We need to train our female clients better
By taking advantage of hormonal shifts and appreciating female physiological differences, you can vastly enhance your client’s outcomes, whatever her age, writes female training expert Nardia Norman.
THE QUICK READ
- In the fitness industry, female biological differences are too often either dismissed or taken advantage of
- The female sex hormones oestrogen and progesterone influence practically every system in the body, including bone health, body composition, mobility, strength, mental health, appetite control and cardiovascular function
- Women respond differently than men to loads and frequency of strength training, utilise fuel differently depending on the stage of the menstrual cycle, and have different tolerance for heat depending on oestrogen and progesterone levels
- Trainers must also adapt training to support a client’s body through the hormonal shift of menopause
- Trainers need to teach female clients how to make great lifestyle choices for their bodies as often as possible, because each decision impacts hormonal profile and overall health and wellbeing.
In 2016 at the Rio Olympics, Chinese swimmer Fu Yuanhui earnt international praise when she told reporters that her poor swimming results were due to her menstrual cycle. ‘It’s because my period came yesterday, so I felt particularly tired – but this isn’t an excuse, I still didn’t swim well enough’ she said.
In doing so, she broke a long-held taboo: discussing the menstrual cycle and, specifically, the impact it had on her lacklustre performance. Yuanhui highlighted one of the big issues in women’s sport today. The menstrual cycle is an under-studied area of sports medicine, even though it impacts an individual’s performance, recovery and injury risk.
But it goes beyond performance. The menstrual cycle is the body’s natural report card, and it tells a lot about the health status of the woman. Biologically, the female body has evolved to carry, grow and give birth to a child. The female sex hormones oestrogen and progesterone are the reasons why it can do this. However, the sex hormones don’t exclusively impact the reproductive system. Nor does every woman choose to, or is able to, have children and fill that biological program.
The female sex hormones oestrogen and progesterone influence practically every system in the body, from bone health, body composition and mobility and strength gains, to mental health, appetite control and cardiovascular function.
These hormones, which are crucial to a woman’s entire being, are created in the ovaries via the menstrual cycle. That is why menstrual cycle irregularities or dysfunctions such as PCOS (polycystic ovary syndrome), and reproductive system stress, such as excessive exercise and low energy diets, negatively impact her overall health, wellbeing and performance.
The menstrual cycle is considered so important to a woman’s health that the ACOG (American College of Obstetricians and Gynaecologists) in 2016 declared it to be a ‘vital sign’. This report stated that ‘By including an evaluation of the menstrual cycle as an additional vital sign, clinicians reinforce its importance in assessing overall health status for patients and caretakers.’
In other words, a healthy menstrual cycle is an essential element of being a healthy woman. So, what does this have to do with you in your role as a personal trainer? Well, if you train women, of any age, then it has everything to do with you.
Women are not little men with breasts
In the fitness industry our biological differences are too often either dismissed or taken advantage of. Rarely are they given the attention and focus they deserve.
On one hand, there is the school of thought that says, ‘women are just like men, train them the same way’. This way of thinking underpins the majority of the exercise prescription recommendations we are currently using in the fitness industry.
Up until 1990, it wasn’t compulsory to include female subjects in exercise science studies. Therefore, a gender bias towards male subjects existed (and still does); in fact, the average man used in these studies was white and 72kg. The idea was that the results could just be extrapolated and made to ‘fit’ a female.
Given that females are, on average, smaller than the average man, and have monthly hormonal fluctuations, the recommendations don’t neatly fit. For example, modern science has shown that women respond differently than men to loads and frequency of strength training. Women are able to train at higher percentages of their 1RM for a given number of sets and reps than men. Another example is the way in which a woman’s fuel utilisation (fats or carbohydrates) changes depending on what phase of her cycle she is in. In a final example, a woman’s ability to tolerate heat changes depending on her levels of oestrogen and progesterone; this is true both for menstruating women and those in their later years.
As trainers, we need to be aware of all of these subtle, yet profound, differences in order to maximise gains for our clients.
While women and men have the same physical blueprint, i.e. we each have a skeleton and our connective tissues are made of the same compounds, the sex hormones subtly impact the body differently, resulting in the following issues:
Women are more likely than men to experience musculoskeletal issues such as knee joint problems, shoulder impingement, rotator cuff tendinitis and feet problems.
