMR lower
cruciferous vegetables
(brussel sprouts,
asparagus), avocados
(healthy fats)
high fiber foods (sweet
potatoes, apples, beans),
complex carbohydrates,
BMR higher
Exercise yoga, light walking,
stretching, rest
higher volume
lifting and cardio
like running or
Pilates
HIIT, heavy
weightlifting, running
Higher intensity
(weightlifitng, running)
to lower intensity (yoga,
stretching)
Holistic Medicine
saffron, gingko
biloba,
acupuncture/self
acupressure,
magnesium, omega
3s/6s
magnesium
Acupuncture, self
acupressure,
magnesium
saffron, gingko biloba,
magnesium
Figure 3. Table depicting the consistency across social media platforms along in addition to literature for cycle syncing
recommendations
Discussion and Analysis
Based upon the literature presented in addition to the experts’ recommendations on cycle
syncing via social media, there is clear overlap and great potential to optimize women’s quality
of life by harmonizing diet, exercise, and holistic methods with the phases of the menstrual
cycle. Below, each phase is listed with recommendations combining the literature review and
social media observational research. Following the amalgamation of the literature review and
expert sources from social media, further analysis, discussion, conclusions, limitations and
implications for further research is completed.
Menstrual Phase
Due to the low hormone levels, patients should focus on consuming iron-rich foods such
as lean red meat and green leafy vegetables to replace any lost iron from the lost blood, foods
high in Vitamin C like citrus fruits and berries to enhance iron absorption, foods high in Vitamin
K like blueberries, eggs, cheese to reduce heavy bleeding, and foods containing Omega-3 fatty
acids like flaxseed and salmon to reduce inflammation and cramping.
In addition to nutrition, exercise during menstruation should have a lower intensity to
support the body’s lower energy like rest, stretching, yoga, and walking. Additionally,
implementing holistic health such as supplements like magnesium, ginger, and raspberry leaf tea
will support menstruation. Magnesium will help mitigate painful periods and support low energy
and libido in this phase and the late luteal phase. Ginger and raspberry leaf tea will assist in
easing period discomfort and cramps.
Follicular Phase
Patients should begin to support the body’s increasing energy levels by consuming lean
proteins and complex carbohydrates such as seeds, lentils, brown rice, and quinoa. Furthermore,
foods that will help balance the body’s increased estrogen levels such as cruciferous vegetables,
fermented foods such as kombucha, and healthy fats like avocados, flaxseeds, and pumpkin
seeds are suggested. Exercise should begin to increase in intensity at this time with a cardio-base
such as running, swimming, and higher volume lifting. Holistic methods such as supplementing
magnesium and nervous system regulation by practice of deep breathing exercises and spending
time in nature will support this phase.
Ovulatory Phase
During ovulation, patients are advised to prioritize estrogen-balancing foods and a diet
sustaining the extra strength and energy of this phase. Two of the most recommended foods were
bell peppers and Brussel sprouts. Exercising should be taken advantage of in this phase as energy
levels are peaking, high intensity interval workouts and attempting personal records is
encouraged at this phase. A holistic method presented by two social media experts to support this
phase is referred to as “womb warming”. Upon further research, it is several practices that are
said to encourage ovulation which include ginger tea, dressing warmly, allowing sunlight on the
stomach, acupuncture to the lower abdomen, and keep the soles of the feet warm.31
Luteal Phase
This phase is dominated by the beginning of premenstrual cravings and hunger. Patients
should be advised to consume complex carbohydrates and high fiber foods such as sweet
potatoes and cruciferous vegetables will keep the body feeling fuller longer. Additionally, it is
suggested to add bananas because the potassium will help reduce bloating. Hydration is also key
to reduce the bloating and brain fog that accompanies the luteal phase. Exercise will look and
feel different at the beginning of the luteal phase versus the late luteal phase. Patients should
begin with medium-intensity cardio and strength training and start slowing things down to yoga,
stretching, and walking as the menstruation approaches and the cycle starts over. Essential oils,
hot compresses, self-acupressure, magnesium, nervous system regulation, saffron, and gingko
biloba can be considered as an adjunct at this time and during menstruation as well.
Conclusions
Although further research is essential to better support, define, and confirm the optimal
changes, it may be possible to optimize overall quality of life if a woman implements cycle
syncing diet, exercise, and holistic medicine into a monthly routine. To succeed, patients must
strictly track the phases of the menstrual cycle and pair that phase with a change in lifestyle
choices. During the menstrual phase, patients should be counseled on the importance of properly
nourishing the body with iron-rich foods along with foods high in Vitamin C and Vitamin K.
