Fuelling female performance

Active individuals often require additional support with nutrition, lifestyle, and supplementation to meet both their health needs and performance goals. In this blog, Nutritional Therapist Annie Edwards will discuss how we can support our clients' active health, whether they are already exercising or starting their fitness journey.

Depending on the type, intensity, and frequency of exercise, greater attention may be needed to macronutrient intake to optimise energy levels, training adaptations, and recovery. Targeted supplementation may also be beneficial to support performance, replenish nutrients, and help manage the increased oxidative stress associated with regular exercise. Equally important is ensuring adequate rest, recovery, and stress management, as these allow the body to repair, adapt, and maintain long-term balance, resilience, and well-being.

Unless you specialise in sports nutrition, most clients won’t be competitive athletes or bodybuilders. More often, they’ll be people who value exercise for their health and need support to fuel and progress in activities such as running, gym training, yoga, HIIT, or a mix of these.

Key factors to consider when working with active female clients

• Age
• Type of training and goals
• Rest and recovery
• Nutrition status, diet
• Cycle status
• Lifestyle
• Stress
• Sleep

Training for women

Until recently, much of the research underpinning exercise, nutrition, and health recommendations was conducted predominantly in men. Although this is beginning to change, many conventional guidelines followed today still reflect male physiology. While men and women both operate on a 24-hour circadian rhythm, women also experience cyclical fluctuations in oestrogen and progesterone across the menstrual cycle. These hormonal changes influence metabolism, appetite, energy levels, exercise performance, recovery, mood, sleep, and cognitive function, with further physiological shifts occurring during perimenopause and menopause. (Sims, 2023)

Oestrogen and progesterone are key regulators of metabolism and nutrient utilisation. Oestrogen influences appetite regulation, energy expenditure, body fat distribution, insulin sensitivity, and glucose homeostasis, while also helping to reduce inflammation and limit excess fat accumulation. Progesterone affects metabolic rate, fluid and electrolyte balance, and protein metabolism, and may increase amino acid oxidation while reducing muscle protein synthesis. Together, fluctuations in these hormones alter how carbohydrates, fats, and proteins are used for energy, both at rest and during exercise.

As our understanding of female physiology continues to evolve, there is a growing need to move beyond outdated, male-centred models of fitness and adopt approaches that reflect the changing hormonal and metabolic needs of women. By considering menstrual status, life stage, and individual health, practitioners can better support women to train, recover, and perform in a way that works with their bodies rather than against them.

Women may respond differently to men in popular ‘biohacking’ trends, including cold-water immersion and fasted exercise, because of their effects on cortisol production and the sympathetic nervous system. Women appear to be more sensitive than men to training fasted; in women, low energy availability may suppress kisspeptin signalling in the hypothalamus, reducing Gonadotropin-releasing hormone (GnRH), Luteinising hormone (LH) pulsatility, and affect thyroid hormones. Research suggests that, in women, it does not appear to confer additional fat-loss benefits and may increase hunger, impair adaptation, contribute to menstrual dysfunction, and increase the loss of lean muscle mass. Consuming food before and after exercise was associated with improved glycaemic control, improved training adaptations, and more favourable metabolic responses. (Frampton, 2021) The evidence suggests that this is not the same for men. (Hagobian, 2008)

Cycle syncing

In the late follicular phase, oestrogen is high, and progesterone is lower, and this is where metabolic rate and energy intake are at their lowest in the cycle. Conversely, during the mid-luteal phase, both hormones rise, along with resting metabolic rate, increasing energy intake. This is often why women feel hungrier in their luteal phase and may require more calories to fuel exercise. (Sims, 2023)

While training based around the menstrual cycles can be useful for some, each stage will be experienced differently for every woman, and so it is often advised to train instead by readiness; how you feel, rather than the day of your cycle. This not only strengthens the mind-body connection but also relieves the pressure on women to constantly achieve and perform. Taking a balanced approach to fitness and opting for lower-intensity exercise or rest when needed is more likely to improve overall health and well-being.

