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Integrative Psychiatry

Femme Fuel: Optimizing Exercise and Nutrition for Female Physiology

By August 25, 2024September 12th, 2024No Comments

Most athletes will agree that getting in a few effective training days is better than many unproductive training days. Everyone goes through peaks and dips depending on where their bodies are functioning, based on potential stressors, sicknesses, and changing lifestyle habits. For those who are influenced by fluctuating female hormones, it becomes second nature to predict patterns in mood, cravings, and energy levels each month.

The notion that any individual operating with hormonal fluctuations (this is inclusive of all genders) “should” be training linearly is outdated and out of tune with physiological functioning. This may be particularly true given the biological cycles of women. Yet fitness has been historically researched and promoted through a male-dominated lens. 

For example, while it is part of many training plans to increase mileage or intensity linearly, studies have found that women can make greater strength gains, feel less pain, and recover faster by sticking to a more phasic training plan (see the section on hormones below). The notion of practicing every day, or even the common “3 weeks on, 1 week off” mentality, does not take into consideration the nature of female hormones. What happens when folks living with female hormonal cycles oriented toward a different strategy, one that would optimize diet and exercise routines based on an intimate understanding of their hormonal, immune, and nervous system patterns? 

Female Hormones and Athletics

Hormonal cycles, especially of estrogen and progesterone, can impact metabolism, muscle recovery, and cognition. During different phases of the menstrual cycle, hormones impact muscle-cell turnover and protein synthesis, carbohydrate-burning abilities, bloating, temperature regulation, cramping, headaches, and gastrointestinal functioning. In addition, cognition and mood can change across the cycle, affecting motivation as well as physical perception and tolerance. These hormonal shifts impact how women respond to exercise and nutrition, necessitating a more nuanced approach to fitness and dietary planning than a “one size fits all” package. In her book, ROAR, Dr. Stacy Sims says “Women are not small men. Stop eating and training like one.”1 She outlines important reasons for considering menstrual cycle into health, wellness, and athletic training:

Menstruation: During active menstruation, energy levels might be lower. It’s often beneficial to focus on light to moderate exercise, such as yoga or low-impact cardio. Nutritionally, it’s important to ensure adequate iron intake to compensate for menstrual blood loss.

Follicular Phase: Following menstruation, estrogen levels rise, boosting energy and recovery rates. This is an ideal time for high-intensity workouts, strength training, and endurance activities. A body can often handle more strenuous exercises and recover faster. A diet rich in protein, healthy fats, and complex carbohydrates will support increased activity levels.

Ovulation: Estrogen levels peak (before dropping again), leading to optimal energy and strength. This phase is excellent for pushing personal limits with intense workouts and challenging fitness goals. Maintaining a balanced diet with a focus on protein and carbs helps support muscle repair and energy needs. 

Luteal Phase: Progesterone increases, which can affect mood and energy levels. Fluctuations in performance and higher fatigue might be experienced. It’s beneficial to adjust your workout intensity and incorporate more restorative exercises. Nutrition should focus on managing PMS symptoms with magnesium-rich foods and maintaining stable blood sugar levels with balanced meals.

Personalizing Your Training Guide

Creating a personalized training guide involves aligning your exercise routine and nutritional intake with your distinct physiological needs. Dr. Sims recommends a strategic approach to ensure that your fitness regimen works harmoniously with your body’s natural rhythms.

Identify Your Cycle Phases: Start by tracking your menstrual cycle to understand which phase you’re in and how it affects your body. Utilize a calendar or smartphone app designed for cycle tracking to note changes in mood, energy, and physical performance.

Tailor Your Workouts: Design your exercise routine to align with your cycle, as described above, by balancing high-intensity interval training (HIIT), strength training, and endurance exercises with more low-impact activities such as swimming, walking, or yoga.

Optimize Your Nutrition: Adapt your diet to support your exercise routine and hormonal fluctuations, as described above.

Monitor and Adjust: Regularly assess your performance and recovery to make necessary adjustments. Pay attention to how your body feels and responds to different exercises and foods, and be prepared to modify your routine based on what your body is telling you.

Focus on Recovery: Adequate recovery is essential, especially during phases when energy levels are lower. Ensure you’re getting sufficient sleep, hydration, and restorative practices like stretching or foam rolling to support overall recovery.

Conclusion

Creating a personalized training guide that enhances performance, supports overall health, and aligns with your body’s natural rhythms is a multi-faceted . Adopting a tailored approach to exercise and nutrition does not only improve results; it also promotes a more sustainable and enjoyable fitness journey. Remember, fitness isn’t always logical, and the concept of “mind over matter” doesn’t always work; health is really about experimentation, to hone in on what feels best for your unique body and lifestyle.

References

  1. Sims, S.T., & Yeager, S. (2016). ROAR: How to match your food and fitness to your female physiology for optimum performance, great health, and a strong, lean body for life. Rodale.

