Working with active females - a new series

Welcome to a series of blogs centred around working with active females.

This should be useful if you are female and active, an athlete or someone who takes their training very seriously – or a coach working with a cross section or exclusively female teams or athletes.

In the series we’ll be dealing with; 

  • Optimising female recovery and training around the monthly cycle.
  • Supporting the use of oral contraceptives with the right nutrients.
  • Dealing with Polycystic ovary syndrome (PCOS) with food and nutrition strategies.
  • The female athlete triad – which applies to any hard training females.
  • Disordered eating habits.

There are clear differences between men and women, the 2 hormones which govern the main differences are estrogen and testosterone. A man will produce about 15 times more testosterone than a woman at any given age after puberty. This accounts for many of the performance advantages in a male athlete. The differences in muscle mass and circulating haemoglobin resulting from the increased T levels account for am 8-12% ergogenic advantage in the male athlete. Normal ranges for T in a male are 7.7-29.4 nmol/l and a premenopausal woman would be up to 0-0.7 nmol/l. If levels go above 5 nmol/l in a female this crosses a line in terms of doping or other violations.

Along the way we’ll be talking about estrogen, estrogen-excess and how this applies to females but also male performance and health.

As is the way with these things, many of you will be very busy which I understand so I’m going to give you some tit bits to help you early on. 

Then when you have time you can delve deeper into the areas which are most applicable to your current health, performance and wellness.

Testosterone and Estrogen

Women produce testosterone and estrogen in the ovaries and adrenal glands. They also product estrogen in the fat tissues – men can do this too via a hormone called aromatase. Male hormones together are called androgens.

Polycystic ovary syndrome (PCOS) is a condition where the female will produce more androgens than average. It affects at least 10% of women, and probably more like 20%. 

Levels in female athletes are likely far higher as the higher testosterone levels offer a competitive advantage. Indeed, when monitored and managed PCOS is a favourable condition, with female PCOS animals making better hunters and mothers, in short, better survival is likely in these conditions. A theory that is supported by evolutionary thinkers.

Put into a modern environment with the higher levels of body fat and insulin resistance (IR) which can result (PCOS lends itself to higher IR) the same condition makes things generally worse.


In a lean and mean environment with scarcity and lower levels of circulating insulin PCOS offers a highly competitive advantage.


This is the cornerstone of the work done at the Centre Of Nutritional medicine, where we helped 100’s, actually probably 1000’s of females with PCOS. Managing insulin through eating a low glycemic impact diet. Basically, lots of vegetables and lean sources of protein, combined with exercising and insulin sensitizing nutrients.




  • Omega-3   turns on lipolytic genes / turns off lipogenic genes / blocks sugar absorption.
  • CLA   increases insulin sensitivity, burns bodyfat & an anti-oxidant
  • Multi-Vitamin   supports detoxification
  • Vitamin E   reduces glycosyylation; and detoxification
  • L-Carnitine   Improves Insulin Sensitivity after IV infusion
  • Vanadyl Sulfate   Improves Insulin Sensitivity
  • Taurine   May improve insulin sensitivity (post w/o or 2 t.i.d)
  • L-Arginine   May improves Insulin Sensitivity after IV infusion
  • Chromium   Improves insulin sensitivity & glucose tolerance
  • Magnesium   corrects a deficiency
  • Calcium   improves insulin sensitivity in some populations
  • Potassium   deficiency leads to insulin resistance
  • Folic Acid   improves glucose metabolism & nerve fx
  • Vitamin C   reduces glycosyylation & provides anti-oxidant activity
  • Biotin   improves glucose metabolism & nerve fx
  • Glutathione   improves insulin sensitivity after IV infusion
  • Coenzyme Q10   improves insulin sensitivity in some populations & anti-ox
  • Lipoic Acid  (R type ONLY) improves insulin sensitivity & anti-oxidant


Botanical Supplementation

  • Fenugreek   Increases Insulin Receptors
  • Banaba Tree Extract   Improves glucose tolerance & improves insulin sensitivity (only use 1x /day 1st thing in morning)
  • Bitter Gourd   inhibits intestinal glucose uptake
  • Gymnema Sylvestre   sugar destroyer & promotes glucose uptake & utilization
  • Grape Seed Extract   improves insulin sensitivity (also good for aromatization)
  • Cinnamon   improves insulin sensitivity
  • American Ginseng   improves insulin sensitivity


My best formula containing many herbs aimed at insulin management is Metabolic Optimiser.

Polycystic Ovarian Syndrome


I was lucky enough to cut my cloth many years ago when I was first starting out as a nutritionist, I worked with the female national rugby squad – before that I helped Katherine Merry win her Olympic bronze medal in the 400m – more recently I supported the English female national soccer team. The information below is based on my experiences across these elites but also it’s important to remember the Harley Street clinic I started out in specialised in female hormonal health – in particular PCOS (polycystic ovarian syndrome) and endometriosis, here I gained really valuable insight into natural integrated medicine, and ways you can help support these conditions, under the watchful eye of Dr Adam Carey -a close friend and former teacher and mentor.

One of the methods I used back then with Katherine Merry and still use now is the systems and layered approach to ergogenic supplementation. In 400m you are dealing with the power and lactate system – I’ve written about this extensively in my exercise Chapter in the Strength For Life Manual. If you want to gen up on the energy systems, brew a nice green tea and skim your way through this.

Lactate is a state of metabolic acidosis – so buffering enables the athlete to tolerate more amounts of lactate in a state of producing maximum power. We can eat an alkaline diet which is proven, recently to help performance, you can take alkaline supplements such as creatine, glutamine, beta-alanine, bicarbonate, sodium citrate, pine-bark extract and liver supporting herbs – as the liver regenerates lactate through something called the cori cycle.

 I hope you found this summary useful. Look out for more articles on women's health over the next few week including the monthly reproductive cycle and how to manage this along with the effects the oral contraceptive pill has on nutrient status.


Have a great week,