Women's Athletic Performance Support* Protocol 

Clinical support for active women, promoting sustained energy, efficient recovery between training sessions, healthy muscle, bones, and connective tissue, and resilience across life stages through evidence-informed lifestyle, dietary, and nutrient interventions.* 

Female Physiology and Performance 

─────────────────────────────────────────

Women’s hormonal profiles and performance-related nutritional needs change throughout the lifespan, from adolescence and the reproductive years to pregnancy, postpartum, perimenopause, and menopause. These natural hormonal shifts influence how the body responds to training, affecting metabolism, thermoregulation, body composition, musculoskeletal health, and recovery.¹

Because these physiological demands evolve over time, performance support should evolve as well. Rather than relying on a one-size-fits-all approach, nutrition, training, and recovery strategies should be individualized according to life stage, health history, and performance goals. Foundational considerations include adequate energy availability, sufficient protein intake, bone and iron status, hydration, sleep quality, body composition, menstrual health when applicable, and recovery capacity.¹

Regular training introduces an additional layer of physiological demand. Meeting increased needs for energy, carbohydrate, protein, fluids, electrolytes, and recovery helps support adaptation to exercise, athletic performance, and long-term health.²

Low energy availability (LEA) can occur when dietary energy intake is insufficient to support the demands of exercise while also meeting the body’s needs for normal physiological function.³˒⁴ LEA may occur intentionally or unintentionally, particularly during periods of high training volume, increased energy expenditure, dietary restriction, or inadequate fueling.³˒⁴

When LEA is prolonged or severe, it can contribute to Relative Energy Deficiency in Sport (RED-S), a broader syndrome that may affect reproductive function, bone and musculoskeletal health, energy metabolism, immune health, cardiovascular and gastrointestinal function, psychological health, training response, and athletic performance.³˒⁴

In women, menstrual irregularity can be an important clinical sign of inadequate energy availability, but RED-S may present across multiple physiological systems. Changes in menstrual function, recovery, injury patterns, energy levels, performance, and fueling behaviors may indicate a need for further assessment.³˒⁴

Key Nutritional Considerations 

─────────────────────────────────────────

1. Creatine Monohydrate
   Women may have lower endogenous creatine stores compared with men.⁵ Creatine monohydrate is one of the most extensively studied performance supplements. In women, supplementation may support strength, high-intensity exercise performance, and selected body-composition outcomes.* 
   
   
2. Foundational Micronutrient Support
   Vitamin D, vitamin K, magnesium, omega-3 fatty acids, and B vitamins help support the physiological demands associated with regular training and recovery.* Individual requirements vary according to dietary intake, training volume, sun exposure, life stage, and health status. 
   
   
3. Bioactive Collagen Peptides
   In a randomized controlled trial of 180 physically active young adults with exercise-related knee discomfort, participants consuming 5 g/day of specific collagen peptides for 12 weeks experienced a greater reduction in activity-related knee discomfort compared with placebo.⁶
   
   In a separate placebo-controlled study of 59 recreationally active women ages 18 to 40, 15 g/day of collagen peptides for 12 weeks alongside concurrent training improved running performance and reduced heart rate at lactate threshold compared with placebo.⁷
   
   
4. Adaptogenic Botanicals & Nutrients
   Everyday stressors, inadequate sleep, travel, and demanding training schedules may influence recovery and performance. Adaptogenic botanicals and nutrients may help support mental and physical resilience during periods of occasional stress, complementing appropriate training, nutrition, and recovery practices.* 

Dietary Considerations 

─────────────────────────────────────────

Distribute Protein Across the Day

Daily protein intake supports muscle protein synthesis, recovery, and adaptation to training. A practical guideline for exercising adults is approximately 1.4 to 2.0 g/kg/day, with about 20 to 40 g of high-quality protein consumed every 3 to 4 hours.⁸ Protein sources may include dairy products, lean meats, poultry, fish, eggs, soy foods, legumes, nuts, and seeds. 

Prioritize Quality Carbohydrate Sources

Carbohydrate availability is an important determinant of the capacity to perform sustained moderate- and high-intensity exercise.² Emphasize minimally processed carbohydrate sources rich in fiber, such as whole grains, legumes, fruits, vegetables, nuts, and seeds while matching overall carbohydrate intake to training demands. 

