The hormone dance
A teacher’s guide to supporting dancers through every life stage.
Hormones influence every dancer, at every age. From the growth spurts of adolescence to the transitions of pregnancy and menopause, these powerful chemical messengers shape health, wellbeing and performance. Yet many dance teachers feel unsure about how hormones affect their students, or what signs might indicate that something is not quite right.
Dr Nicky Keay
Dr Nicky Keay
To help demystify the subject, we spoke to Dr Nicky Keay, a hormone health expert, Honorary Clinical Lecturer in Medicine at University College London, medical adviser to Scottish Ballet and a specialist in dancer health. A lifelong dancer herself, Dr Keay combines medical expertise with first-hand experience of the dance world.
Why hormones matter
"My interest in dance started from a very young age of about four when my grandmother took me to my first ballet classes," says Dr Keay. "Over my years of clinical experience and research with dancers, it became clear that hormones, and the dances that hormones perform over our life, are crucial to dancer health and performance."
So what exactly are hormones?
"Hormones are chemical messengers transmitted in the bloodstream and so have access to every single cell in the body. The word hormone derives from ancient Greek meaning 'setting in motion'."
When a hormone arrives at a target cell, it directs the expression of DNA, effectively bringing the body's blueprint for life into action.
This is why hormones affect everything from energy levels and mood to recovery, strength, bone health and performance.
"Hormones are key determinants of our mental and physical health. Hormones are also crucial in supporting dance performance. So, if you want to be a healthy dancer performing to your best, it is important to appreciate hormones and harness their power to your advantage."
Dr Keay is keen to challenge one common misconception:
I'm not a big fan of the expression 'hormone imbalance', because that implies there's some blame placed on the hormones. Often we should look more at the balance of our behaviours because the hormones simply respond to what we do.
Nutrition, training, rest and sleep all influence hormone health. Rather than fighting hormones, dancers should aim to work with them.
Young dancers: growth, puberty and development
One of the most important periods in a dancer's life is puberty.
Before puberty begins, growth hormone drives the adolescent growth spurt. This is followed by increased production of sex steroid hormones, including oestrogen and testosterone, which shape physical and emotional development.
For dance teachers, understanding the challenges associated with rapid growth is essential.
"During those growth spurts and changes in body proportions, that's a real challenge," explains Dr Keay. "There's a big change in proprioception. Where you thought your leg was behind you in arabesque, actually now your leg's a lot longer and maybe in a different place."
Young dancers may suddenly seem less coordinated, despite working just as hard as before. This is often a normal consequence of growth rather than a lack of ability.
Puberty can also affect confidence.
"The body you've got to know over the last 10, 14 years suddenly is different. Especially for girls, body shape is changing and that can dent confidence or create uncertainty."
Teachers should remain mindful of language around body shape and appearance during this vulnerable period, keeping the focus on artistry, technique and wellbeing.
The importance of fuelling
Puberty is also the period of highest energy demand across the entire lifespan.
"You need energy to produce the hormones and energy for the hormones to take their effect. To grow, obviously, you need energy to do that."
At the same time, many young dancers are juggling academic pressures, school sport and increasing dance commitments.
Warning signs that a dancer may not be fuelling adequately include:
- Faltering growth
- Delayed puberty
- Falling behind peers developmentally
- Puberty appearing to start but then progress no further
- Ongoing fatigue and reduced performance
For girls, one particularly important red flag is primary amenorrhoea, meaning periods have not started by age 15.
For boys, unusually slow growth or delayed progression through puberty should also be assessed.
If growth stops and doesn't start again, or puberty seems to be going okay but then seems to stop, then medical advice should be sought.
Female dancers and the menstrual cycle
The menstrual cycle is often viewed as an inconvenience, but Dr Keay encourages dancers and teachers to see it differently.
The menstrual period is the barometer of internal healthy hormones.
In fact, she describes a regular menstrual cycle as "a free monthly medical check".
The effect of the menstrual cycle on dance performance varies enormously between individuals.
"You will find some female dancers who say actually the menstrual cycle doesn't make an important difference to how they feel. Others will notice particular flashpoints."
Common challenges include...
During menstruation
- Period pain and cramping
- Temporary fatigue
- Discomfort during training
Dr Keay advises that gentle activity can often help alleviate cramps.
"Don't skip class. Try and do class, but maybe just have a quiet word with the teacher that you're going to go a little bit easier."
During the luteal phase
The luteal phase occurs after ovulation and before the next period begins.
"One of the hormones called progesterone increases and this can increase metabolic rate, so you will feel hungrier."
Some dancers may also require additional recovery and rest during this phase.
Rather than following generic advice, Dr Keay encourages dancers to track their own experiences.
"Make your own personal record of how you feel over the menstrual cycle. Gather that information for yourself."
When should teachers be concerned?
Painful, irregular or absent periods should not be ignored.
If symptoms do not improve with simple self-care measures, teachers should encourage dancers to seek medical advice.
Most importantly, studios should foster a culture where conversations about menstrual health feel normal and safe.
"I think the teachers being open about it and encouraging the students, 'If you're having a tricky time in your menstrual cycle, please let me know', is really helpful."
Adult dancers: balancing training, recovery and hormones
Hormones continue their work throughout adulthood.
"The hormones are still continuing their work, their hormone dance, as I describe it."
