HRV in women: menstrual cycle & menopause - Part 2

My first HRV blog explained what Heart Rate Variability (HRV) is; what your smartwatch is actually measuring; and how fitness, nutrition and lifestyle factors can affect or improve it.

This 2nd blog provides specific insights for the female recreational athlete. This is where things get really interesting – and where a lot of generic “HRV advice” (based on male data!) falls short as women’s HRV patterns are unique — and dramatically influenced by hormones, menstrual cycles and menopause.

HRV Across the Menstrual Cycle

Research consistently shows:

Follicular Phase (period → ovulation)

• Oestrogen rises

• Resting HR decreases

• HRV increases

Luteal Phase (ovulation → period)

• Progesterone rises

• Resting HR rises

• HRV drops, especially in the late luteal phase 

• PMS symptoms (poor sleep, mood changes, cravings, bloating) can also lower HRV indirectly

This is normal. Not a sign you are unfit or overtrained.

Training Implications

• You may feel stronger, faster, more recovered in the mid-follicular phase

• Late luteal (PMS) may feel harder, therefore reduce intensity or increase recovery

• HRV tracking + cycle tracking = extremely useful

On hormonal contraception, patterns vary depending on the method - HRV may be flatter across the month.

You might want to adapt your training cycle around your monthly cycle to maximise gains and recovery (see my blog "Training Around your Menstrual Cycle" for more advice on this topic)

HRV in Peri-menopause & Menopause

With menopause, ovarian oestrogen production permanently declines. This affects cardiovascular and autonomic function. These autonomic changes may contribute to increased cardiovascular risk seen after menopause.

Studies show post-menopausal women often experience:

• Lower HRV (especially vagal tone)

• Higher sympathetic activity (“wired but tired”)

• More sleep disruption and hot flushes → HRV drops especially overnight 

• Weight gain, rising blood pressure or blood sugar around this time also tends to lower HRV

• Slower recovery from hard training

What Helps? 

• Strength training (supports bone, muscle & cardiometabolic health)

• Aerobic exercise

• Prioritising sleep hygiene

• Reducing alcohol

• Adequate fuelling, especially protein

• Stress-reduction

• HRT may also help some aspects of autonomic function and symptoms although evidence is still evolving 

Work with a Personal Trainer who specialises in womens health and fitness to design a programme that supports both your hormonal fluctuations as well as your body composition or performance goals.

How to use HRV wisely (and not obsess over it)

A few closing thoughts:

1. Think trends, not daily drama.

   HRV will bounce around day to day. Zoom out and look at weekly or monthly patterns.

2. Always cross-check with how you feel.

   If the data says “recovered” but you feel awful – trust your body and ease off.

3. Remember hormones.

   For anyone with a menstrual cycle, expect HRV to be phase-dependent. For peri-/post-menopausal women, expect some gradual change and focus on overall heart health.

4. HRV is one dial on the dashboard.

   It’s a useful marker of stress and recovery, but it doesn’t replace:

   • blood pressure

   • blood tests

   • ECGs

   • or an actual GP discussion when something feels off.

     
     

Used well, it can help you train smarter, spot early signs of overload, and give you feedback that your sleep, nutrition and stress-management changes are paying off.