Movement and exercise should be more limited to walking, stretching, and light yoga. Over the
course of the follicular phase, patients should consume lean proteins, complex carbohydrates,
and fermented foods. With increasing energy levels, patients can begin to push to higher intensity
workouts including running and higher volume lifting. While in the ovulatory phase, patients
should be advised to eat estrogen-balancing foods and support the basal metabolic rate to sustain
higher energy and ovulation. Due to peak energy levels, patients should be advised to exercise at
highest intensity. Within the luteal phase, patients should be advised to consume complex
carbohydrates and high fiber foods and start with higher intensity workouts at the beginning of
the phase with slow transition to lower intensity workouts as the cycle begins to repeat itself
again. Holistic medicine can be used to support the phases with supplements like raspberry leaf
tea, ginger, womb warming, and nervous system regulation.
All things considered, it is most important to listen to what feels right for the body and to
take into consideration what the body is doing physiologically paired with psychological feelings
to make decisions on how to fuel and move the body throughout the month.
Implications and Limitations
The cycle syncing trend has advanced before evidence-based research studies and
analysis have been completed. The question remains of why this is, which there is no simple
answer for. It’s well known that scientists prefer simplicity. If the research goal is to evaluate a
chemical or molecular mechanism, it makes most logical sense to eliminate as many external
variables as possible to prevent outliers. Women’s bodies and hormonal fluctuations are the
opposite of simple and present an anomalies and deviation nightmare for scientists. The
fluctuating hormones are background noise to any data found. This becomes inconvenient,
expensive, and time-consuming to control its variability. Therefore, men’s bodies are a simpler
test subject and that is what has been studied for years. In addition to research on a “healthy”,
there is another layer of difficulty added when pathology is involved in the cycle such as
Premenstrual Dysphoric Disorder (PMDD) or polycystic ovarian syndrome (PCOS).
Research utilizing women is essential for better understanding of the true biological
differences between biological males and females and how that may affect the way the body
metabolizes medicine, reacts to stressors, or better predict how the body will respond during
certain times of the month with different levels of hormones to name a few. This will not only
improve healthcare outcomes, but also women’s quality of life by displaying concern and
attentiveness to the patients as individuals.
Another obstacle while attempting to cycle sync is not knowing the exact phase a patient
is currently in. While there are methods to track the menstrual cycle with the use of apps, basal
body temperature, ovulation predictor kits, and measurement of hormones, this is not an exact
science. Because of this, the days may range slightly from what is expected as in Figure 1, which
can complicate knowing exactly when or what to implement for nutrition, exercise, and holistic
methods.
Using social media as an outlet for advice in cycle syncing presents two major issues: (1)
the algorithm and (2) potential for the content creator to monetize the content or promote brands.
Social media’s design is specialized because the more research done on a particular topic, more
of that content will be exposed to the consumer on what is called the “For You Page” or “Feed”.
Because of this, if a patient is researching cycle syncing and comes across an influencer or
person spreading falsified information on the topic of cycle syncing, more of that falsified
information will continue to come up on the feed. Unfortunately, this isn’t something that can be
controlled as the algorithm is set to “optimize user experience by showing relevant and engaging
content that’s likely to keep users on the platform longer”.32
Secondly, many content creators, even registered dieticians, MDs, et cetera, use social
media as a monetizer. Because of this, validity may be questionable if there is an attempt to sell
their own product, gain a greater follower count, or advertise certain products for commission.
This causes conflicts of interest and blurs the lines of what is true and what is being promoted for
financial compensation. This phenomenon is already seen in other areas of medicine with weight
loss teas or pills or detox diets and is something all users should be aware of when attempting to
do research. While there is quite a bit of overlap between the literature and what can be found on
social media, there are irregularities. Whether this is due to false information or lack of research,
it can cause confusion on what could really work to optimize a woman’s hormonal cycle.
Although it appears that evidence exists for diet, exercise, and holistic medicine to be
used during each menstrual cycle phase to optimize women’s quality of life, effects are still
trivial due to the lack of research, inability to determine which phase a woman is in, pathology of
cycles, and potential spread of false information for promotions and commission on social
media. As additional studies emerge, it is hopeful that the findings from this literature review and
observational research will be further confirmed, adding greater validity to the results.
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