Here at the Metabolic Effect clinic we specialize in hormonal fat loss. Female Phase Training or Menstrual Cycle Training is one such protocol we have developed.
What is Female Phase Training or Menstrual Cycle Training?
Female phase training is a way to cycle female conditioning and nutrition in a way that takes advantage of the monthly fluctuation of steroid hormones (estrogen and progesterone) in the normal female menstrual cycle. Estrogen and progesterone impact fat gain and loss through their direct impact as well as their effect on other hormones.
Before I get started, and because I know it is going to come up, this protocol needs to be viewed differently by those women on contraceptive therapy as these therapies render the normal female cycle obsolete by giving standard and static doses of hormones throughout the month. That being said, cycling diet and exercise are excellent strategies in general for both men and women. So even if you are not menstruating regularly a cycling strategy such as this can work wonders. For more on that see this blog on the 4 metabolic toggles.
Another caveat regarding this program is to understand what we call the primacy of insulin and cortisol. What that means is that a women with high insulin and/or cortisol levels (i.e. eating a standard American, high starch diet) and insulin resistance will not see the pronounced effect of this style of training due to the fact that insulin and cortisol are far greater promoters of fat regulation than either estrogen or progesterone.
Bottom line, this protocol works best in the context of a balanced carb & reduced insulin lifestyle. High levels of insulin and cortisol essentially “wash out” any of the weaker effects of the female reproductive steroids.
Brief review of the menstrual cycle.
The hypothalamus (a part of the brain just above the brain stem) at the beginning of the woman’s cycle secretes ganodatropin releasing hormone (GnRH). This hormone then activates the release of follicle stimulating hormone (FSH) and leutinizing hormone (LH). These two hormones are involved in ripening the follicle (the place where the egg is held) and then causing the follicle to rupture and release an egg (LH).
There are two distinct phases of the menstrual cycle. The follicular phase is marked by the beginning of menses (day 1 of the cycle) and ends at ovulation (day 14 of the cycle in the textbook case).
It is called the follicular phase because the follicle, (which contains the female egg), is maturing during this phase mainly under the influence of follicle stimulating hormone (FSH). The proper maturation of this follicle is essential for the release of an egg. Improper maturation usually results in the formation of a cyst and no release of an egg. As the follicle matures, estrogen levels released from the ovaries steadily rise.
The second phase of the cycle is the luteal phase. This phase is marked by ovulation and the subsequent transformation of the follicle into the corpus luteum once the egg is released. This phase is triggered by a large surge in lutenizing hormone which causes the follicle to “pop” and release its egg.
The corpus luteum becomes the source of progesterone and the rising levels help change the chemistry of the uterine lining increasing the chances that a fertilized egg can attach and implant itself.
If the egg is not fertilized, the corpus luteum degrades, estrogen and progesterone levels both fall, and the uterine lining is shed resulting in bleeding (i.e. menses).
The different ways to view the menstrual cycle
There are actually several ways to view the menstrual cycle we need to be aware of. We can divide the cycle into two distinct phases, one where estrogen dominates over progesterone (follicular phase), and one where progesterone dominates over estrogen (luteal phase).
We also can view the cycle in four phases. Estrogen rising and progesterone low (early follicular phase), estrogen high and progesterone low (late follicular phase), estrogen high and progesterone high with progesterone dominating (early luteal phase), and then estrogen and progesterone falling low with progesterone dominating (late luteal phase).
Dividing the cycle into two phases looks at things from a relative perspective. We are simply interested in estrogen and progesterone relative relationship. This is useful for overall fat loss considerations.
Looking at the cycle in four phases looks at things from an absolute perspective in terms of estrogen and is more useful for targeted fat loss. For example, the hips, butt and thighs of women burn fat more slowly due to high density of alpha receptors in the fat tissue. Estrogen amplifies the activity of these alpha receptors and therefore low estrogen levels, absolutely speaking, are best if targeting these areas. The lowest estrogen levels of the cycle come the week before and after menses (late luteal and early follicular).
What does this have to do with fat loss?
In addition to having reproductive function, estrogen and progesterone have an impact on fuel storage and fuel use. They also impact brain chemistry. There are receptors for estrogen and progesterone all over the body, including the muscle and fat tissue.