For prolonged endurance training or competition, easily digested carbohydrate sources before and during exercise, such as honey, raisins, or sweet potatoes, may help maintain energy availability and performance.² 

Aim for at least 25 g/day of dietary fiber from a variety of plant foods, while recognizing that needs may vary with total energy intake.⁹ As fiber intake increases, adequate fluid intake also becomes increasingly important to support digestive comfort and function. 

Include Healthy Fats

Include a variety of unsaturated fats from foods such as olive oil, avocado, nuts, seeds, and fatty fish. Meeting recommended intakes for essential fatty acids (e.g., omega-3s) provides the fats needed to support healthy cell signaling, reproductive function, and hormone-related processes, complementing a balanced sports nutrition plan. 

Clinical Assessment Considerations 

─────────────────────────────────────────

Laboratory assessment can help identify nutritional insufficiencies and physiological factors that may influence training load capacity, recovery adaptation, and overall health. Consider evaluating the following when clinically appropriate: 

Body Composition and Musculoskeletal Health 

• Body mass index (BMI)
• Body fat percentage 
• Lean body mass 
  

Clinical History 

• Menstrual history and cycle regularity 
• Medication and hormonal contraceptive use 
• Sleep quality and duration 
  

Energy Availability & Recovery 

• Dietary intake relative to training demands 
• Recent changes in training volume or intensity 
• Unexplained fatigue or impaired recovery 
• Recurrent injuries, including bone stress injuries 
• Changes in training adaptation or performance 

Consult with a health-care practitioner to assess thyroid function, metabolic health, and iron and vitamin D (25-OH) status. 

Lifestyle Interventions 

─────────────────────────────────────────

• Use progressive resistance training to support muscle, strength, and bone health. 
• Match energy and carbohydrate intake to training demands. 
• Aim for seven to nine hours of quality sleep. 
• Include walking, mobility work, stretching, yoga, or low-intensity aerobic activity as appropriate. 
• Use practical stress-management strategies such as mindfulness, breath work, or time outdoors. 
• Individualize fluid and electrolyte intake according to sweat rate, climate, exercise duration, gastrointestinal tolerance, and personal needs. 

Supplement Protocol 

─────────────────────────────────────────

The following Designs for Sport® products may be incorporated into an individualized performance nutrition plan based on dietary intake, training demands, health history, life stage, and practitioner recommendations. 

Supplementation amounts are based on a 150‑pound healthy adult and may be adjusted according to body weight. Practitioners should individualize protocol use by selecting some or all listed products, determining timing of introduction (i.e., all at once or staggered), and guiding duration based on clinical judgment, patient presentation, complaints, and biomarkers. 

	Power Pack PFP030-DS | 30 Packs How To Use: Take 1 pack daily with food and plenty of water.  Power Pack™ combines omega-3 fatty acids, vitamin D3, vitamin K1 + K2, magnesium, and B vitamins to provide foundational nutritional support for active individuals.* These nutrients help support normal muscle function, bone health, energy metabolism, cardiovascular health, immune function, and healthy inflammatory responses associated with exercise.*
	Adrenal Flow ADP090-DS | 90 Vegetarian Capsules  How To Use: Take 3 capsules daily with meals (divided dosing recommended).  Formulated with adaptogenic botanicals, bioavailable B vitamins, vitamin C, and N-acetyl-L-tyrosine to support healthy cortisol metabolism, adrenal function, and a healthy response to occasional stress.*
	Collagen Complex™ WBC390-DS | 390 G (13.8 OZ)  How To Use: Mix 13 grams (approx. 1 scoop) with 8 oz of water per day. For best results, add powder prior to adding water.  Clinically studied collagen peptides that may help support connective tissue integrity, exercise-related joint comfort, and healthy recovery from repetitive training.*
Additional Support
	Grass-Fed Beef Protein PPPCHC-DS (Chocolate) | PPPVAN-DS (Vanilla) | 810 G (1.8 LB)  How To Use: Mix 27 grams (approx. 1 scoop) with 8 oz of water per day. For best blending results, liquid should be at room temperature.  When daily protein needs cannot be consistently met through whole foods, dairy-free supplemental protein for individuals seeking a high-quality alternative may help support muscle recovery, lean muscle maintenance, satiety, and daily protein intake.*

Clinical Considerations 

─────────────────────────────────────────

This protocol is intended to support healthy training, recovery, and performance through evidence-informed nutrition, lifestyle practices, and dietary supplementation. It is not intended to diagnose, treat, cure, or prevent any disease or replace individualized medical care. 

