A Shift in Perspective

I’d like to invite you to explore what I have come to discover is a missing component of health and fitness. I’m talking specifically about women and menstruation. Right away some of you might think “Oh man I don’t want to hear about this” or “eww… gross”, and yet I know there are others who struggle, or have struggled, with this very thing. How do I know this? Because I have, and as a result I feel it is important to shine some light on.

As personal trainers and fitness instructors, we see the value in asking our clients if they have any health conditions that would affect their output capacity; conditions such as high blood pressure, heart conditions, diabetes, and anything else that could be seen as a physiological limiter. However, one of the things we do not seem to ask, across the board, is about menstruation. For some reason, we seem to miss this important factor in our discovery of what health challenges our female clients might have. This information is imperative to assisting women in their capacity to increase their gains and achieve physical and mental goals.

Many women are still under the impression that we need to “suck it up” during our periods. That said, we seem to be forgetting that there is a big physiological event going on that, yes, for some women is very smooth, but for others becomes a limiter as iron deficiency anemia and low hemoglobin are the main issues with menstruation. And in some cases, such as mine, menstruation can even be life threatening.

Do you know that, more than ever before, there are more and more women searching for more extreme treatments due to their massive blood loss during menstruation? From taking the pill, to skipping periods with the pill, to IV iron therapy. Some women are going as far as having blood transfusions and even resorting to hysterectomies to eliminate the problem altogether. These are all viable options and are very personal to each individual.

Blood loss is a big component in the overall capacity of our aerobic system. If we are not taking into consideration our capacity to uptake and deliver oxygen during our training, we could be pushing ourselves and our clients to limits that are bridging on extreme and even dangerous. Pushing the body into aerobic demand without some foundation of understanding their baseline for output, can create adverse reactions in our clients including; fatigue, vomiting, dizziness and mental upset. Not to mention, if it is a chronic condition, this can become a significant player in burnout, adrenal fatigue, heart palpitations, enlargement of the heart, and even at its most extreme case, this can lead to heart attack. If the heart is having to pump harder to sustain the oxygen demand being placed on the body, overtime these conditions become a real cause for concern.

Why is it that we don’t make this issue a higher priority when we are discovering our clients’ wellbeing during the consultation process or more so during our training sessions? The menstrual cycle is not something that should be ignored. The menstrual cycle should be explored, understood, and included in the design and execution of our programs.

Let’s look at some of the science behind this.

In many cases iron deficiency anemia parallels a decrease in hemoglobin. However, it’s important to state that some women can have a healthy level of hemoglobin yet still have a deficient level of iron, which therefore also leads to a deficiency in oxygen uptake. Follow me here: if we recall our physiology basics, it is the hemoglobin within the red blood cell that carries the oxygen to the cells for gas exchange. However, it is the iron that binds the oxygen to the hemoglobin, so if you have enough hemoglobin but you do not have the iron, you have nothing to bind or carry that oxygen to where it needs to be. So, if we picture a red blood cell floating around without enough oxygen molecules connected to it, because of a limited carrying capacity, the heart then has to pump harder to try and accommodate the oxygen demand being placed on the body. In some cases, if we are not aware and we push through this threshold, our bodies will then react by passing out, or vomiting (as mentioned earlier) as a means to stop the demand. Some trainers still value pushing clients and/or themselves to the limit of vomiting. This belief, and it’s result, means that one has reached a maximal output, and therefore will make greater gains. However, I encourage you to ask yourself what the body is trying to tell us by causing the person to vomit. It is literally throwing its arms up to put a stop to the insane demand being placed upon it. If the client then reaches a point of passing out during a session, we should not hesitate to suggest they ask their doctor to test their hemoglobin and iron levels in addition to the other standard tests.

This is really only scraping the surface of my passion and experience with this.

So my question to you is, why are we not asking these key questions in our client intakes? This topic should be as important as asking about heart disease, diabetes, high blood pressure, and the like. I always ask clients about their sleeping patterns, lifestyle stressors, dietary choices, and even about their bathroom habits. Why? These all help to paint a detailed picture of the clients foundation. It has only been recently that I have begun to inquire about their menstrual cycle. And I have noticed a huge foot hold we have been missing in client care!

We need to break away from the old view that periods are private and taboo, and bring it to the forefront in our discovery. Menstruation is a vital piece of information in furthering the health and wellness of our clients and ourselves.


With a bachelors degree in kinesiology, Ginette brings her experience to training clients with secondary stage injuries, world class level athletes, and everything in between. She presents at numerous conferences and events across western Canada. Ginette is passionate to share her knowledge and first hand experience. She is currently writing a book on mind-body-spirit wellness.