These two hormones can influence what type of fuel is burned (sugar versus fat). They also impact hunger, energy and cravings (HEC). This is mainly because they can mildly influence two primary fuel regulating hormones, insulin and cortisol and the brain chemicals serotonin, dopamine and GABA. And, if you think for a minute, this makes sense. The reproductive capacity of a women and the viability of her offspring depends on the ability to consume and store resources.
During the follicular phase the egg is not yet released, but after ovulation the possibility of an egg being fertilized means the body shifts into more of fat storing, craving physiology and becomes more reliant on sugar burning (more insulin resistant) which would provide easily accessible fuel for a growing fetus.
So, very simply, the follicular phase is a time of relatively better fat burning, while the luteal phase shifts the body into more relative use from sugar versus fat.
Estrogen directly opposes the action of insulin on the major fat storing enzyme LPL, essentially making the body less prone to fat storage and more prone to fat release. Estrogen is also anti-cortisol (as is progesterone).
This means women may be able to better tolerate a little more starch and burn greater proportions of fat during exercise with less consequences of stress hormone production. This is a great time to focus more on an eat more, exercise more strategy.
The body may be able to better handle the stress of more frequent, more intense exercise like metabolic conditioning or longer exercise sessions. This includes steady state, longer-duration and moderate intensity cardiovascular exercise (since women burn higher proportions of fat at all exercise intensities during this phase).
Progesterone opposes the action of estrogen and may make the body more reactive to starch/sugar (i.e. more insulin resistant). Based on these metabolic changes, women may want to control their starch/sugar intake to a greater degree during the luteal phase.
Progesterone, like estrogen, is anti-cortisol but it decreases insulin sensitivity. The luteal phase is a time where both estrogen and progesterone are elevated together, but with progesterone more dominant.
With progesterone relatively higher than estrogen, the female metabolism becomes more of a “sugar burner” (more insulin resistant) and may be more reminiscent of the male physiology. This especially becomes true at menses (late luteal phase) when estrogen and progesterone both fall away.
Estrogen may enhance fat release during exercise, but may blunt the metabolic effect that comes after a workout. The after-burn of exercise MAY be accentuated in the luteal phase, allowing women to take advantage of this unique aspect of exercise.
Given estrogen and progesterone are elevated together in the early luteal phase, they may be able to enjoy high-intensity workouts like metabolic conditioning during this time without over stressing the system. It is also important to consider the late luteal phase likely becomes a time of increased stress reactivity when the two hormones fall low.
Based on all these considerations, here are two different protocols for phase training. One for overall fat loss and one for targeted fat loss. Obviously, if one understands the biochemistry here there could be many other ways to attack this, but the protocols below have been used and tested in our clinic. They work best.
Protocol 1: General Fat Loss (using two phases of the cycle)
- Follicular phase (Days 1-14): 40:30:30 macronutrient intake (carbs:protein:fat). 3 times weekly full body traditional weight training (squat, bench press, back row, shoulder press), 4 sets of 10 using a 8-12 rep max. 5 days per week steady state moderate intensity cardio (30-60 minutes) and/or metabolic conditioning (10-30 minutes). Daily leisure walking
- Luteal phase (Days 14-28): 30:40:30 macronutrient intake (carbs:protein:fat). 2-3 days per weekfull body traditional weight training (squat, bench press, back row, shoulder press), 4 sets of 10 using a 8-12 rep max and/or metabolic conditioning (mixed weight & cardio interval training). Daily leisure walking and special focus on rest and recovery approaches.
- Repeat next month
Protocol 2: Targeted Fat Loss (using four phases of the cycle)
- Early Follicular phase (Days 1-7): 40:30:30 macronutrient intake (carbs:protein:fat).2-3 days per week full body traditional weight training (squat, bench press, back row, shoulder press), 4 sets of 10 using a 8-12 rep max and/or metabolic conditioning (mixed weight & cardio interval training). Daily leisure walking and special focus on rest and recovery approaches.
- Late Follicular phase (Days 7-14): 30:40:30 macronutrient intake (carbs:protein:fat). 3 times weekly full body traditional weight training (squat, bench press, back row, shoulder press), 4 sets of 10 using a 8-12 rep max. 5 days per week steady state moderate intensity cardio (30-60 minutes) and/or metabolic conditioning (10-30 minutes). Daily leisure walking
- Early Luteal phase (Days 14-21): 30:40:30 macronutrient intake (carbs:protein:fat).3 times weekly full body traditional weight training (squat, bench press, back row, shoulder press), 4 sets of 10 using a 8-12 rep max. 5 days per week steady state moderate intensity cardio (30-60 minutes) and/or metabolic conditioning (10-30 minutes). Daily leisure walking
- Late Luteal phase (Days 21-28): 40:30:30 macronutrient intake (carbs:protein:fat). 2-3 days per week full body traditional weight training (squat, bench press, back row, shoulder press), 4 sets of 10 using a 8-12 rep max and/or metabolic conditioning (mixed weight & cardio interval training). Daily leisure walking and special focus on rest and recovery approaches.
