As part of Women In Sport week, we are taking a closer look at the increased awareness around the menstrual cycle in female sport. Andy McGeever is a PHD Researcher at Atlantic Technological University studying the sleep, menstrual cycle and performance of female athletes. He is also currently the assistant coach with the Ireland U20 Women's team.
There has been a recent surge in the coverage over the last number of years surrounding how the menstrual cycle and factors associated with it can have an impact on the performance, perceived readiness to compete, and overall comfort level of the athlete. Some high-profile athletes have provided insight about their experiences with things like endometriosis, which is thought common in elite athletic populations. Although many of the stories being shared by athletes are of negative experiences there is also growing highlights of how this can be empowering for female athletes. It is important to remember that they are shared to help promote positive change, increase awareness, and drive education. The topic of the menstrual cycle has been (for far too long) a taboo topic within the coach-athlete dialogue. The opening of the conversation about the menstrual cycle in athletes is by far the most important thing that can come from research and media coverage in this area.
When we think about the menstrual cycle, oftentimes people are focused on the stage of menstrual bleeding, which can be a period when negative symptoms associated with menstruation (e.g., nausea, headaches, cramps) could be particularly prevalent. Some findings suggest that 50-67% of women feel that their exercise performance is disrupted by their menstrual cycle. The pre-menstrual phase (the few days leading up to menstruation) and the early follicular phase (menstruation), is where adverse symptoms can be most prevalent hand have the biggest impact on performance and recovery. Here, there may be negative implications for performance and possibly an increased need for extended recovery periods or more optimal recovery practices, to reduce the chances of injury, illness, or increased perceived fatigue in athletes. In a study of AFLW players it was found that subjective sleep quality declined, and subjective fatigue increased during the late luteal (pre-menstrual) phase. Fatigue is a reported symptom of the menstrual cycle but is also a by-product of decreased sleep quality, illustrating the importance understanding the impacts of the menstrual cycle on aspects of general health and recovery. Menstrual cycle symptoms can affect all females and could be a possible barrier to regular physical activity for exercising women.
It is important to remember that the menstrual cycle is a physiological process that involves the fluctuation of reproductive hormones over the duration of the cycle. Estradiol (the main form of oestrogen produced by the ovaries) increases, which drives the luteinising hormone surge, resulting in ovulation. Oestrogen has anabolic effects (e.g., can help in the growth and repair of muscle tissue) and neuroexcitatory effects, whereby it increases how fast our brain can send signals to our muscles. Therefore, when oestrogen rises, it is possible that it could have positive implications for performance. Progesterone, which increases post-ovulation (luteal phase), has an oestrogen-inhibiting effect. Because if this it could be speculated that the performance impacts of oestrogen could be greater in the period preceding and during ovulation. However, recent reviews of literature on this topic have found the impacts on exercise performance to be negligible, and more understanding is needed in this area with higher quality studies necessary.
Athletes need to be able to perform on any given day. Therefore, we cannot plan and organise competition and training solely around the menstrual cycle. It is extremely important to note that no two peoples’ menstrual cycles are the same, and that no one person has the same menstrual cycle repeat itself. This extreme intra and inter-individuality of the menstrual cycle further amplifies the need for an individualised approach. Keeping track of and monitoring your menstrual cycle and symptoms could be invaluable to you beginning to understand your cycle, and what approaches you might need to take during certain periods surrounding your recovery or managing your training load. This should be done before any significant changes are considered to training or recovery practices. The main priority should be to continue to educate both coaches and athletes alike on the topic of the menstrual cycle. More importantly, normalising the conversation between coaches/practitioners and athletes will enable athletes to get the most out of their training and recovery, and make them more comfortable in discussing a normal physiological process that can have performance implications.