England Lionesses gave an astonishing performance to win the Women’s Euros 2022 in front of a home crowd.
There were multiple reasons for their success, and among the various recovery tools like regular cryotherapy, the coaching team centralised the training regime around female health and training according to menstrual cycle.
Dr Ritan Mehta, England’s doctor, admitted that menstrual cycle and female health are the areas where female athletes did not have the same support in the past 10 years.
“The research wasn’t there and the understanding wasn’t there. The more we know, the more we can implement and the more we can help players feel better and minimise any of those symptoms” concludes Dr Mehta.
In February 2020, Chelsea Women’s manager Emma Hayes talked openly about introducing an app which would track athlete’s periods and symptoms associated with menstruation and adjusted training programs to suit women’s physiology. Just by paying closer attention to female physiology athletes could improve overall performance, boost injury prevention, improve recovery and overall wellbeing.
Luckily nowadays, professional sportswomen talk more openly about the menstrual cycle and its impact on performance.
Current tennis world No 1 Iga Swiatek talked publicly in November 2021 about premenstrual cycle (PMS) and its effect on her performance.
Towards the end of a match against Maria Sakkari, she was seen in tears on the court, eventually admitting that PMS hit her hard on that day although, in the post-match press conference, she stressed that she did not want to use hormones as an excuse. Yet, Swiatek was not able to play at a high standard because of it.
Symptoms of PMS range from mood swings and feeling upset to changes in appetite and under- performing in a sport environment.
This is something female athletes must face every month without coaches being necessarily aware of what they are going through. On the other hand, male athletes do not have to tackle similar symptoms.
It is a crucial moment for female athletes to open the conversation, while allowing training prescription tailored more to female physiology.
Having a period is a natural ergogenic aid that could be used for maximising training gains in the weights room or any chosen sport.
For example, in the 2022 Boat Races Cambridge University Boat Club’s women’s crews did exceptionally well, with all their crews victorious. Their success was, in part, attributed to strength training according to menstrual cycle, tracking menstruation, screening for low energy availability (LEA) and relative energy deficiency in sport (RED-S).
Furthermore, England’s defender Millie Bright admitted that talking about periods in sport is becoming a norm, female athletes should not be shamed or hide. As much as we believe in the notion that women can train as hard as men, there are significant physiological differences in how females can tolerate training load due to periods.
Unfortunately, women in general have a long history of being shamed into not talking about menstruation.
Most of the time female athletes deal with the menstrual cycle in silence or amongst each other. Although this can still be a significant hurdle to overcome, a multidisciplinary team of coaches could make the process easier for everyone.
The best approach would be to appoint one senior member of staff - for example a sport psychologist, nutritionist or a strength and conditioning coach, preferably female - to become a contact point for athletes to discuss any issues related to their period. The worst thing coaches could do is to randomly ask their athletes about menstruation during a training session.
Understanding and unriddling menstrual cycle
An average cycle is 28 days long, yet very rarely athletes will have a 28 days long menstrual cycle, it will more likely range between 21 to 40 days.
It is super crucial for sportswomen to start tracking the cycle - via app or pen and paper - in order to track recovery, appetite swings and general aches. Day one - the first day of bleeding - through day 14 are called a follicular phase. Days 15 through 28 - last day before period - are referred to as a luteal phase. Ovulation happens right in the middle of a cycle.
For performance, it means the most preferable time for intense training and increased volume is during the period, as the hormones are most favourable.
Naturally, female competitors worry about having their period during a big event, yet physiologically it is the most optimal time for physical activity. The best remedy to navigate cramping as well as aches and pains is movement after all.
Once the body knows pregnancy is not an option, it can naturally relax and refocus energy systems on locomotion and exertion.
Similarly, the homeostasis continues through the follicular phase right until ovulation, just before the luteal phase kicks in.
In terms of strength training, researchers found that women could make greater strength gains and exert higher rate of force development when strength training in follicular phase versus luteal phase. Additionally, in the first part of menstrual cycle neuromuscular adaptation, recovery, pain perception and thermoregulation are at its finest.
The event calendar cannot be moved around to suit physiology. What if athletes must race during high-hormone phase? It has been reported VO2max and lactate threshold remain relatively constant throughout the cycle, indicating endurance athletes to be able to score a personal best even during PMS. Per contra, athletes in team sports or stick-and-ball sports, may notice a drop in performance when in high hormone phase.
Luckily, there are nutritional interventions that could be implemented for athletes having to compete with PMS. The main intervention would be to bring the systemic inflammation down via specific foods, supplements, cryotherapy and most of all an increased protein and complex carbohydrates intake.
In conclusion, coaches should make every effort to equip themselves in knowledge about women’s menstrual cycle.
As Hayes pointed out this would be a new generation of athletes who are well educated about their physiology and understand the significance of it.
This could become a culture not only within every football club, but women’s sport in general, as a result everybody could cope better with the menstrual cycle.
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