After crushing menstrual taboo, here's how female athletes are coping with it

“It’s that time of the month. I know the ladies watching are probably like, yeah, I got you,” Lydia Ko, golf’s world Number 3 told a flabbergasted male journalist at a post-match interview in California earlier this month.

The interviewer had asked the New Zealander about an on-course physiotherapy treatment she received at the final round of the Palos Verdes Championship, and if it would be a recurring problem.

“I hope not,” Ko quipped, adding how period cramps make her back tight during matches, making her reach out for her physiotherapist, driving the fumbling interviewer to muster a “thanks”.

Watch: ‘Wish I were a man’, says Chinese tennis player Zheng Qinwen

On Tuesday, China’s Zheng Qinwen, visibly tormented by period cramps, said she wished she were a man, after losing against world Number 1 Iga Swiatek at the French Open.

“The first day is always so tough and then I have to do sport and I always have so much pain on the first day…I couldn’t go against my nature. I wish I can be a man so that I don’t have to suffer from this. It’s tough,” the 19-year-old tennis player told reporters.

Women athletes today are not only openly talking about periods and menstrual cramps, but also managing symptoms with the help of experts and planning their training regimen and diet around their periods.

Acceptance, discourse the first steps

Like Ko and Qinwen, the first step female athletes have taken towards addressing the problem is accepting the impact of menstruation and pre-menstruation symptoms on performance.

Chinese swimmer Fu Yuanhui, for instance, was lauded for smashing the taboo around periods and sharing how it made her feel weak and tired after her team came fourth in the 4X100m medley relay at the 2016 Rio Olympics.

In 2015, British tennis player Heather Watson blamed her defeat at the first round of the Australian Open on her period.

She found support in fellow and former sportswomen including former British tennis Number 1. Annabel Croft, who lauded Watson for talking about something which until now was considered “a girl thing.”

“It was one of those things that was all hushed up. I remember being on court feeling dizzy, disoriented, tearful, then coming off court, going into the locker room, and finding my period had started – and realising, ah, that’s why I was all over the place,” Croft told The Guardian, reminiscing her professional years.

Marama Davidson, lauding Ko’s candour about period cramps, admitted that the issue of period pain for athletes was “definitely not acknowledged enough.” “It’s really healthy that we actually mention it as a normal part of sport that has to be factored in, not just physically, but also psychologically. We have to consider that people go through cycles and we have to think about that when we are planning training and events,” clinical psychologist Karen Nimmo, who works with high performance athletes, told The Guardian.

Nimmo said periods should be normalised as a part of sports, and female athletes like Ko initiating a dialogue is just a “gateway to discuss it.”

Cycle mapping

Ten years ago, Dame Jessica Ennis-Hill was torn between absorbing the ‘gold medal moment’ and the fear of being seen with period blood on her skirt, after finishing first in the 800 m women heptathlon at the London Olympics. The experience of not enjoying the moment of triumph because she had her periods to take care of, inspired Ennis-Hill to come up with Jennis, a menstrual-cycle mapping app.

The app guides women including professional athletes to track their menstrual cycle and train according to the ebb and flow of their hormones.

The body produces oestrogen and progesterone, the primary sex hormones in females, in varied quantities, across the four-phases (period phase, follicular phase, luteal phase, pre-menstrual phase) of the menstrual cycle spread over 28 days, causing energy levels to dip and rise.

Apps like Jennis, as well as FitrWoman, Clue and Flo, help women train their body according to the energy level available in each cycle. For instance, the body is in its fittest stage in the follicular phase, which is just the week after the period ends, when oestrogen levels are spiked and the individual feels energised and ready to train.

However, energy levels dip during the premenstrual or the fourth phase, when the individual feels cranky and experiences lethargy and bloating due to falling oestrogen and progesterone levels. Low-impact exercises are recommended at this stage for those experiencing anxiety while high-impact workouts are suggested for those feeling frustrated.

Leveraging tech 

Several teams across the globe are now mapping the menstrual cycles of their athletes to keep them fit and optimise their performance.

Professional sports women get their periods monitored by their sport’s governing body, which in turn customises their training and diet according to their menstrual cycle.

“When we look at the menstrual cycle, when we’re in the low-hormone phase our bodies are really resilient at taking on stress. They can push the loads and we see really good recovery. Then, after ovulation, we want to tone down the intensity and utilise more technique. Then, a few days before the period starts, this is where we dial in economy of movement,” Dr Stacy Sims, a female athlete performance physiologist who has worked with Olympic gold-medal-winning Black Ferns team, told The New Zealand Herald.

Dawn Scott, the head coach of the US women’s football team, has said on record that tailoring diets and exercise around the menstrual cycles of athletes have led to better performance.

British hockey player Hannah Macleod has said that with period being a much-discussed topic in her team of 30 females, strength and conditioning coach Ben Rosenblatt makes it a point to monitor all of their menstrual cycles. Stating that the ritual began 18 months before the London Olympics in 2012, Macleod said the team was game as no one wanted to take any chances. 

Indian athletes beginning to talk

In India, where female athletes dreaded talking about periods with their coaches a few years back, the topic is slowly gaining acceptance with sporting bodies and organisations lending support to sportswomen in training according to their periods.

The national women’s hockey team is asked to update their menstrual status on a Google form every day and encouraged to keep track of it on their phones or through calendars. A similar tracking system is operational across different sporting disciplines.

“We have been tracking periods of athletes, and our nutritionists and sports sciences team. We work closely with them,” Neha Aggarwal, head of partnerships and communications at Olympic Gold Quest, told Indian Express.

Pain still a reality

But when it comes to period cramps, as the schedules of giant events like Olympics cannot be adjusted with menstrual cycles of athletes, the latter have no option but to manage symptoms with medical advice – this may range from using hot water bottles to painkillers to contraceptives.

Macleod told The Guardian that while only a few in her team took oral contraceptives, offered to regulate their menstrual cycle and symptoms of PMS, others preferred to suffer the symptoms and monitor their cycles to “manage expectations.”

Saumya Khullar, who works with the Boxing Federation of India, told IE that athletes are given choices to deal with the pain according to their symptoms. “Options for Athlete A…I know if she uses a hot water bottle, she will be fine,” Khullar said.

“That and some sort of diet modifications a few days prior and during her periods. That’s sorted. Take another player, Athlete B. It might be that she has to rely on pain medications after discussing with the team doctor. Maybe there is another player, Athlete C, who could have more aggressive symptoms…then there are conversations around manipulating that. That needs to be discussed with the doctor and the athlete themselves,” she added.

Can periods affect performance?

Even though sporting bodies have found that training and making adjustments to the diet of athletes in tandem with their menstrual cycles optimised performance, research has varying conclusions on the topic.

A 2011 study on female rowers found no difference in heart rate, oxygen consumption, power output, blood lactate levels among other parameters of endurance between menstruating and non-menstruating women.

However, a research commissioned by Women in Sport in 2010, found a fall in aerobic capacity and strength in menstruating female athletes.