Medals and Menstruation
The CRH’s Dr Jackie Maybin collaborated with Scottish athlete Eilish McColgan to create this valuable resource. Please have a read and share it with your networks.
Q-Firstly, huge congratulations on your recent successes at the Commonwealth Games and European Championships, you brought such joy to the Scottish and UK public. I personally was cheering loudly in the hospital coffee room as you crossed the line. Can you tell me a bit about the physical and mental training involved to reach this level?
I started athletics in my last year of primary school. My PE teacher entered me into the cross country, and I just absolutely loved it. I begged my parents to take me along to the local club – Dundee Hawkhill Harriers. I tried all events before deciding that running was what I loved the most. I suffered some serious injuries at the start of my career and made my first GB team at the age of 21. I think going through those career threatening injuries are really what has moulded me into the athlete I am today. I now train twice a day, most days – running in the morning and cross training in the evening. With a day off every week.
Q-That’s a demanding schedule. As a gynaecologist and researcher who focuses on problematic periods, I know that the hormonal changes throughout the menstrual cycle really impact the whole body. What do you find are the most positive and negative effects of your menstrual cycle on your performance?
I know first-hand how much periods can affect performance. Periods can be an added injury risk and have an impact on training. A few years ago, I made the mistake of training too hard during a certain phase of my cycle and ended up tearing my hamstring. Many women's teams in sports such as hockey and football are now adapting their training programmes to accommodate the athletes' cycles. As female athletes we need to adapt our training schedule every single month, which can be hugely frustrating. When it comes to competitions, the timings are much more rigid. You can’t phone the Olympic committee and ask for a race to be rescheduled if it falls on your period. I’ve not finished three major races in my time, the dreaded DNF (Did Not Finish). All three were due to my period. I have tried taking ibuprofen to help with the searing pain in my stomach, but legs that feel like they’re filled with concrete do not result in medal winning performances. To try and run, or at least perform to the best of my ability, is an almost impossible task when I’m menstruating. Some months, it's manageable. Other months, it's unbearable. There is just no telling which Eilish will be at the starting line if my period comes during a competition. After all the training, money and time to attend international competitions, it can be soul destroying and very stressful.
“To try and run, or at least perform to the best of my ability, is an almost impossible task when I’m menstruating.”
But there are positives to the menstrual cycle too. The extra energy and positivity that comes in the first half of the cycle in particular, can be harnessed during training. To me, having a period is also an outward sign of health. If an athlete is over-training or under-fuelling, the menstrual cycle is often the first thing to disappear. As much as I hate getting my period, it does give me some reassurance that my body is healthy and has a good energy and hormone balance. This is one of the most important messages I want to get across to younger athletes.
“To me, having a period is also an outward sign of health. If an athlete is over-training or under-fuelling, the menstrual cycle is often the first thing to disappear.”
Q-What a lot of extra ‘work’ for athletes who menstruate. How about other female athletes? Just how widespread a problem are periods in elite sport? Is it common for women competing at a high level to have these problems?
When I’ve spoken about how periods have affected my performance on social media, I’ve had a wave of supportive comments from other women. There have also been some less positive comments, which just show me the complete lack of awareness that some people have about periods and period problems. Menstruation has always been shrouded in shame and embarrassment, meaning that misconceptions that have been passed down the generations. Period taboos still exist in the UK and across the world. Previously, menstruation wasn't something Olympic athletes spoke about and as a result people assumed that menstruation didn’t affect us. More people are now speaking about these issues which shows attitudes are changing. People are starting to discuss menstruation, such as Dina Asher-Smith who recently talked to the media about how periods caused her to pull out of her 100m race at the European Championships.
“Menstruation has always been shrouded in shame and embarrassment, meaning that misconceptions that have been passed down the generations.”
Q-Have you found anything has helped with the more negative effects? Is there specific support available for those who menstruate in sport?
When I was younger, I went to the doctors and they prescribed the pill to help with my periods. It made me feel rotten. I was crying almost every day and snapping at the smallest of arguments. I quickly stopped taking it. As I got older, my symptoms eased and life was manageable. However, as I transitioned into elite athletics, the impact of my periods increased again as it translated into performances. Medications that take away my natural cycle don’t appeal to me as I like having it as a benchmark of how my body is functioning. There doesn’t seem to be much else out there for period problems. It still fascinates me that a large majority of women struggle with their menstrual cycles every month, and yet no one seems to have the answers. Even now, the research is sparse, especially related to periods and sport. I think things would be different if it affected men - especially our top male athletes.
“As I transitioned into elite athletics, the impact of my periods increased again as it translated into performances"
Q-What more do you think could be done for female athletes (and others) who experience problematic periods?
We need to break the taboo surrounding periods to identify the issue and potential solutions. We all need to talk more openly about periods and smash the stigma. This shouldn't be an embarrassing topic. Coaches, physiotherapists, teachers, parents, partners and friends - they all play a role in making this an open dialogue. We need to feel comfortable having this discussion to improve things for those who menstruate. One of the best things I ever did was open up the conversation - not only between other professional athletes but also online, to a larger community of women. Sharing experiences, listening to others and taking advice about treatment options. I personally feel much more educated on the subject than ever before.
“We all need to talk more openly about periods and smash the stigma.”
Talking openly about periods can also drive research in this area. We still don’t know what impact hormones have on training, exercise and performance. Or conversely, what impact exercise has on periods. Research into menstruation has been chronically underfunded, as have women’s health services over recent decades. This needs to change. I, for one, will keep having conversations about periods and associated problems to raise awareness, attract funding and encourage research. I hope this will provide the answers so desperately needed by women in sport and beyond.
Access the PDF here
Dr Jacqueline Maybin, Senior Research Fellow and Honorary Consultant Gynaecologist at MRC Centre for Reproductive Health, said:
I was delighted to be given the opportunity to collaborate with Eilish McColgan to raise awareness of problem periods. We all need to talk more openly about periods and smash the stigma associated with menstruation.
Hearing about the impact that periods have highlights why the research carried out by our research group at CRH is so important and continued funding is crucial.
We hope to improve the ways in which we identify and treat heavy menstrual bleeding so that women can receive the help they deserve.
I’d like to say a huge thank you to Eilish for her part in encouraging an honest and open discussion. Hopefully this will help to get people talking about menstruation in schools, the workplace and at home.
Support and guidance about menstruation for all ages and genders is offered via the HOPE website – have a browse and feel free to share.