Sara Reed, MS, LMFT

Sara Reed is a Licensed Marriage and Family Therapist and CEO of Mind’s iHealth Solutions, a digital health company that provides evidence based and culturally responsible mental health services for underserved groups. As a mental health futurist and clinical researcher, Sara examines the ways culture informs the way we diagnose and treat mental illness. Sara’s prior research work includes participation as a study therapist in psychedelic therapy research at Yale University and the University of Connecticut’s Health Center. Sara was the first Black therapist to provide MDMA-assisted psychotherapy in a clinical trial and continues to engage in ongoing advocacy work around health equity in psychedelic medicine.

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Jeffrey Guss, MD is a psychiatrist, psychoanalyst, and researcher with specializations in psychoanalytic therapy and the treatment of substance use disorders. He was Co-Principal Investigator and Director of Psychedelic Therapy Training for the NYU School of Medicine’s study on psychedelic-assisted psychotherapy in the treatment of cancer-related existential distress, which was published in Journal of Psychopharmacology, 2016. He currently is a study therapist in the NYU study on Psychedelic-Assisted therapy in the treatment of Alcoholism, a collaborator with Yale University’s study on psychedelic-assisted therapy for Major Depressive Disorder and a study therapist with the MAPS (Multidisciplinary Association for Psychedelic Studies) study on treatment of Post Traumatic Stress Disorder with Psychedelic-Assisted Psychotherapy. 

Dr. Guss is interested in the integration of psychedelic therapies with contemporary psychoanalytic theory and has published in Studies in Gender and Sexuality and Psychoanalysis, Culture and Society. He has published (with Elizabeth Nielson, PhD) a paper on “the influence of therapists’ first had experience with psychedelics on psychedelic-assisted psychotherapy research and therapist training” in The Journal of Psychedelic Studies, August, 2018. He is an Instructor and Mentor with the California Institute of Integral Studies’ Center for Psychedelic Therapies and Supervisor in NYU’s Fellowship in Addiction Psychiatry. 

Dr. Guss maintains a private practice in New York City.

Will Van Derveer, MD

Will Van Derveer, MD is Co-Founder of Integrative Psychiatry Institute and Integrative Psychiatry Centers. Dr. Van Derveer was co-investigator on a phase 2 MAPS study of Psychedelic-assisted psychotherapy for treatment-resistant PTSD, and co-authored the publication of this study in 2018. He has also provided Psychedelic-assisted psychotherapy in two MAPS training studies. An active provider of KAP at his clinic in Boulder, CO, he has been teaching others KAP therapy for several years. Dr. Van Derveer contributed a chapter on mescaline in the 2021 "Handbook of Medical Hallucinogens" (edited by Charles Grob and Jim Grigsby). He is co-host of the Higher Practice Podcast.

Dr. Van Derveer regards unresolved emotional trauma as the most significant under-recognized root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass.


Scott has been a student of consciousness since his honors thesis on that topic at the University of Arizona in the 1970s under the tutelage of Dr. Andrew Weil. Following medical school, Scott studied Jungian therapy and acupuncture while working as a primary care physician in a rural area for four years. Psychedelic-assisted psychotherapy became a facet of his practice before this medicine was scheduled in 1985. He then completed a psychiatry residency at Columbia program in New York. Scott studied cross-cultural psychiatry and completed a child/adolescent psychiatry fellowship at the University of New Mexico.

In 2010 he founded Wholeness Center in Fort Collins. This innovative clinic provides cross-disciplinary evaluation and care for all mental health concerns. Scott serves as a site Principal Investigator and therapist for the Phase III trial of psychedelic-assisted psychotherapy for PTSD sponsored by (MAPS). He has also published numerous articles about his research on (CBD) in mental health. Currently, Scott works extensively with psychedelic-assisted-psychotherapy. He lectures all over the world to professional groups interested in a deeper look at mental health issues, safer tools, and a paradigm-shifting perspective about transformative care.

Will Van Derveer, MD is co-founder of Integrative Psychiatry Institute (IPI), along with friend and colleague Keith Kurlander, MA. He co-created IPI as an expression of what he stands for. First, that anyone can heal, and second that we medical providers must embrace our own healing journeys in order to fully command our potency as healers.

Dr. Van Derveer spent the last 20 years innovating and testing a comprehensive approach to addressing psychiatric challenges which transcends the conventional model he learned in medical school at Vanderbilt University and residency at University of Colorado, while deeply engaging his own healing path.

He founded the Integrative Psychiatric Healing Center in in 2001 in Boulder, CO, where he currently practices. Dr. Van Derveer regards unresolved emotional trauma as the most significant root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass. In addition to his clinical work and teaching, he was co-investigator in 2016 a Phase II randomized clinical trial, sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). He continues to support this protocol, now in a Phase III clinical trial under break-through designation by FDA.

Dr. Van Derveer is a diplomate of the American Board of Integrative and Holistic Medicine (ABoIHM) since 2013, and he was board certified in the first wave of diplomates of the new American Board of Integrative Medicine (ABIM) in 2016.