The female body is not static. Throughout life - and even throughout the month - it undergoes variations that influence how the body functions, how it moves, and how it responds to effort.
These changes are part of female biology. However, they are still often undervalued, interpreted as “normal,” or simply ignored. Understanding these variations is essential for a more informed approach to health, exercise, and well-being.
MENSTRUAL CYCLE: A FOUNDATION OF CONSTANT VARIABILITY
The menstrual cycle is marked by hormonal fluctuations, particularly in estrogen and progesterone levels. These variations are not limited to reproductive function; they affect multiple systems within the body.
Throughout the cycle, changes may occur in:
- energy levels
- perception of effort
- neuromuscular control
- pain sensitivity
Although responses vary from person to person, evidence suggests that these fluctuations can influence how the body adapts to exercise and load. Recognising this variability allows for the adjustment of expectations and strategies, rather than demanding a consistency that does not reflect the body’s physiology.
PREGNANCY AND POSTPARTUM: STRUCTURAL AND FUNCTIONAL ADAPTATION
During pregnancy, the body undergoes profound changes, both hormonally and mechanically.
Key changes include:
- increased ligament laxity
- alterations in the centre of gravity
- adaptation of the pelvic floor
- modifications in intra-abdominal pressure
These changes are necessary to support pregnancy, but they influence how the body moves and responds to load. In the postpartum period, not all of these adaptations reverse automatically. Recovery requires time, guidance, and, in many cases, specific intervention.
Physiotherapy can play an important role in:
- movement re-education
- restoring function
- managing symptoms such as pain or urinary leakage
MENOPAUSE: A NEW PHASE, NEW DEMANDS
Menopause represents a significant transition, associated with a decline in estrogen levels.
This hormonal change can influence:
- muscle mass
- bone density
- body composition
- tissue quality
These changes do not represent an inevitable loss of capacity, but they do require an adjustment in how the body is cared for and stimulated. Exercise, when properly guided, plays a central role in this phase, contributing to the maintenance of function and autonomy.
THE MOST COMMON MISTAKE: NORMALISING WHAT DESERVES ATTENTION
Across different life stages, many symptoms are often undervalued:
- disabling menstrual pain
- urinary leakage
- pelvic pain
- persistent discomfort
Although common, these signs should not automatically be considered “normal.” They may reflect changes in how the body is functioning and can benefit from a more detailed assessment.
THE ROLE OF PHYSIOTHERAPY
Physiotherapy allows for an individualised approach, adapted to each woman’s stage of life.
Through appropriate assessment, it is possible to:
- understand specific needs
- adjust load and type of exercise
- address movement patterns
- support recovery and adaptation
Rather than treating isolated symptoms, the focus is on understanding the body as a dynamic system, constantly adapting.
IN CONCLUSION
The female body is not the same every day and that is part of its biology.
Throughout life, different phases bring different demands. Understanding these changes allows for a more appropriate approach, not only to exercise but to health as a whole.
Rather than seeking uniformity, the goal should be to adapt, respect, and optimise the body’s capacity at each moment.
References
McNulty KL, Elliott-Sale KJ, Dolan E, Swinton PA, Ansdell P, Goodall S, et al. The effects of menstrual cycle phase on exercise performance in eumenorrheic women: a systematic review and meta-analysis. Sports Med. 2020;50(10):1813-27. doi:10.1007/s40279-020-01319-3.
Tenan MS, Hackney AC, Griffin L. Maximal force and tremor changes across the menstrual cycle. Eur J Appl Physiol. 2016;116(1):153-60. doi:10.1007/s00421-015-3248-3.
Bo K, Frawley HC, Haylen BT, Abramov Y, Almeida FG, Berghmans B, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction. Neurourol Urodyn. 2017;36(2):221-44. doi:10.1002/nau.23107.
Stuenkel CA, Davis SR, Gompel A, Lumsden MA, Murad MH, Pinkerton JV, et al. Treatment of symptoms of the menopause: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2015;100(11):3975-4011. doi:10.1210/jc.2015-2236.
World Health Organization. WHO recommendations on physical activity for health [Internet]. Geneva: World Health Organization; 2020 [cited 2026 Apr 6]. Available from: https://www.who.int/publications/i/item/9789240015128
