– BY YAYERI VAN BAARSEN –

Menstruation and (elite) athletic performance. Usually not a winning combination. If you do break a record in the premenstrual phase, it’s more likely to be in throwing plates than throwing javelins. When on your period, you often have a bit less stamina. Also you’re usually less competitive and more injury-prone. Logical that most athletes prefer to not menstruate during major tournaments.

Or they blame bad performance on their period, such as Chinese tennis player Zheng Qinwen who recently lost her fourth round at the 2022 French Open. Speaking to the media after the match, Qinwen stated: ‘I cannot play my tennis, (my) stomach was too painful. It’s just girls’ things, you know. The first day is always so tough and then I have to do sport and I always have so much pain in the first day. And I couldn’t go against my nature.’

Exceptions: ‘I’m on my period. Great!’

There are of course exceptions to this rule. Dutch former professional cyclist Leontien van Moorsel said she actually prefers to menstruate during an important match, because her pain threshold is higher. ‘I’m on my period, so that’s great,’ she told newspaper Trouw in 2003, before she indeed established a new world hour record. Also Dutch cyclist Marijn de Vries (‘The day before I’m often a bit listless and grumpy. But once it happens, I’m on fire,’ she wrote in her column in Trouw) and English rugby star Rachael Burford (‘The numbers don’t lie when you’re lifting heavier [in the gym] during that phase’ can be read on HuffPost) perform better when menstruating.

‘Having to put on a bikini while on my period, an achievement in itself’

For most athletes, however, it’s a different story. British tennis player Heather Lawson, who lost in the first round of the Australian Open in 2015, attributed this loss to her period. ‘I think it’s just one of these things that I have, girl things,’ she told BBC Sport. After Watson’s confession, also tennis player Tara Moore, marathon world record holder Paula Radcliffe and former world champion swimmer Libby Trickett revealed they rather don’t menstruate during major tournaments. In the 2016 Olympics, Chinese swimmer Fu Yuanhui who was holding onto her stomach after a race said she got her period the night before and felt really tired.

Recently, female athletes have opened up about the subject even more. American tennis player Danielle Collins talked about her endometriosis surgery with the media in April 2021. In April 2022, five Australian athletes teamed up to call for more discussion around menstruation in female sport. In this ‘I’m an athlete. Period.’ initiative, Olympic beach volleyballer Becchara Palmer said: ‘Rocking up to training and to competitions and having to put on a bikini while I’m on my period is something that I’ve had to do for years and years and I think is a real achievement in itself’.

Menstruation + sports: not the best match

New Zealand golf player Lydia Ko, currently number 3 in the world, was asked in May 2022 if she was having any long-term physical problems as she’d been receiving treatment from a physiotherapist. Ko’s reply, ‘I hope not. It’s that time of the month. I know the ladies watching are probably like, yeah, I got you’ left the male interviewer speechless. Other men do want to have their say on the subject. We quote radio sports commentator Valentijn Driessen in his report of the football match Netherlands – Canada in the 2019 Women’s World Cup: ‘Luckily Miedema wasn’t on her period.’

More than half (55,4%) of the 789 participants in this study claim their menstrual cycle impacts on their training and performance. Another study of 430 elite female athletes shows that more than three quarters (77,4% to be precise) of them experience negative side effects during their cycle, primarily on day 1 and 2 of menstruation. The disadvantages are clear: tiredness and less focus because of cramps and/or pain. Add to that the worries about leaking, especially when you need to perform in a bathing suit or a leotard (at the Tokyo 2021 Olympics, the German gymnasts decided to wear full length unitards) or are forced to wear white when playing at Wimbledon. Long story short: menstruation and athletic performance usually aren’t the best match.

Red card for your period?

Apart from the mental and physical impact, there’s also the management issue. How to change your tampon while running a marathon, for example. Indeed, that’s pretty impossible. That’s why German long-distance runner Uta Pippig, who won the Boston Marathon in 1996, crossed the finish line with blood on her legs. In 2015, Kiran Gandhi chose to run the London Marathon without menstrual products, which made her the symbol of free bleeding and the hero of a growing group of activists who campaign against period shame. Although a leakage stain can become a statement when used strategically, most menstruating athletes prefer to give their period a red card. They use hormonal contraception which lessens or stops the bleeding altogether.

In some cases, athletes don’t need synthetic hormones to stop their menstruation. Exercising releases endorphins. Too much exercise and these endorphins suppress the hypothalamus, the section in the brain responsible for hormone production. This leads to a deterred pituitary gland, which task it is to send out the female hormones. Excessive exercise can also lead to functional hypothalamic amenorrhea when the level of body fat is below 16%, something that isn’t uncommon for ballet dancers. Your body doesn’t have enough (fat)reserves to deal with a pregnancy, which messes up your cycle. Brilliant solution, you might think. But there’s a reason why functional hypothalamic amenorrhea is seen as a menstrual disorder: in the long run, too little estrogen can lead to osteoporosis.

High-intensity workout? In the follicular phase

Instead of suppressing your menstruation, you can also make your cycle work for you. That does require knowing how it all works on a hormonal level. The basics are simple. In the follicular phase, when estrogen levels are rising, your energy and strength increase. Therefore this is the ideal moment for weight training and high-intensity workouts. The luteal phase, on the other hand, is the time to slow down a bit when it comes to training.

