Female Athletes and Menstruation- it is a Bloody Sport

It is a bloody sport. Have you ever seen a difference in your output on the field because you have been on your period? Have you ever felt like you are more prone to injuries during that time of the month? Do you feel that sometimes your output during your workouts is amazing while some days you just barely manage to finish your reps? If you are a female who menstruates monthly, chances are you answered yes to these questions on bloody sports. A females body goes through considerable changes in and around the time that her menstrual cycle is about to begin. It is vital to know the effect that it has on your body and your performance so you can schedule your training sessions around it. The topic of female athletes and menstruation has historically been a taboo for ages but it is high time the trends changed.

Bloody Sports

Female athletes who play sport at an elite level can also experience oligomenorhea (irregular pattern) or amenorrhea (cessation extending beyond 90 days) that could develop in the female athletes involved in high-intensity training. The exact cause of amenorrhea in female athletes is unknown. The reason of this disorder could be excessive weight loss, changes in body composition, insufficient nutrition, psychological stress, and intensive training (Kishali et. al).

It is important for coaches and athletes both to track the menstrual cycle as to improve training during these phases. In a recent study conducted by Mid Sweden University in 2019, more than half of elite female athletes reported  that hormonal fluctuations during their menstrual cycle negatively affected their exercise training and performance capacity. A recent study indicated that approximately 75% of athletes experience negative side effects due to menses. The most common side effects include cramps, back pain, headaches, and bloating. Research also indicates fluctuations in strength, metabolism, inflammation, body temperature, fluid balance and injury risk that are concomitant with hormonal fluctuations throughout the cycle. However, the way in which the menstrual cycle affects females and their performance is highly individual and a number of studies indicate no differences across the cycle.

Training according to various cycles of menstruation

Depending on your menstrual cycle it is important to not only track but also to change your workouts and switch up the intensity based on which phase of the menstrual cycle you are in. Recommendations of how to go about the same are as follows:

Follicular phase:

This phase starts on the first day of menstruation and ends with ovulation. This phase is ideally the best for high-intensity workouts as the females body has a higher pain tolerance and higher perceived energy levels. At this time, having a diet rich in carbohydrates before workouts or exercise will lead to higher endurance and higher intensity workouts. This phase also makes it easier to build and maintain muscle.


Ovulation occurs in the middle of the menstrual cycle, around 2 weeks before menstruation starts. This time for athletes would be the best time to achieve personal bests during strength training as a significant increase in quadriceps strength during ovulation, compared to the follicular and luteal phases, has been reported. It is important to be careful during this stage of menstruation as women are at higher risk of injury during this period. For example, ACL ruptures in some athletes are more likely to happen around ovulation.

Luteal phase:

During this phase the body releases progesterone along with small amounts of oestrogen. This combination of hormones usually maintains the thickening of the wall of the uterus, waiting for a fertilised egg. More hormones means a decrease in anabolic, or muscle-building, capacity. This means that it’s time to take it easier, focusing on lower-intensity workouts with more recovery time. In this phase, a females body is not primed for high intensity training. Women face pre-menstrual syndrome which occurs 7-10 days before the start of your period and this might affect training. Body mass is also higher at the time due to fluid retention in the body. In this stage, your body needs fuel from extra carbs and calories from the outside (that is your diet and the amount of calories you consume daily). Plus, your body also needs more water during this phase – more hormones means a greater risk of dehydration. During these weeks, you will probably feel hungrier than usual. This is completely normal. In fact, your body uses up 5-10% more calories during this premenstrual phase. Don’t fight it and listen when your body is telling you to eat.

Menstruation and Female athlete TRIAD

A major component during menstruation is also the female athlete triad. Female athlete triad is a syndrome of three different conditions that affect physically active females. The three conditions it is comprised of are:

  1. Low energy availability with or without disordered eating
  2. Amenorrhoea (absence of menstruation) and other menstrual disturbances
  3. Decreased bone density

The symptoms of these usually occur with signs of fatigue, hair loss, disordered eating, dry skin, weight loss, low self-esteem and increased time needed to heal from injuries. Athletes diagnosed with the female athlete triad do not have to show all three components simultaneously. The leading cause of the female athlete triad is the imbalance in energy intake and energy expenditure. Female athletes use a lot of energy in training and are often careful in what they eat. This can result in disordered eating and not consuming enough food to compensate for the energy being used. Weight loss resulting from dietary restrictions can result in amenorrhoea because weight-loss affects the hypothalamus’s ability to secrete hormones needed for the secretion of sex hormones. Osteoporosis and reduced bone density result from low oestrogen levels and poor nutrition, which are both factors contributed by the two other components of the female athlete triad.

The main element of preventing the female athlete triad is raising awareness and educating female athletes and coaches. Athletes need to be informed about nutrition and the importance of eating enough, as well as knowing when to rest and recover. Additionally, all women should have a good understanding of what a healthy menstrual cycle looks like. Also important is having good communication between the athlete, their coach and their family, and encouraging athletes to seek counselling can help too to prevent the full onset of the triad.

Un-Taboo the subject with Coaches and Parents:

Opening up the conversation and not treating it as a taboo would be worthwhile. Regardless of the gender of the parent or coach, speaking about periods openly and educating adolescent females about this topic is very crucial. Coaches can either talk to their female athletes or parents individually or in groups about how the athletes feel and what exactly do they require from their coaches during their cycle. They can schedule training dates around the cycle of the athletes as to maximise performance levels. Coaches or parents can also take into account the individual athletes and how they are affected by their cycle as each female has different symptoms when on their menstrual cycle. For example, do they feel nauseous with cramps in the luteal phase? Or do they feel fatigued at any point of their cycle? These questions are important to ask and to note because while these topics are personal they are important to discuss for the athletes overall wellbeing. For one, it allows the coach to understand their players better and understand why there may be dips or increases in performance at times where there’s no obvious physiological or lifestyle change. Secondly tracking ones period, signs and symptoms is extremely important for their health and well-being going forward and can often help identify some issues concerning their reproductive health early on.


So why haven’t we realised this sooner? Or why is it that we have never even addressed the elephant in the room that males and females train differently? Not because one is lesser than the other but because we don’t want to accept the bloody sport. Or address the subject of female athletes and menstruation. These are biological changes that occur in the female body that we just cannot change or ignore. It is imperative that we stop treating menstruation as a taboo and talk openly and unashamed about the changes that the female body and performance faces due to it.








image courtesy : https://www.freepik.com/premium-photo/sport-woman-is-having-injury-her-stomachache-peroid_2977058.htm

Watch this Interview with Indian Badminton player : Aditi Mutatkar on Menstruation and Female Athletes.

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