Beyond Bleeding: Decoding the Absence of Periods in Sport
When we talk about periods in the context of sport, we tend to focus on the ways they can be inconvenient, unpleasant, or something to endure. When we lose them, we practically celebrate, and many of us take a pill to “manage” or suppress them. After all, if getting pregnant isn’t high on your list of priorities, then what’s the point of them anyway?
I used to ask the same question. When my period vanished a decade or so ago, I barely paused for thought. It was normalised in my sporting circles, and with medical experts supporting such a notion, I had no reason to consider otherwise. Until a few years later, when all other options were exhausted, I started to wonder if its absence could hold the answers to my myriad of health problems. I took to the internet for research, and I was shocked by what I discovered.
Functional Hypothalamic Ammenorea (FHA) is the clinical term for a missing menstrual cycle, a condition where the hypothalamus halts the reproductive hormonal cascade to conserve energy for movement. This hormonal imbalance is linked to risks like bone health issues, heart disease, low libido, depression, fatigue, and more. This explained my own health struggles and eventually led me to the cause: RED-S (or REDs). Surprisingly, such crucial information was absent from mainstream awareness, leaving me frustrated by the sports and medical communities’ dismissal of its importance.
The frustration mounted as I considered how menstruation has been a taboo topic for centuries. Long, long ago, various cultural myths and prejudice turned a normal (and AMAZING) bodily function into something to feel ashamed of and embarrassed about, and we’ve been thoroughly socialised not to talk about it ever since. How many of us, for example, were educated at school about the magnificent system working away behind the scenes throughout the month—not just the bit when we bleed? Or about how maintaining a monthly menstrual cycle is a key indicator that your body is working the way it should?
Baby-making aside, the female reproductive system is directly responsible for your day-to-day moods, concentration, energy levels, metabolism, sex drive, muscle growth and adaptation, exercise recovery, and so much more.
Yet many of us simply blame them for making us erratic, emotional, or for getting in the way of our sport, social, or sex lives.
Within the realm of sports, the lack of understanding about female physiology perpetuates this taboo. Everything we think we know about physiological adaptations, training mechanisms, nutrition plans, psychology, and recovery has come from research carried out on men and then inaccurately extrapolated to females. As a result, very few of us truly understand how our bodies function, which leaves us at far greater risk of experiencing issues like FHA, low energy availability (the cause of RED-S), and a wide range of resultant health effects.
Without the basic education we so desperately need, how can we expect to make informed choices that are in the best interests of our long-term health, wellbeing, and performance? And, when so few of us are ‘in the know’ about our menstrual cycles, how do we go about identifying problems or adjusting our behaviours when the balance gets tipped? Instead, when we run into trouble, we remain puzzled and frustrated by our body’s display of seemingly disconnected symptoms, never knowing what is wrong or how to fix it.
For instance, how many female athletes realise that not maintaining a monthly menstrual cycle significantly increases their risk of illness, bone-health issues, other injuries, gastrointestinal distress, fatigue, and an impaired rate of recovery? How many understand that losing their period can decrease their ability to absorb the effects of training, gain strength and endurance, and maximise their potential in sport? Worryingly, these very same athletes are often encouraged by medical professionals (through no fault of their own) to simply take the contraceptive pill, masking their missing periods and stripping them of their most valuable tool for monitoring their hormonal health.
Thankfully, the tide seems to be turning in professional sport at least. We’re starting to see trends in elite sportswomen choosing periods over the Pill, using alternative methods of contraception, and tracking cycles on smartphones.
Olympic level athletes are becoming part of a movement of women speaking openly about their menstrual health and promoting the notion that a period isn’t just a period but also a precious training tool that we can use to unlock higher levels of female performance.
By reading this, you too are part of this movement. No matter what your sport, age, or situation, there is no better time to gain the knowledge you need to tap into your own biological advantage. The longer you wait for science and society to catch up, the longer you’re depriving yourself of reaching the state of health that you can and should be in. NOW is the time to take charge of your hormones and commit to working with, not against, them. Better still, spread the word.