Exercise benefits

The physical and mental health benefits of exercise are well known. Exercise stimulates the release of irisin, a myokine that plays a role in mitochondrial function, oxidative stress, insulin regulation, metabolism, energy expenditure, and the conversion of white to the more metabolically active brown fat involved in thermogenesis. Irisin supports osteogenesis and mitigates bone loss in osteoporosis and sarcopenia, which is particularly relevant to perimenopause and ageing. Neurologically, it is involved in dopamine pathways and has been associated with increased expression of brain-derived neurotrophic factor (BDNF), a key regulator of neuroplasticity, synaptic function, learning, and memory. (Paoletti, 2024)

Oestrogen helps regulate muscle protein synthesis, but as levels decline, so does muscle mass and strength, slowing metabolism and increasing the risk of sarcopenia, weight gain, and metabolic dysfunction. Strength training helps preserve and build lean muscle, supporting metabolism, energy, mobility, and joint health. Research also suggests that resistance training can improve body composition, reduce inflammation, and lower metabolic risk in postmenopausal women. (Nunes, 2023)

What kind of exercise is best?

The best kind of exercise is the one your client enjoys, will stick to, and will be consistent with.

Resistance training (RT) is one of the most effective ways to maintain and build muscle, improve body composition, reduce fat mass, and raise resting metabolic rate. (McLeod, 2019; Brittany, 2025) It can support insulin sensitivity, HbA1c markers, reduce type 2 diabetes risk (Jansson, 2021), and reduce the risk of cancer, heart attacks, stroke, and hypertension. (Shailendra 2022)

Muscle mass naturally declines from around the age of 30, with losses often accelerating during perimenopause. As oestrogen levels fall, the risk of osteoporosis also rises, and bone turnover speeds up, which can gradually weaken the skeletal system. RT helps counter these changes by placing controlled, healthy stress on the bones. This mechanical loading signals the body to rebuild and strengthen bone tissue, helping maintain density, improve structural integrity, and lower the likelihood of fractures.

Other forms of exercise, such as high-intensity interval training, have been found to improve cardiorespiratory markers such as VO₂ max, while also reducing visceral and abdominal fat, improving insulin sensitivity, and glucose regulation. Cardiovascular exercise is also an excellent way to support overall fitness, cardiovascular function, endurance, and metabolic health. (Taylor, 2023)

For optimal well-being, a balanced exercise programme should combine cardiovascular training with resistance exercise, alongside mobility and flexibility work, providing comprehensive benefits for strength, fitness, movement, and long-term health.

Nutrition

Many women turn to exercise to lose weight and improve their health. While these can be positive outcomes when approached sustainably, it is important to recognise that, in the pursuit of these goals, some women may unintentionally undereat and fall into a state of low energy availability. This can leave the body without the fuel it needs to support training, recovery, hormone health, and overall well-being.

Active women should be encouraged to consume a nutritionally balanced diet, to support energy levels and performance, aim to eat within 30–60 minutes of waking, avoid fasted training, and prioritise both protein and carbohydrates post-workout to optimise exercise performance, recovery, muscular adaptation, and sustained energy levels. Exercise should serve to enhance women’s physical capacity, resilience, and confidence, rather than contribute to fatigue and depletion.

Supplement considerations

While in no means an exhaustive list, some supplement considerations for active women include:

B Vitamins

B12, along with other B vitamins, plays an important role in energy production, exercise, and physical performance. It is an essential nutrient that helps convert food into energy, and is needed for ATP and red blood cell production, which is necessary to carry oxygen throughout the body to support aerobic exercise. It is also involved in maintaining the health of the nervous system, which directly impacts muscle contraction and coordination during physical activity.

Iron

Iron deficiency is one of the most prevalent micronutrient deficiencies among women in the UK, with diagnosed deficiency estimated to affect at least 12%. (NICE, 2025) However, this figure is likely to vastly underestimate, as it does not account for women with suboptimal iron stores who may experience clinically significant symptoms despite lab results remaining within range.

