To Hell in a Hormone Handbag
When it comes to your period and sports, should you go with the flow?
From Women’s Sports and Fitness
By Jean Weiss
Way back in the year 200, a Greek physician had the brainstorm that menstrual blood was the draining of female juices that accumulated as the result of an idle life. Public opinion regarding menses hadn’t improved much by 1488, when the Catholic church mustered the proclamation that not only was menstruation a disease, it snatched wives away for too long a time from their familial duty to breed. Several centuries, sanitary napkins, tampons and ibuprofen pills later, a couple million onlookers watched distance runner Uta Pippig win the Boson Marathon with an obvious line of menstrual blood trickling down her leg. It was no longer a private matter that could have been politely overlooked the same way the checkout clerk at the grocery store pretends that your box of slender regulars is just another yogurt carton passing through the electronic sensor. There Pippig was, far from idle and diseased, pulling off an exceptional performance obviously on the rag. Now that was hopeful.
No matter how uncomfortable they were, the media could not overlook the topic and neither could the public. Pippig’s overflow raised the question: How does a woman’s menstrual cycle influence her athletic performance? Ask an athlete, and most likely you’ll hear the comment that she doesn’t think it helps her much.
“Usually the day before and definitely the first day of my period, I am worthless as far as competing,” says Judi St. Hilaire, 38, who ran the 10,000 meters at the 1992 Olympics and continues to race on the elite circuit. “I can run and go through the motions, but I dread competing the first day. My mind wants to do one thing but my legs—mostly I notice it in my quads—they just don’t fire. It feels as if I have a short circuit.”
St. Hilaire’s plea that she’s disadvantaged during her menstrual flow is echoed by both professional and recreational athletes. The big surprise is that medical research indicates the opposite. When you’re feeling your worst, you might actually have the potential to perform your best. Here’s why.
The menstruation of eumenorrheic women (women with functioning, healthy cycles) consists of four phases, each phase exhibiting a different balance of hormones. In a typical 28-day cycle, menses, the time during which you bleed, occurs on roughly the first through the fifth day. During this stage, estrogen levels are low. The postmenstrual, or follicular, phase immediately follows menses, and lasts from about day six through about day 13 or 14. Estrogen levels are low at the beginning of this phase, then steadily rise. Ovulation, during which estrogen levels are high, begins sometime on about days 13 through 15. Then the postovulatory, or luteal, phase occurs approximately between days 15 and 28, with estrogen levels steadily decreasing until menses, when they are again at their lowest.
The complicated stack of research on the subject boils down to a few useful nuggets for women athletes. First, it is thought that the high estrogen levels interfere with VO2 max, the body’s ability to utilize oxygen. Therefore, when a woman’s estrogen levels are at their lowest, it’s likely that her aerobic capacity is at its peak. Who would have thought it. At the exact time you feel like an edemic sloth permanently sealed to your sofa, you could be out there racking up a personal best. Second, studies have proven that women think their performance is worse just before and while they are menstruating, even though objectively it’s not. “There’s some evidence that even though women feel bloated and there’s an increased rate of perceived exertion in the week or so just before their period, energy metabolism for aerobic exercise may actually be better during the luteal phase because of the glycogen-sparing actions of both estrogen and progesterone,” says Dr. Connie Lebrun, director of primary care sport medicine at the Fowler Kennedy Sport Medicine Clinic at the University of Western Ontario in London, Ontario. Lebrun’s interest in the subject was piqued when she played volleyball on Canada’s national team and in the 1976 Olympics. Her studies indicate that the time during and just after a woman’s period is even more optimal. “During the first couple of says, there is a tendency to have menstrual cramps, which may have an adverse effect on training and competition,” says Lebrun. “After the cramps go away, during the menses and into the follicular phase, estrogen and progesterone levels are at their lowest and are likely to have the least impact on athletic performance.”
Don’t pray to the gods of low estrogen just yet. There is a catch. The variances are so minute, they would make a difference only for top athletes. “It probably doesn’t make a huge difference for the recreational athletes,” says Lebrun. “We’re most likely looking at people at the elite level. If you have a small difference of performance in a high-level athlete, it’s significant. It might mean the difference between first and second place.”
Lebrun uses the phrase most likely, because she’s keenly aware of the flawed nature of studying women whose cycles themselves are variable. She also points out that estrogen might not be the sole factor inhibiting VO2 max. For example, progesterone could play a role as well. It just happens that estrogen levels are high when VO2 max is inhibited. yet while some of the research is contradictory there are snippets of information about other phases of the cycle that apply to the female athlete. While VO2 max is the leading indicator of aerobic athletic ability, the research of Elizabeth Hampson, Ph.D., associate professor of psychology at the University of Western Ontario, documents an entire case of characteristics that shine during the remainder of the month. Hampson’s findings indicate that when estrogen levels peak at midcycle, during the later part of the follicular phase and just prior to ovulation, women experience unusually sharp mental focus. The fact that you are better at tongue twisters and can rapidly recall the right word might not help in a mountain-bike race. What could apply is the increase in perceptual speed (how quickly you notice things) and fine motor function that occur during this phase. The flip side is that while your powers to assess and think clearly are soaring, your spatial visualization is at an ebb. You can’t have everything.
