Female Athletes and Menstruation

Menstruation topic have long been stigmatized both in the general population and in sport settings. 41%–66% of women athletes reported that their menstrual cycle negatively affects their training and sport performance. It has been suggested that the menstrual cycle can impact sport performance in various ways, as reproductive hormones influence cardiovascular, respiratory, thermoregulatory, and metabolic parameters.

What should athletes know about the menstrual cycle?

Some athletes, especially those in sports that focus on leanness strongly believe that getting to a state at which they are not having periods (amenorrhea) will help them to perform. In fact, amenorrhea can be a sign of relative energy deficiency in sport (RED-S), a syndrome of poor health and under athletic performance that happens when athletes do not obtain enough fuel through food to support the energy needs of their daily lives and training.

How does energy availability impact bone health?

This will greatly affect bone mineral density if athletes experience low energy availability for long term and will exposed them to the risk of osteopenia and osteoporosis. For optimal performance in sport and daily life, athletes should eat sufficient nutritious foods to have energy for exercise, growth, and development. They also need energy for normal physiological functions, including a normal menstrual cycle.

How are bone health and menstrual cycles related?

Menstrual cycle is closely tied to bone mineral density. Healthy levels of estrogen and other hormones help build strong bones and keep them from breaking down. When athletes don’t get enough energy for their body’s normal functions due to over-training or lack of proper nutrition, their hormones can become disrupted, which can ultimately harm their bone and reproductive health.