Many female athletes train and tone their bodies to a standard beyond what is actually healthy. Sometimes it’s an intentional sacrifice made for their sport, but more often it’s based on ignorance or the misguided advice of coaches. When these athletes complain about the resulting cycle amenorrhea (that is, “skipped” periods), hormonal contraceptives “fix” the problem by masking the issue or eliminating menses altogether.
But is that really what is best for their overall health? Experts — and some champion athletes themselves — think not.
New York City Marathon winner Shalane Flanagan says she’s never missed a period, despite the years of endurance training it took to race among the best runners in the world.
“I run 120, 130 miles a week. I don’t miss [my period]. So it’s not normal [when that happens],” she revealed to the Wall Street Journal. “That doesn’t mean I’m not trying or training hard enough.”
CCL board chairman and leading fertility awareness expert Mike Manhart, PhD, says Flanagan is right.
“Most elite athletes stop menstruating altogether and traditionally this has been thought to be a consequence of hard training,” Dr. Manhart explains. But the science begs to differ. “The new insights are indicating amenorrhea is not a sign of good training but in fact signals over-doing it which can be dangerous and give suboptimal results.”
In fact, fighting menstrual cycles — especially with hormonal contraceptives — can hurt athletic performance. Inadequate nutrition, sleep, and body fat negatively impact hormone levels, which in turn can create symptoms that disrupt training such as sluggishness, bloating, intolerable cramping or bleeding, and more. Medicating cycles away with artificial hormones can create further troubles, including poor bone density and increased risks of blood clots in otherwise healthy athletes.
Dr. Kathryn Ackerman, medical director of Boston Children’s Hospital’s Female Athlete Program cuts to the chase. “The best solution is [for women] to get their own cycles,” she says.
It isn’t easy, of course. Every woman responds differently to the seemingly endless variables that can impact cycles. How can individual athletes know how to adapt their workout to their bodies? How can coaches, responsible for training dozens of women at once, keep up with the demands of as many unique cycles?
U.S. Women’s Soccer coach Dawn Scott credits the period-tracking app FitrWomen and its coaches’ companion app for guiding the team as they learned to optimize their workouts according to their cycles. The apps allow individual players to track their full cycles — not just menses — and create regular reports for Scott. On her end, FitrWomen recommends nutritional, athletic, and rest guidelines for the team, grouping the athletes by their current cycle phases.
The cooperation with their bodies paid off — the team went on to win the World Cup.
Dr. Manhart has high hopes about the attention this unique cycle-based training is receiving.
“The [Wall Street Journal] article calls attention to the fact that not menstruating is not good fittness, and [that it’s] a sign of physical stress,” he says.
There’s also value in tracking a cycle from beginning to end, even without a desire to optimize workouts. Women who track their cycles report earlier identification of reproductive disorders, have more ability to respond to negative period symptoms, and even report improved self-esteem.
“If elite athletes are becoming more open about the menstrual cycle being normal and a sign of health, it may signal the tip of the wave of [a change in] thinking for all women,” Dr. Manhart hopes.
— CCL Staff Member