- Repeat next month
- Remember, this outlines one approach and rationale. These protocols can be adjusted based on your understanding of the biochemistry.
- You may want to familiarize yourself with the different metabolic toggles of eat less & exercise more (ELEM), eat less & exercise less (ELEL), eat more & exercise more (EMEM) and eat more & exercise less (EMEL). ELEL and EMEM are what we use in these protocols. See details at this blog and this blog
- Luteal phase increases both energy intake and energy expenditure in women as well as increases cravings for sweet and fatty foods. The cravings are likely a result of the falling estrogen and progesterone levels premenstrually, both of which have receptors sites in the brain and influence both GABA, serotonin, and dopamine. We use unsweet cocoa powder & BCAA supplements mixed in water to deal with this as it will raise neurotransmitters (cocoa raises serotonin and dopamine & BCAA increase GABA). Ironically chocolate, most especially dark chocolate, is a proven craving in women at this time. Cocoa powder allows a calorie free brain chemistry directed treatment specific to this issue in women. You can get the specific cocoa we use to combat this here.
- The follicular phase is shown to be a more anabolic time overall allowing women to engage in more cardio based exercise with less chance of losing muscle as well as derive enhanced lean tissue gains from weight training.
- The luteal phase is more of a catabolic time for muscle tissue making long-duration cardio less beneficial and higher protein diets more prudent. There is some evidence the luteal phase has a greater EPOC and after-burn effect associated with it.
- Oral contraceptive pills provide clues as to some of the effects stated above. The progestin only OCPs show a greater tendency toward weight gain in studies. The traditional biphasic OCPs show less of an effect illustrating increased metabolic rate along with increased energy intake. This lends credibility to the estrogen and progesterone effects stated above. HRT in menopausal women indeed seems to result in weight gain, but does seem to spare the belly fat accumulation that can occur in menopausal women (this may be the anti-cortisol impact of estrogen and progesterone). HRT (whether contraceptive or menopausal replacement) in women looks more like the luteal phase.
- As stated previously, much of the impact of female reproductive hormones is a mute point if background insulin levels are too high. Their influence seems to be exerted only undercontrolled carbohydrate intake and consistent training states.
If you are interested in learning where much of the information for this article comes from, see the references below. Also, understand we have extrapolated this information from the research and applied these protocols in our clinic with very good clinical success. The current state of research in this area is highly controversial as well as contradictory.
This is largely due to the inability to isolate these effects under the influence of other more powerful hormonal influences as well as the fact that each female has a unique cycle. Hormones do not work in isolation and estrogen and progesterone are far down the totem poll in their influence on fat metabolism. Their influence becomes relevant only when these other hormones are controlled.
What we offer here is our interpretation of the information and our experience (research, hormonal lab testing in our clinic, and clinical results using the protocol) and our clinical use of it. This protocol has been refined overtime and will continue to be adjusted as we learn more. We hope it is useful for lean/fit women struggling to lose fat from stereotypical stubborn fat deposits (hips/thighs/butt).
- Gretchen, et al. Menstrual cycle phase and oral contraceptive effects on triglyceride mobilization during exercise. J Appl Physiol 2004;97: 302-309.
- Davidson, et al. Impact of the menstrual cycle on determinants of energy balance: a putative role in weight loss attempts. International Journal of Obesity. 2007;31:1777-1785
- D’eon et al. The Roles of Estrogen and Progesterone in Regulating Carbohydrate and Fat Utilization at Rest and during Exercise. Journal women’s health and gender based medicine 2002;11(3):225-237.
- Nakamura et al. Hormonal Responses to Resistance Exercise during Different Menstrual Cycle States. Medicine & Science in Sports & Exercise. 2011 Jun;43(6):967-73
- Oosthuyse & Bosch. The Effect of the Menstrual Cycle on Exercise Metabolism. Sports Medicine. 2010;4(3):207-227.
**Last Updated 12/22/2016**