Bleeding While Competing: Athletes and Menstruation

Photo Credit:    Creative Commons,  edited by August Nyson

Photo Credit:  Creative Commons, edited by August Nyson

In case you missed it: Last month, Mirai Nagasu became the first American female figure skater to land a triple axel at the Olympics. (You go, girl!) But this isn’t the only reason we here at Be a Rose think she’s awesome. Mirai boldy embraced the topic of menstruation, telling Cosmopolitan that menstruating while competing is “really not that big of a deal.” She also mentioned issues addressed in our January blog post: exercise helps alleviate menstrual cramps. We love how Mirai discusses menstruation like a totally normal, unembarrassing thing - which it is!

The interview got us pondering if and how menstruation impacts athletes like her - and, alternately, if athleticism impacts menstrual cycles. Since periods and their symptoms are often framed as barriers to physical activity, one might expect competitive athletes to alter their menstrual cycles with contraceptives more than people who are recreationally active. However, according to one study, that turns out to not be the case; competitive athletes are no more likely to use oral contraceptives to manipulate their periods than women who exercise for fun.

Though menstruation appears to have little impact on athleticism, the same cannot be said of intensive physical training’s impact on an athlete’s menstrual cycle. Competitive and heavy physical activity during childhood can delay the onset of puberty, both in terms of secondary sexual development and menarche (first menstruation). Further, if an athlete follows an especially demanding exercise or training regimine, her periods might stop, even if she has had normal pubertal development and bleeding previously. This is known as exercise-induced amenorrhoea. Amenorrhoea is harmless for limited stretches of time but can be hazardous in the long term because the estrogen produced during a normal menstrual cycle is needed to help build bone mass in young women and to protect the heart.

Not all women who exercise or train intensively experience exercise-induced amenorrhoea; we do not yet fully understand its triggers. However, this type of amenorrhoea is associated with low bone mass and insufficient nutrition, often because the athlete has not altered her dietary intake to appropriately meet increased nutritional needs. In fact, this combination of amenorrhoea, low bone mass, and inadequate nutrition is common enough that it has its own name: the Female Athlete Triad. Athletes at risk should maintain a diet sufficient to meet their nutritional needs, maintain a healthy weight, track their menstrual cycles to ensure they are not missing periods, and seek help for repetitive injuries or if they develop disordered eating. (The latter most often occurs in sports and activities that emphasize leanness, such as gymnastics and running.)

As we have learned, bleeding while competing is often low among elite athletes’ concerns.Training safely, meeting nutritional needs, and maintaining a healthy weight have much more impact upon performance. Next time you experience a leak in public, before you panic, remember what Mirai says: don’t let it get to you. Save that energy for something more important, whether it be putting away the groceries or nailing that triple axel!

By: Sarah Hoyle-Katz