Research suggests that postmenopausal women may experience a slower recovery of hepcidin levels following exercise, with elevations persisting for up to 24 hours. As hepcidin reduces iron absorption and availability, this may have implications for iron status and recovery in physically active women. (Sims, 2023)

Furthermore, in the follicular phase, lower hepcidin and progesterone levels can enhance iron absorption and recycling, while the rise in progesterone after ovulation, moving into the luteal phase, increases hepcidin and decreases iron absorption. (Badenhorst, 2021)

Creatine

Women generally have lower endogenous creatine synthesis and up to 80% less intramuscular creatine stores compared with men. (Sims, 2023) Across the menstrual cycle, fluctuations in oestrogen and progesterone during the follicular and luteal phases may influence creatine metabolism and requirements. Similarly, the hormonal changes that occur during perimenopause and menopause can contribute to reductions in muscle mass and strength, declining bone density, changes in mood, and reduced cognitive function. Creatine supports muscle strength, exercise performance, body composition, bone density, metabolism, cognitive function, and mood. (Smith-Ryan, 2025)

Nicotinamide Riboside

Nicotinamide riboside (NR) is a form of vitamin B3 and a precursor to nicotinamide adenine dinucleotide (NAD+), a molecule essential for energy production, metabolism, DNA repair, and cellular health. NAD+ plays a critical role in mitochondrial function and ATP production, supporting energy, cardiovascular function, healthy ageing, and potentially exercise performance. (Martens 2018)

D-ribose

D-ribose is a naturally occurring sugar that forms part of ATP and may help support energy production, improve exercise capacity, reduce perceived exertion, and enhance recovery by decreasing delayed onset muscle soreness (DOMS).

Conclusion

Female physiology is unique, influenced by fluctuations in hormones, differing metabolic demands, and distinct nutritional requirements, which can change at different stages of life. Recognising and understanding the female body and tailoring nutrition, training, supplement support, recovery, and lifestyle strategies accordingly can empower women to optimise their health, performance, and well-being.

References

• Allman, B. R., et al (2019). Effects of six weeks of resistance training on appetite and energy intake in young adults. Journal of Applied Physiology, 126(3), 739–745.
• Badenhorst, C. E., et al. (2021). Iron status in athletic females: A shift in perspective on an old paradigm. Journal of Sports Sciences.
• Frampton, J., et al. (2021). The acute effect of fasted exercise on energy intake, energy expenditure, subjective hunger and gastrointestinal hormone release compared to fed exercise in healthy individuals: A systematic review and network meta-analysis. International Journal of Obesity.
• Hagobian, T. A., et al. (2009). Effects of exercise on energy-regulating hormones and appetite in men and women. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 296(2), R233–R242.
• Jansson, A. K., et al (2022). Effect of resistance training on HbA1c in adults with type 2 diabetes mellitus and the moderating effect of changes in muscular strength: A systematic review and meta-analysis. BMJ Open Diabetes Research & Care, 10(2), e002595.
• Martens, C. R., et al. (2018). Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nature Communications, 9(1), 1286.
• McLeod, J. C., et al. (2019). Resistance exercise training as a primary countermeasure to age-related chronic disease. Frontiers in Physiology, 10, 645.
• National Institute for Health and Care Excellence. (2021). Anaemia – iron deficiency: How common is it? NICE Clinical Knowledge Summaries.
• Nunes, P. R. P, et al. (2023). Effect of resistance training volume on body adiposity, metabolic risk, and inflammation in postmenopausal and older females: Systematic review and meta-analysis of randomized controlled trials. Journal of Sport and Health Science.
• Paoletti, I., & Coccurello, R. (2024). Irisin: A multifaceted hormone bridging exercise and disease pathophysiology. International Journal of Molecular Sciences, 25(24), 13480.
• Shailendra, P., et al (2022). Resistance training and mortality risk: A systematic review and meta-analysis. American Journal of Preventive Medicine, 63(2), 277–285.
• Sims, S. T., et al. (2023). International Society of Sports Nutrition position stand: Nutritional concerns of the female athlete. Journal of the International Society of Sports Nutrition, 20(1), 2204066.
• Smith-Ryan, A. E., et al. (2025). Creatine in women's health: Bridging the gap from menstruation through pregnancy to menopause. Journal of the International Society of Sports Nutrition, 22(1), 2502094.
• Taylor, J. L., Holland, D. J., Spathis, J. G., et al. (2023). High-intensity interval training and cardiometabolic health: A systematic review and meta-analysis. Sports Medicine, 53, 2031–2053.

All of our blogs are written by our team of expert Nutritional Therapists. If you have questions regarding the topics that have been raised, or any other health matters, please do contact them using the details below:

nutrition@cytoplan.co.uk

01684 310099