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The Top 5 Risks of Overtraining for Females

What is Overtraining Syndrome (OTS)?

Overtraining is the excessive frequency, volume, or intensity of training which results in fatigue, a decrease in performance, mood changes, and excessive soreness due to a lack of proper rest and recovery. Typically, OTS is caused by improper training: either too much too soon or repetitive overuse and duration.

In all athletes, overtraining has both short and long term detrimental effects. It can result in decreased motivation, infection, and injury due to a combination of changes in hormones, suppression of the immune system, physical fatigue and psychological changes.

Why is training different for males and females?

Like men, women train to build muscle and improve their intensity, agility, endurance, and cardiovascular health. But the way we go about training must be different because our hormonal cycles are different. Men operate on daily hormonal cycles with one core hormone (testosterone) while women’s monthly cycle involves the fluctuating activity of three (estrogen, progesterone and testosterone).

What are the risks of overtraining for females?

Extreme Fatigue/ Tiredness

Although extreme fatigue and tiredness is not specific to females with OTS, why females experience this is different because it can relate to a misalignment with their cycle. It’s likely they’re pushing when the timing of the month calls for recovery – and they’re not eating the right foods at the right time to fuel their body’s energy reserves.

When this occurs, insomnia can also be present. If a female athlete is frequently waking up in the middle of the night – especially in the early hours of the morning – it’s likely her blood sugar is off, causing a cortisol issue. An imbalance in cortisol, in turn, impacts metabolism regulation and hinders the body’s ability to reduce inflammation – thus impacting its ability to recover. Cortisol also controls the salt and water balance in the body, impacts blood pressure, and weakens the immune system.

Amenorrhea and Hormonal Damage

Amenorrhea, the absence or irregularity of a menstrual period, can occur as a result of overtraining, especially in low body weight athletics like swimming and diving, dancing, long-distance running, and figure skating. The hormone imbalance causing Amenorrhea adversely affects sports performance but also increases a woman’s risk of infertility, sexual dysfunction, adrenal malfunction, and osteoporosis.

Osteoporosis (as a result of Amenorrhea)

Osteoporosis is a medical condition in which bones become brittle and fragile from loss of tissue, typically as a result of hormonal changes, or deficiency of calcium or vitamin D. Female athletes who overtrain and experience Amenorrhea – especially for an extended period of time – increase their chances of permanent bone weakness and loss. Essentially, the decrease of their natural hormone levels at a young age looks more like females in a postmenopausal state, thus giving their body more time to lose bone mass over time.

Thyroid Issues

The thyroid is a two-inch long, butterfly-shaped gland located low on the front of the neck. It secretes thyroid hormones and regulates your body’s metabolic rate. These hormones also regulate heart and digestive function, muscle control, brain development, mood, and bone maintenance.

Both men and women can suffer from thyroid issues, but women are about four times more likely to suffer from hypothyroidism, which is when the thyroid gland is unable to produce enough thyroid hormones. People who experience thyroid issues experience a range of symptoms ranging from fatigue, weight gain, mood swings and lethargy in hypothyroidism and weight loss, coldness, or an irregular heartbeat in hyperthyroidism.

To ensure proper thyroid function, in-depth blood work tests show thyroid hormone levels, specifically the release of T4 and T3, and can give insight on vitamin D, iron, and B-12 levels – as well as the body’s ability to absorb those necessary nutrients.


As you’ve learned, the risks of overtraining for females are largely hormone-based. When overtraining occurs, injuries are common. For example, in female overtrained runners, they tend to fail to deploy proper running technique and form. They may have poor breathing mechanics, tight muscles (especially the hamstrings), and swayed lower back.

This physical compensations from overtraining can lead to pain, muscle strain, and joint compression. Poor technique paired with the hormone disruptions caused by overtraining creates the perfect opportunity for injury.

How can females prevent overtraining?

Because women cycle monthly, so must their training in order to optimize their body’s performance and protect it’s natural hormone production. This training strategy isn’t new; Olympic teams are already implementing it with impressive results.

The secret?

Proper recovery, nutrition, and – for females – timing both with their menstrual cycle.

The female-specific training strategy requires a deep understanding of what hormones are at play during the different points of a woman’s cycle. Jessica Drummond, MPT, CCN, CHC, and the Founder and CEO of the Integrative Women’s Health Institute, is an expert when it comes to the health of female athletes. She explains that the first few days of menstruation – when hormones are lowest – are the best time to rest and recover with lighter exercise.

Alternatively, around day three to fifteen – when ovulation typically occurs – a woman’s hormones increase, making it the ideal time for performance gains and healthy fat intake. Women are also naturally less insulin-resistant at this time due to the increase in estrogen.

The time after ovulation is great for sealing in the gains made on day three to fifteen. During this time, progesterone is dominant and quality proteins should be consumed to build and retain muscle.

How does Urban Wellness Clinic rehabilitate overtrained females?

Urban Wellness Clinic serves overtrained females to help them prevent and heal from overtraining. Depending on their individual condition, any of the following methodologies may be used:

Active Release Technique (ART)

When overtraining leads to injury, we use Active Release Technique (ART) for soft tissue massage, which breaks up scar tissue to increase blood flow to the affected area and promotes faster healing. ART removes fibrosis/adhesions which can develop in tissues as a result of overload due to repetitive use. It also releases entrapped nerves, vasculature, and improves lymphatic flow. It is our go-to massage to release tension in the body at Urban Wellness Clinic.

Dynamic Neuromuscular Stabilization (DNS)

DNS is a manual and rehabilitative approach to optimize the movement system based upon the scientific principles of developmental kinesiology (DK). With DNS, purposeful movements of the muscles, joints, and segments are reinforced by the coordinated activity of segmental postural stability.

Fatigue often leads to improper form and movements in sport, which can lead to sudden or chronic injury. DNS supports the body in optimized movement, thus preventing injury and healing the effects of overtraining. What we see at Urban Wellness Clinic in our ladies who overtrain is an extension compression compensation in the low back and neck.

What does this mean exactly? Overtraining leads to a stressed breathing pattern putting our ribs in a flared position, overarching out low back and neck, and making the mid-back tight. This overarching creates compression of the joints in the lower back and neck leading to pain. DNS helps get the body out of the extension compression compensation, and back to center.

Strength Training

Females who overtrain with an excess of cardiovascular exercises need balance with strength training. At Urban Wellness Clinic, we offer personalized functional training strategies to improve strength and ensure a balanced fitness regimen – taking into consideration a female’s cycle and when she’d best benefit from certain activities.

Blood Flow Restriction (BFR) Therapy

BFR Therapy improves the body’s ability to recover and enhances strength and muscle growth by encouraging oxygen delivery. For overtrained females, it’s critical to incorporate a recovery regimen to get the body back on track. BFR helps rebuild muscles, which is especially important for people with thyroid dysfunction, healing surgeries, or the desire to increase the efficacy of their training.


NormaTec is an innovative tool for rehabilitation. It emphasizes recovery as an integral part of an athlete’s training through compression therapy. One of the keys to healing or avoiding overtraining is recovery, and this state-of-the-art system increases circulation, decreases inflammation, and relieves pain.

Visit Urban Wellness Clinic if you believe you suffer from overtraining – or if you want to avoid it – and get the most out of your precious recovery time so you can get back out there and give your best. Give us a call 212-355-0445 or shoot us an email with any questions on overtraining at

In good health,

Dr Emily Kiberd