The female athlete: What is the menstrual cycle and how can it effect the female athlete?

The menstrual cycle is typically divided into four main phases: menses (bleeding), follicular, ovulation and luteal with normal cycles lasting 21-35 days. The phases can be defined mainly by oestrogen and progesterone hormonal profiles.

The menstrual cycle may be classified as normal, oligomennorheic, ammenorhea.

Oligomennorhea - menstrual cycle length >6 weeks but less than 6 months

Ammenorhea - absence of menstrual cycle >6 months

Previous research has indicated that the female athlete maybe more likely to suffer from changes in menstrual function due to the availability of energy while performing in sport. A change in menstrual cycle that is a result of low energy availability has been termed relative energy deficit syndrome and has been linked to other negative responses such as low bone density, changes in hormone profiles, reduced performance and medical complications with the major systems of the body (Mountjoy et al. 2014).

You may want to read this 'Athletics Weekly' article by athlete Bobby Clay: My osteoporosis nightmare

Other published research refers to ligament laxity (reduced stability) in ligaments during the course of the female menstrual cycle, mainly focussing at the knee and the anterior crucial ligament (Chaudhari et al. 2007). However, there is conflicting research and it is unclear at exactly what phase the change in stability may occur.

During sports performance there have been recent public statements identifying that it may effect performance, as well as females reporting fatigue particularly at the menses phase, but once again more research is required in this area.

I currently have two articles under review, one investigating the effects of menstrual phase on ankle stability and the other profiling elite female soccer players. I will keep you updated once these articles are published. Also, a recent survey of female athletes that I conducted received 194 responses, which was phenomenal - I will be analysing and writing scientific articles based on the survey very soon.

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References:

Chaudhari AM, Lindenfeld TN, Andriacchi TP, Hewett TE, Riccobene J, Myer GD, et al. Knee and hip loading patterns at different phases in the menstrual cycle: implications for the gender difference in anterior cruciate ligament injury rates. The American journal of sports medicine. 2007;35(5):793–800.

Mountjoy M, Sundgot-Borgen J, Burke L, Carter S, Constantini N, Lebrun C, et al. The IOC consensus statement: beyond the Female Athlete Triad—Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine. 2014;48(7):491–7.

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