Ovulation can be the perfect time to set a new strength record. But the high estrogen levels in this phase can also lead to injuries; just before ovulation, athletes have a higher risk of anterior cruciate ligament (ACL) tear. Because of hormonal fluctuations, the ligaments are more relaxed and the anterior cruciate ligament (one of the major ligaments in the knee) is more likely to tear or sprain. A study of 172 female skiers showed that ACL tear was 2.4 times more frequent in the pre-ovulatory than the post-ovulatory phase.

The menstrual cycle can also be divided into four phases. If you know in what cycle phase you are, you can tailor your training intensity and nutrition. The British national hockey team was one of the first who started doing this, just before the 2012 Olympic Games where they won bronze. All players would track their menstruation, so the coach could adapt their training loads accordingly. ‘We would send a text on day one of our cycle, so he could mark it on our training calendar,’ former GB team captain Kate Richardson-Walsh told the BBC. No-one knows if their victory was caused by this cycle strategy, but fact is that in 2016, the British team won gold.

All players on the app

More and more (elite) athletes use their cycle as a secret weapon. In 2019, the US Women’s National Team (USWNT) tracked the cycles of all soccer players and made sure things like sleep, nutrition and recovery were optimised to counter menstrual complaints. With success: the team won that year’s World Cup. Coach Dawn Scott stated this period tracking was one of the many strategies that helped them win. ‘We could see what [menstrual cycle] phase a player was in and what some of their symptoms were. I would just text or say to a player, ‘Hey you’re in phase three and we know you get disrupted sleep, so make sure you do x, y and z.’ she revealed in Good Morning America. Also the British Chelsea FC Women and the Australian rugby team Brisbane Lions tailor their training to their players’ menstrual cycles by using a tracking app.

Expert when it comes to menstruation and elite athletic performance is the British Dr. Georgie Bruinvels, Senior Sports Scientist at Orreco and former elite athlete herself. Bruinvels, who at the time helped coach Scott analysing the menstrual data of the American soccer players, currently assists Chelsea FC Women and a whole bunch of other elite athletes. She also co-created FitrWoman. This exercise-app provides personalised training and nutritional suggestions that are tailored to the changing hormone levels throughout your cycle. Your strength and recovery, but also your metabolism, hydration, body temperature and motivation – all of it is influenced by your hormones. What’s more, the app isn’t only meant for elite athletes. Also those dragging themselves to the gym once a week can benefit from its insights.

Go with the flow

Actually it’s strange that when it comes to elite athletic performance, until recently literally everything – from calory intake to weight and from body fat percentage to mental health and wellbeing – has been measured and monitored, apart from the menstrual cycle. Most scientific research, also when it comes to sports, has been done on men. An example of the notorious gender gap. But by completely leaving their cycle out of the equation, females are at a disadvantage. You simply do have a menstrual cycle and this impacts your performance in all kind of ways. It’s better to go with the flow than to fight against it.

When it comes to the combination menstruation + sports, things are certainly moving in the right direction. Worldwide, coaches and athletes are more open to new insights. After all, what used to be the last sports taboo (menstruation), can also increase your chance of a victory. Speaking about victories: since this summer the jerseys of Indian cricket team the Rajasthan Royals from Jaipur display the logo of sanitary towel company Niine. Cricket is in India what football is here. And menstruation is in India – and lots of other parts of the world – a gigantic taboo. No wonder this sponsor news went viral. In Europe, although there are football clubs who have deals with Tinder, Burger King and Villa Erotica, there’s no tampon or sanitary pad in sight when it comes to sport sponsorship.

Do try this at home

Gold medals have been won in every phase of the menstrual cycle. However, it’s a good idea to lower your training standards a bit in some phases of the cycle. This doesn’t always mean listening to your body though. On your period, you’re usually more of a couch potato than a go-getter. But, even if you don’t feel like it, do get off that couch. Because exercise is always a good idea. Especially when you’re feeling a bit down. When exercising, your body produces endorphines, which eases pain and cramps and also puts you in a better mood. No need to run half a marathon. Going for a brisk walk (with or without dog) also works.

It might even work better, as research shows that especially moderate intensity exercise helps against menstrual complaints. About 78% of the over 14,000 women who participated in the study by activity tracker Strava and FitrWoman said exercise reduces the symptoms of their period. Mind you: 69% of the women reported having to change their normal routine when menstruating. When exercising on your period, make sure to drink enough water, always do a thorough warm-up and cool-down and take a break when you need one. It’s also important not to overtrain; know your own limits when it comes to tiredness and pain. Want five more tips before putting on your trainers? Click here.

Period! is an independent, online magazine about all aspects of menstruation. Period! is not intended as a substitute for medical advice. If you’re suffering from medical complaints, always visit your doctor or GP. Editorial articles can contain affiliate links. Sponsored collaborations can be found in the category Spotlight. Any questions? Check our Contact page.

Also read:
Good for the muscles?
Jump in, also when menstruating
Athletes open up about their periods
Your cycle affects… your competitiveness
How to use a menstrual cup?

Image: Shutterstock.
LATEST UPDATE: 5-6-2022