Two claims get made about training women, and they contradict each other.
The first is that women should train differently: lighter weights, higher reps, more caution around the knees, programming built around the menstrual cycle. The second, usually made in response, is that none of it matters and a woman should train exactly like a man because physiology is physiology.
Both are wrong in the same way. They are confident about something the research has not settled.
What the research shows, and how strongly
Start with the claim that gets repeated most: that performance changes meaningfully across the menstrual cycle, so training should be periodized around it.
A 2020 systematic review and meta-analysis in Sports Medicine pooled 78 studies on cycle phase and exercise performance in women with regular cycles. It found a trivial effect on both endurance and strength outcomes, with slightly reduced performance in the early follicular phase. The largest difference identified anywhere in the network analysis was between the early and late follicular phases, and it was still small. The authors classified the overall quality of that evidence as low (1).
So the honest version is this. There may be a small average performance dip in one phase, the effect is trivial at the group level, individual variation is large, and the evidence supporting even that much is weak. That is a long way from the confident cycle-syncing programs sold as settled science.
Joint laxity is a stronger signal. A systematic review and meta-analysis covering 21 studies and nearly 69,000 participants found significantly increased anterior knee laxity during the ovulatory phase compared with the follicular phase, and four of five studies on injury timing found the luteal phase was the least associated with ACL injuries (2). The same review rated its overall strength of evidence as low, and noted hormonal contraceptives may reduce ACL injury risk by roughly twenty percent in the largest and highest-quality studies available.
Women being at substantially higher risk of ACL injury than men is not in dispute. What is far less settled is what a coach should do about it on a given Tuesday.
What that means in practice
Here is where I land after reading it, and I would rather state the reasoning than the conclusion alone.
The laxity finding is real enough to inform how we handle knees, particularly around load, deceleration, and the positions where an ACL is vulnerable. It is not strong enough to build a rigid week-by-week program around, and anyone selling that certainty is ahead of the data.
The performance finding is weak enough that I would not schedule someone’s training blocks around it at all. What I will do is take it seriously when a client reports it. If someone consistently feels flat during a particular stretch of their cycle, that is real information about that person, and it beats a group-level meta-analysis for programming decisions about them specifically. The individual report is the better instrument here, which is a strange thing to say after citing two large reviews, and it is what the low evidence quality implies.
That is the whole distinction. Group data tells you what to watch for. It does not tell you what is happening in the person in front of you.
The difference that shows up more often than any of this
In practice, the thing that changes most about training women at our studio has nothing to do with hormones.
It is the gap between passive flexibility and active control. A lot of women arrive with plenty of available range and very little strength inside it, and the training history behind that is usually years of stretching, yoga, or general flexibility work with almost no loading at end range. So the joint can get into a deep position and cannot produce force once it arrives.
That combination is worse than being stiff. Being flexible and still feeling stuck is a control problem, and it is the one where conventional advice fails hardest, because the obvious response to feeling tight is more stretching, which widens the gap that caused the problem.
The correction is loading. Functional Range Conditioning trains strength at the end of a range rather than range alone, which is what turns available positions into positions somebody can use under load. For a hypermobile shoulder or a knee with more laxity than average, that end-range strength is not optional. It is the thing standing between available range and a joint that can protect itself in it.
What we adjust and what we do not
Volume, intensity, and exercise selection get adjusted for every client, and the inputs to that are training history, joint capacity, recovery, and what the assessment found. Sex is one variable feeding into that, well behind what a specific joint can do.
What does not change is the expectation. The advice to train lighter has done real damage, and there is no version of the research above that supports it. Higher joint laxity is a reason to build more strength around a joint, not less. It has never been a reason to lift less.
What also does not change is that the plan comes from measurement. Which joints are limited, where the passive-to-active gap sits, and what the training history has already built are all specific to a person and none of them are predictable from demographics. That is what a Motive Movement and Mobility Assessment is for, and it is why we do not publish a sample week here. A templated three-day split is exactly the thing an assessment exists to replace.
The short version
Real physiological differences exist, and the evidence behind the confident programming advice built on them is weaker than almost anyone selling that advice admits. Both of those are true at once.
What holds up regardless: build strength inside the range you already have, load it rather than only stretching it, and let the specific joint in front of you decide the plan instead of a category.
If you want to know where your own gaps are, an assessment is where that starts.
References
- McNulty KL, Elliott-Sale KJ, Dolan E, et al. The effects of menstrual cycle phase on exercise performance in eumenorrheic women: a systematic review and meta-analysis. Sports Medicine. 2020.
- Herzberg SD, Motu’apuaka ML, Lambert W, et al. The effect of menstrual cycle and contraceptives on ACL injuries and laxity: a systematic review and meta-analysis. Orthopaedic Journal of Sports Medicine. 2017.
Written by
Brian Murray, FRA, FRSC
Founder of Motive Training
Motive Training is a coaching studio in South Austin built around assessment, joint health, and strength you can use. Train with us in the studio, come to a KINSTRETCH class, or work through the progressions in KINSTRETCH Online.