In the end, the story is most interestingly told by the athletes themselves. “Medals have been won and world records set by women at every phase of their cycles,” says Jenny Stone, a manager of clinical programs in the division of sports medicine for the U.S. Olympic Committee. That doesn’t mean the women have always felt just peachy as they’ve earned their golds, silvers and bronzes. For every St. Hilaire, whose experience has shown her that if she races during her period, she loses a good 20 to 30 seconds off of her 10K time, there’s someone like ski racer Hilary Lindh, 28, a 1992 Olympic medalist and the 1997 world champion. “I had my period at the world championships, and I don’t think it hurt,” she offers. “If I can’t afford to have anything bother me, it doesn’t. If I have the time and it doesn’t really matter very much if I’m affected, then it will affect me.”
As solo athletes, St. Hilaire and Lindh have the luxury—or the disadvantage, depending on how you look at it—of focusing on how their bodies feel. It’s different for women who are part of a team. “As an individual-sport athlete, your success of failure is for the most part an individual thing,” says Stone. “If you are a team player, you can not be feeling well, but that doesn’t mean the team fails. In an individual sport, how you do is directly dependent on how you feel.”
Less is at stake for a member of a team who’s feeling under par because of her menstrual cycle. It’s easier for a team player to get absorbed in the game and forget about how her body feels moment to moment. Members of the U.S. women’s soccer team are expected to handle any discomfort or lethargy they feel on their own personal time. “Performance is performance and it has to be good,” says Lauren Gregg, assistant coach for the team. “There are a lot of factors that can influence your performance. You have to be at the edge all the time. Our philosophy is to block anything that influences your focus, whether it’s emotional or physical. managing these factors is critical.”
In a sport like crew, the team mentality can cause a problem when it comes to menstruation. It’s not uncommon for groups of women to synchronize their periods, especially small groups. Two-time Olympian rower and silver medalist Amy Fuller, now the assistant to the national team coach, says that her boat used the phrase, “those who row together, flow together.” When members of an entire four or eight boat experience every menstrual phase together, it can make a difference. “We would joke about it, but we could definitely tell it affected out mental training a bit,” says Fuller. “We always tried to perform on our worst days and tried not to let it affect us. Still, we were a bit more emotional, more reactive to negative comments, less tolerant of some of the things that go on with the rigors of daily training. We trained so hard, and we were at such a high level, I can’t say if we were seconds faster or seconds slower, But when you have eight women blowing things out of proportion, it can get ugly, until someone points out that it’s that time of the month.”
Things can get even grimmer if your life depends on your morale and your ability to think quickly. Mountaineers and big-wall climbers fit this category. In sports that rely on the athlete’s ability to endure discomfort, pampering and self-indulgence don’t work. “To be a good mountaineer, you have to tolerate suffering,” says National Outdoor Leadership School (NOLS) instructor and course coordinator Lynne Wolfe, 36, who’s been on four expeditions, including two to the Himalayas to climb Pumori and Baruntse with all-women teams. “We really notice ourselves all getting on the same cycle,” says Wolfe. “How you handle it had to do more with the maturity of the players on your team. Are you regulated by your emotions, or do you recognize them for what they are? It’s more of a hassle. You’ve got these bibs on, and this and that and the other thing. The last thing you want to be doing is dinking around with a tampon.”
Big-wall climber Eve Tallman, 36, best known for her solo climb of Moonlight Buttress in Zion National Park, agrees with both points—about the hassle and about the need to buck up. “When I go up on a wall for a week, it’s a drag if that’s what’s going on,” she says. For the fist five or six years after Tallman started climbing big walls, it seemed that every time she attempted a major route, she got her period. “I’ve climbed long enough and hard enough,” she says. “Sometimes you just have to rise to the occasion. If I know I can just lie around on a Saturday, I will. If you’re in the middle of a climb, you’ve got to keep it together.”
Perhaps the best way to keep it together is to integrate the medical research with your own experience. It’s useful to know theoretically when your body might do its best. However, if, like St. Hilaire, you have evidence to the contrary, trust it. “Keep track of your cycle and symptoms and performance on a monthly basis,” says Lebrun. “You know yourself best. Maybe you’ll find out that, ‘yes, I’m better a couple days after the start of my period.’”
The one direction not to take with the discovery that low estrogen levels improve VO2 max is to deprive your body of estrogen through over exercising, eating inadequately or smoking. Dr. Jerilynn Prior, a professor of endocrinology at the University of British Columbia in Vancouver who, with Lebrun, published the research paper documenting this, is emphatic about this point. “I would caution that we are talking about very, very small changes,” she says. “We’re talking about a study in women who were ovulating. If a person exercises in a healthy manner, eats well and isn’t overstressed, her lower estrogen phase will be in a low enough range. The optimum performance comes from a healthy woman not from a woman who is depriving herself.”
As a professional athlete, Brandi Chastain, 29, a member of the U.S. soccer team, takes this philosophy to heart. “I’ve noticed, especially on the Olympic team, that a group of women in tune with what is happening with their bodies tends to be more prepared,” she says. “We understand how our cycles work, therefore we make the fluctuations in mood and performance less significant by preparing with our diet or sleep or training.”
After all, Chastain points out, rarely does your body lie to you.