Hi Dr Kim,
I have now clocked up a stunning 4 road circuit races and have noticed that the two that I have done in my 'pre-menstrual' week (which also includes random tears and general flappy-ness) I have REALLY struggled in, for no other real apparent reason.
Yesterday I found that I lacked any real power and strength. Also by lap two it felt so hard i was nearly in tears and alsmost gave up - which also happened last time.
In my other races I've been able to get round in relative style without too much of a problem. Also the two races I've struggled in have had lower average speeds that the ones I've got round in tact!?
So I was wondering if anyone else has noticed a real dip in performance at certain parts of their cycle or if i need to find something else to blame...
Maybe the good Doctor could help me out?
Thanks, spanner x
Winning form can be affected by your period
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Kim's reply:
In 1930, Sir Adolphe Abrahams, who was considered to be an authority on sports medicine, stated: "One girl has been credited with the ability to run over the marathon course of 26 1/2 miles in 3 hrs.40 mins.5O secs., a feat which I am disposed to doubt". Despite this attitude prevailing for some 40 years afterwards, modern female marathon runners have put this comment into perspective somewhat. Just look at the times achieved by current world marathon record holder, Paula Radcliffe, and the amazing display of performance at this year's London Marathon that saw Deena Kastor becoming the 12th woman in the world to achieve a sub-2hr20mins time!
However, the reason for Sir Adolphe Abrahams' attitude towards the perceived lesser sporting performance in female athletes was that “they are faced with the tedious business of menstruation”! Thankfully, outdated superstitions about avoidance of sport for females, particularly during menstruation, have been largely eliminated. But, how does your period affect your sporting performance?
Periods and Performance
Whether periods have an effect on sports performance remains an area of considerable debate! Hormone-related changes in the body during the cycle could theoretically effect certain physiological functions during exercise. For example, temperature is known to rise around ovulation and muscle strength (but not endurance) may be improved when oestrogen levels are at their highest. So how does the theory translate to the reality?
Female athletes often report that the pre-menstrual and menstrual phases of the cycle coincide with a feeling of decreased performance. However, many studies have shown no significant adverse effect on performance. It certainly appears that VO2 max is not effected by the menstrual cycle, although perceived exertion and mental performance may alter. One study of female swimmers showed that they achieved their best performance mid-cycle, although many of the study subjects believed that their periods resulted in poorer performances so there is likely to be a significant psychological component.
One thing the sports science fraternity can agree on on this topic is that the effects of menstruation between individuals is huge and the impact of menstruation on sporting performance is likely to be equally variable and individual specific. So, you need to know what works for you. That said, Olympic medals have been won and world records have been broken by female athletes at all stages of the menstrual cycle.
Pain and Mood Swings!
Dysmenorrheoa (painful periods) and pre-menstrual syndrome (PMS) are often implicated as causes of reduced sporting performance by female athletes. The painful cramps that are commonly associated with menstruation are abdominal, may radiate to the thighs, and range from mild to severe. The pain is thought to be caused by contractions of the womb due to release of prostaglandins during this phase of the cycle, hence the treatment is aimed at limiting the release of prostaglandins to reduce pain (see below).
Pre-menstrual symptoms can be classified as emotional or physical. The table below shows some of the most common symptoms that occur, although over 60 different symptoms have been described! One look at that list and it soon becomes apparent how pre-menstrual syndrome (PMS) could impact sporting performance both physically and mentally.
Everyone's cycle is different!
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- Physical
- Headaches
- Bloating Anxiety
- Fluid Retention
- Breast soreness
- Breast enlargement
- Changes in appetite
- Emotional
- Altered mood
- Depression
- Irritability
- Insomnia
- Altered libido
Minimising Impact
Exercise itself has been shown to have a beneficial effect on painful periods through an endorphin mediated effect (endorphins are the “natural high” hormones that are released during physical exertion). Endorphins can also help improve your mood, so regular exercise can help to alleviate some of the symptoms of pre-menstrual tension.
I'm sure we've all used them at one stage or another! Non-steroidal anti-inflammatory painkillers (such as ibuprofen) are thought to be particularly helpful for the treatment of painful periods because they limit the release of prostaglandins that are thought to cause the painful cramps.
Pyridoxine (vitamin B6) has been found to be effective in reducing fluid retention, breast tenderness and depressive symptoms. Other prescription only medications that reduce fluid retention, such as diuretics, are banned for use in competitive sport by the International Olympic Committee so don't go there if you race!
Take Control
If you want to be free of a period for major competitions it is possible to use hormone-based medication to manipulate your cycle. If you are already on the combined oral contraceptive pill then you can run your 21-day packs back-to-back to avoid having a withdrawal bleed. If you are not on the pill, you may want to try norethisterone, which is taken a just before you anticipate your period starting in order to delay it for a few days. Norethisterone does not provide contraception! These medications are prescription only so you must see your GP who will check there is no reason for you to avoid using them.
As a cautionary note, the use of medication to delay your periods should not be considered a method of avoiding periods long-term and should be used for occasional major competitions (where performance is of paramount importance) rather than on a regular basis.
Top Tips
Your periods and the effect of your periods on sports performance may be different from the girl stood next to you on the start line. Unfortunately, there is no “one size fits all” remedy. Know how your body works and what works best for you!
Regular exercise has been shown to improve period pains and help alleviate PMT.
A good intake of vitamin B6 (200 to 600 milligrams per day) has been found to be effective in reducing fluid retention, breast tenderness and depressive symptoms.
For major competitions, you may want to try a hormonal medication to ensure you're period-free for the big day. See your GP, they're prescription only.
Coming Next: The Female Athlete Triad. How does your training effect your period? All your questions answered through the SheCycles Clinic.
DISCLAIMER: Advice and information is provided via SheCycles.com Clinic on a free of charge basis as a supportive service to women in sport. It should not replace the use of your General Practitioner for medical problems.
Copyright 2006
Dr K Hurst
Rebecca Charlton
