Menstrual Cycle and Physical Performance of Female Athletes

The menstrual cycle is a complex physiological phenomenon (Kin 2000). Some

female high school students get through their monthly periods easily with few or no
concerns. However other girls experience physical and emotional changes just before
and during menstruation. From heavy bleeding and missed periods to unmanageable
moods swings, these symptoms may affect a females way of life. Studies shows that
females feel a decrease in their physical capacity during menstrual cycle because of
menstrual disturbances. These include heavy menstrual bleeding (menorrhagia) and
painful menstrual bleeding (dysmenorrhea) and the reason of these disturbances could
be excessive weight loss, changes in body composition, insufficient nutrition,
psychological stress, and intensive training (Fox 1988; Kimberly 1998). Although there
is abundant research addressing how exercise affects menstruation, less is known
about how menstruation affects female physical performance. This article will look at
some of the research on how exercise performance is affected by the menstrual cycle.
For these female athletes even small differences in performance may be critical to
athletic success.
The typical menstrual cycle is 28 days long, with the first day of menses
(shedding of the uterine lining) considered Day 1. Menstruation is usually completed by
Day 5-7 and the mucosal lining (endometrium) of the uterus once again begins to
proliferate in preparation for an egg. The phase from Day 1 to ovulation, which is
normally Day 15, is called the follicular phase. The luteal phase is from ovulation until
the day before menses, normally about Day 28.
As most women know, symptoms that accompany menstrual cycles vary
considerably. Some women do not experience any symptoms; others may suffer slight
discomfort to severe pre- or initial-flow discomfort. Changes in exercise performance
during the menstrual cycle are also variable. Many women report impaired performance
and many do not. There are a number of women who have won Olympic medals while
menstruating. Some women may experience some minor discomfort but merely push

themselves forward during participation. Alterations in athletic performance experienced

during different phases of the menstrual cycle are subject to considerable individual
variability.
Lebrun (1993) published a comprehensive review of the literature examining the
effect of menstrual cycle phase on athletic performance. According to an analysis of the
surveys, most female athletes did not report any detriments, while a minority reported
improvements during menstruation. Some studies report differences during the cycle
phases with best performances during the intermediate postmenstrual days and worse
performances during premenstrual and initial-flow days. Dysmenorrhea, in practical
terms affects athletic performance more than menorrhagia. Many female athletes suffer
from dysmenorrhea. Dysmenorrhea distracts from the feeling of well-being. For that
reason, it negatively affects performance; some of the problem may be psychologically
induced.
Other reports are effects of premenstrual syndrome (PMS) on exercise
performance. Nearly all women are familiar with symptoms of bloating, headaches,
fatigue, and cramping during the late luteal phase. Many studies relate an increase in
perceived exertion during premenstrual and early menstruation days. As well, several
authors reported that effects of PMS could alter performance as the tasks increased in
difficulty and complexity. Others note impairments in exercise performance arise from
breast tenderness, abdominal constriction, and fatigue.
Also according to the research of Lebrun (1993) the menstrual cycle can also
increase the risk of having musculoskeletal and joint injuries. The lack of the protective
effect of estrogen on bone causes demineralization or premature osteoporosis, leading
to an increased risk of scoliosis, stress fractures, and other more serious fractures.
Even with resumption of normal menses, some of these changes can be irreversible.
Adolescence in particular is when 60-80 percent of skeletal bone is laid down and
consolidated. Low estrogen and poor nutrition during these years may lead to a low
peak bone mass.

However, some physical and physiological characteristics of athletes were found

significantly different between sport branches according to Claessens (1992) .It was
determined that high-intensity training in team sports increased menstrual dysfunction
but it was found that the menstrual function returned to normal after decreasing the
training intensity or stopping the training for a while.(Uysal, 1996). These dysfunctions
happen as a result of hormonal and body function changes during high-intensity training
(Shangold, 1990).Excessive loss of body weight and body fat ratio causes the irregular
menstrual cycle. Training and competition stress also causes these dysfunction.
Several coaches suggest their female athletes log their menstrual cycle and
associated physical and emotional states. They can also chart their exercise and
athletic performance to establish strongest and best training days and when they are
impaired. This will facilitate modifying a training schedule by planning for strenuous
sessions, peak training and when rest is needed. Factors that can be altered are
volume (number and duration of repetitions), intensity (speed and load), and difficulty
(skill level and injury risk). Nutritional considerations should also be factored to optimize
recovery and fuel stores. It is important for athlete and coach to remember that all
athletes are individuals and may respond differently. A master plan may not work for all.
Careful record keeping and modifications in training if needed may increase
performance and reduce risk of injuries. In todays increasingly competitive sports field,
this may become important to achieve athletic excellence.
Conclusively, the effect of menstruation on performance is equivocal and unclear,
but a woman who is experiencing PMS will likely not perform well while she is
experiencing the symptoms. Female athlete experiencing menstrual irregularities and
disturbances should undergo a detailed medical investigation and management before
further training. Exercise-related reproductive disorders have been shown to have
serious consequences, mainly involving osteoporosis. Thus, preventive measures,
prompt evaluation and management of individuals at risk are highly recommended.