Women are more likely than men to experience mental health issues, such as general anxiety disorder and depression, as well as hypertension which can lead to heart disease, the number one killer of Australian women (women are almost 3 times more likely to die from heart disease than breast cancer – Source: Heart Foundation).
Women are 2.5 times more likely than men to have IBS and have a more sensitive gastrointestinal tract.
Women have a lower eccentric loading capacity than men, which has implications for how plyometrics and strength programs are designed and implemented.
Women who haven’t had children can still experience pelvic floor dysfunction such as incontinence, and are more likely to do so than men.
All of these issues directly affect a woman’s health, wellbeing and results, yet due to a widespread lack of knowledge, they are routinely ignored or dismissed. As trainers, our number one job is to improve our clients’ health, while getting them results. Remaining ignorant to the subtle but powerful impact that female sex hormones have on her body, throughout her lifetime, is doing her a disservice.
On the flip side, from a social standpoint, there’s a part of the industry that still preys on women’s insecurities and counts on their failures in order to profit. Historically, the only goals that women have been ‘allowed’ to pursue have been ones to do with making themselves smaller. Many fitness marketing campaigns have centred around messages such as ‘lose weight’, ‘drop a dress size’, ‘tone up’, ‘slendersize your muscles’, ‘get bikini ready’, ‘lean up’, ‘shrink’, ‘detox’ and ‘sculpt’. These campaigns are accompanied by images of small, lean women holding a pastel dumbbell in one hand and an apple in the other.
Thankfully the tide is turning, and a concerted effort is being made to use positive marketing messages that include women getting ‘strong’, ‘fit’, ‘fast’, ‘bigger’, ‘confident’ and ‘powerful’. This is to encourage women to get into the gym and not be afraid of doing resistance training or lifting heavy weights. But there is still a long way to go to help women overcome their fear of ‘getting bulky’.
Understanding a woman’s beliefs, fears, barriers and motivations is crucial if you are to help her create sustainable change.
The later years
Like with the menstrual cycle, the peri-menopausal and menopausal years are rarely discussed, and if they are, are associated with negative experiences. Hot flushes, change in body shape, sleep disruption, dry skin, change in emotions and loss of libido are some of the signs and symptoms that start to impact women as young as 40.
It is a time of momentous change; her reproductive functions start to wind down and she enters her next phase of life. Often, the signs and symptoms can be alarming, and the woman can feel confused, upset and frustrated by what’s happening to, and in, her body. Society, in general, doesn’t like to talk about these changes, and neither do some individuals, but it’s important that we, as trainers, are privy to her experiences.
It is up to us to adapt our training to support her body through this hormonal shift. If we keep throwing high intensity exercise at her in order to combat her mid-section fat gain, we can accidentally cause the opposite to happen. This isn’t to say that a woman in this transition can’t do high intensity training, rather that – as with everything we prescribe – it must be personalised and tailored to her capability, experience and lifestyle.
Lifestyle choices impact results
Many women today juggle the multiple demands of careers, families and domestic responsibilities, while also being bombarded with targeted messages tying their worth to their looks. They are time poor and inundated with often contradictory information, and marketing and social media-fanned misinformation, about health.
We have to teach our female clients how to make great choices for their bodies as often as possible. Each decision will impact her hormonal profile and therefore her overall health and wellbeing.
Some of the key things that can negatively impact a woman’s health are:
- Chronic stress (and associated poor coping strategies)
- Nutrient poor diets high in manufactured sugars and fats
- Nutrient poor diets where there is low energy availability (e.g. dieting, detoxing, not eating enough calories)
- Poor liver health
- Excessive bouts of exercise, or long periods of exercise, coupled with low energy availability.
It’s time to start giving female clients the attention they deserve. It’s time to train women like women – knowing full well that they are more than capable of being fit, strong, powerful, fast and whatever else they want to be.
This means taking advantage of her monthly hormonal shifts over her menstrual cycle, paying attention to how the sex differences impact her ability to get results, using strength training to mitigate the effects of age-related decline, and delivering individualised, nuanced training programs.
Let’s help women unleash their potential and normalise all aspects of being a woman.
An award-winning presenter and educator, Nardia has 20 years’ experience in coaching, education and personal training. Recipient of FILEX’s Presenter of the Year Award 2018, Personal Trainer of the Year 2014 and an Australian Institute of Fitness Legend, her passions lie in business coaching for female fitness professionals, and educating trainers on how to work with women clients more effectively.