The foundations of good hormone health are generally straightforward:
- Adequate nutrition
- Sufficient recovery
- Consistent sleep
- Managing stress
- Avoiding excessive training loads
Of these, sleep is often overlooked.
"The hormones work their magic, come to life, do their dance when you're asleep. If you skimp on sleep, you're going to deprive yourself of the beneficial effects of these hormones."
Intense training schedules can also pose challenges if recovery is insufficient.
You can train loads and loads, but you won't derive the benefits from that training if you don't have that match with sufficient recovery and rest.
For dance teachers, this highlights the importance of periodisation, balancing periods of hard work with quieter phases that allow adaptation and recovery.
Male dancers should not be excluded from conversations around hormone health.
"We shouldn't exclude male dancers from this conversation about hormones."
Just like female dancers, inadequate fuelling, lack of recovery and excessive training can contribute to fatigue, reduced performance and poorer health outcomes.
Pregnancy and returning to dance
Pregnancy brings major hormonal changes, including high levels of oestrogen, progesterone and relaxin.
"As the name suggests, relaxin relaxes ligaments."
This increased flexibility means pregnant dancers should be particularly cautious about overstretching.
"Dancers love their flexibility and stretching, so they might think, 'Great, I'm super flexible'. Please just do maintenance stretching and not more, because you might injure yourself."
Changing body proportions and balance will also affect movement and technique.
Dr Keay encourages dancers to continue dancing if they feel well enough, adapting intensity sensibly throughout pregnancy.
"Continue doing what you're used to. This is not the time to start trying anything new."
After birth, hormone levels shift dramatically and recovery takes time.
Be kind to yourself. Just manage your own energy levels and don't be too impatient to get back exactly how you were.
Breastfeeding places significant demands on energy reserves and periods may not return immediately, which is usually normal.
Teachers can play a valuable role by encouraging gradual progression, providing flexibility and creating supportive spaces for new mothers.
Photo by Gustavo Fring on Pexels
Photo by Gustavo Fring on Pexels
Menopause, ageing and dance
Just as puberty marks the beginning of reproductive life, menopause marks the transition when ovarian hormone production winds down.
"The ovaries retire."
Perimenopause, the period leading up to menopause, is often the most challenging stage due to fluctuating hormone levels.
Perimenopause, in my opinion, is probably the most challenging time because it's up and down.
Symptoms may include:
- Changes to menstrual cycles
- Mood fluctuations
- Increased recovery needs
- Reduced resilience to training loads
- Difficulty maintaining muscle mass
For mature dancers and teachers, Dr Keay recommends focusing on quality rather than quantity.
"You need probably to do some additional muscle strength work outside the studio. It could be Pilates, weight training or resistance bands."
Nutrition also becomes increasingly important.
Increase your protein intake. We know that helps with muscles.
For some women, Hormone Replacement Therapy (HRT) can be beneficial, particularly when symptoms persist despite optimising lifestyle factors.
Men are also affected by age-related hormonal changes, although they tend to occur more gradually. Declining growth hormone and testosterone can impact muscle mass, body composition and recovery, making strength training and adequate protein valuable for ageing male dancers too.
Menopause, ageing and dance
Just as puberty marks the beginning of reproductive life, menopause marks the transition when ovarian hormone production winds down.
"The ovaries retire."
Perimenopause, the period leading up to menopause, is often the most challenging stage due to fluctuating hormone levels.
Perimenopause, in my opinion, is probably the most challenging time because it's up and down.
Symptoms may include:
- Changes to menstrual cycles
- Mood fluctuations
- Increased recovery needs
- Reduced resilience to training loads
- Difficulty maintaining muscle mass
For mature dancers and teachers, Dr Keay recommends focusing on quality rather than quantity.
"You need probably to do some additional muscle strength work outside the studio. It could be Pilates, weight training or resistance bands."
Nutrition also becomes increasingly important.
Increase your protein intake. We know that helps with muscles.
For some women, Hormone Replacement Therapy (HRT) can be beneficial, particularly when symptoms persist despite optimising lifestyle factors.
Men are also affected by age-related hormonal changes, although they tend to occur more gradually. Declining growth hormone and testosterone can impact muscle mass, body composition and recovery, making strength training and adequate protein valuable for ageing male dancers too.
What every dance teacher should know
Perhaps Dr Keay's most important message is that dance teachers are uniquely placed to notice when something has changed.
"You have a really good eye for picking up things."
Teachers often know their students extremely well and may spot subtle warning signs before anyone else.
A dancer who becomes withdrawn, loses concentration, appears unusually fatigued or performs noticeably below their typical standard may be signalling that something is wrong.
That does not mean teachers need to become medical experts.
We're not expecting dance teachers to be doctors. But you are in that front line and you play a really crucial role.
A simple conversation, a supportive question or encouragement to seek professional advice can make a significant difference.
The key takeaway
If Dr Keay could offer one piece of advice for dancers at every life stage, it would be this:
Listen to your body and don't try to override your hormones. Harness your hormones.
Whether supporting a young dancer through puberty, a student struggling with periods, a new mother returning to class or a colleague navigating menopause, understanding hormones allows teachers to provide informed, compassionate support.
Because when dancers learn to work with their hormones rather than against them, they are far better equipped to thrive, both in the studio and beyond.
*Source material based on interview responses and transcript provided by Dr Nicky Keay.
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