Women experiencing persistent menstrual irregularity, unexplained fatigue, impaired recovery, recurrent stress injuries, significant changes in performance, or concerns related to inadequate fueling should be referred to an appropriately qualified health-care practitioner for further evaluation.³˒⁴

Menstrual irregularity has multiple potential causes and should not automatically be attributed to training or low energy availability. Appropriate evaluation is important when assessing possible LEA or RED-S and before recommending significant changes to nutrition, training, body-composition goals, or medical management.³˒⁴

Supplement recommendations should always be individualized and may require additional consideration during adolescence, pregnancy, lactation, fertility treatment, medication use, or in individuals with diagnosed endocrine, psychiatric, cardiovascular, renal, hepatic, or bleeding disorders. 

Disclaimers: 

This information is provided as a medical and scientific educational resource for the use of physicians and other licensed health‑care practitioners (“Practitioners”). This information is intended for Practitioners to use as a basis for determining whether to recommend these products to their patients. All recommendations regarding protocols, dosing, prescribing and/or usage instructions should be tailored to the individual needs of the patient considering their medical history and concomitant therapies. This information is not intended for use by consumers.

Dosing recommendations are given for typical use based on an average 150-pound healthy adult. Health‑care practitioners are encouraged to use clinical judgement with case‑specific dosing based on intended goals, subject body weight, medical history, and concomitant medication and supplement usage. Any product containing botanical substances has the potential for causing individual sensitivities; appropriate monitoring, including liver function tests (LFT), is recommended.

For considerations regarding herb‑drug and nutrient‑drug interactions, please refer to reliable, evidence‑based resources such as the Natural Medicine Database or Stargrove MB, Treasure J, McKee DL. Herb, Nutrient, and Drug Interactions: Clinical Implications and Therapeutic Strategies. Mosby‑Elsevier; 2008. 

*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease. 

References:

1. Sims ST, Kerksick CM, Smith-Ryan AE, et al. International Society of Sports Nutrition position stand: nutritional concerns of the female athlete. J Int Soc Sports Nutr. 2023;20(1):2204066. doi:10.1080/15502783.2023.2204066 
2. Thomas DT, Erdman KA, Burke LM. American College of Sports Medicine joint position statement: nutrition and athletic performance. Med Sci Sports Exerc. 2016;48(3):543-568. doi:10.1249/MSS.0000000000000852 
3. Cabre HE, Moore SR, Smith-Ryan AE, Hackney AC. Relative Energy Deficiency in Sport (RED-S): Scientific, clinical, and practical implications for the female athlete. Dtsch Z Sportmed. 2022;73(7):225-234. doi:10.5960/dzsm.2022.546 
4. Ghazzawi HA, Khataybeh B, Al Aqaili R, Alnimer L, Omoush RM, Ali HA. Protecting women's health in sport: the role of low energy availability in the Female Athlete Triad and RED-S. Front Sports Act Living. 2026;8:1776533. doi:10.3389/fspor.2026.1776533 
5. Smith-Ryan AE, Cabre HE, Eckerson JM, Candow DG. Creatine supplementation in women’s health: a lifespan perspective. Nutrients. 2021;13(3):877. doi:10.3390/nu13030877 
6. Zdzieblik D, Brame J, Oesser S, Gollhofer A, König D. The influence of specific bioactive collagen peptides on knee joint discomfort in young physically active adults: a randomized controlled trial. Nutrients. 2021;13(2):523. doi:10.3390/nu13020523 
7. Jendricke P, Kohl J, Centner C, Gollhofer A, König D. Influence of specific collagen peptides and concurrent training on cardiometabolic parameters and performance indices in women: a randomized controlled trial. Front Nutr. 2020;7:580918. doi:10.3389/fnut.2020.580918 
8. Jäger R, Kerksick CM, Campbell BI, et al. International Society of Sports Nutrition position stand: protein and exercise. J Int Soc Sports Nutr. 2017;14:20. doi:10.1186/s12970-017-0177-8 
9. Dahl WJ, Stewart ML. Position of the Academy of Nutrition and Dietetics: health implications of dietary fiber. J Acad Nutr Diet. 2015;115(11):1861-1870. doi:10.1016/j.jand.2015.09.003