Each month, females have to deal with the effects of a menstrual period. However, menstruation becomes even more complex for the female athlete. Because athletes are generally unable to break from training or competition for multiple days out of the month, learning how to combat adverse effects becomes all the more important.
According to Dr. Charlotte Alabaster, a normal period lasts from three to seven days, and it is imperative that females are experiencing a regular cycle. “It is not normal to not have periods. This is a sign that that an athlete is overdoing things. There is an energy imbalance and there is an increased risk of fractures when there is a prolonged absence of periods. I can’t emphasize enough how important it is to have a regular cycle,” explained Dr. Alabaster.
With females who experience regular periods, one of the most significant side effects is menstrual cramps. For tennis players, suffering from menstrual cramps can be a monumental disadvantage during training and match situations.
Another potential byproduct of the menstrual cycle is the occurrence of heavy bleeding, which can cause excessive loss of iron and lead to fatigue. If heavy bleeding is present, match and training performance will be impaired.
To mitigate these hinderances to performance, Dr. Alabaster suggests a number of different solutions. “When having their period tennis players should stay well hydrated with warm drinks or fluids at room temperature,” she said. “Cold drinks and ice will make menstrual cramps worse. Warm drinks on a daily basis and keeping cold feet as warm as possible will also help. Chai tea and Bengal Spice are teas that are warming, and drinking them on a regular basis is very helpful.”
With menstrual cramps, it is often difficult for athletes to stay focused on the task at hand. “Having a warm pack is helpful, but prior to the match, taking anti-inflammatory medication such as Ibuprofen can help relieve cramps,” said Dr. Alabaster.
When bleeding is abnormally heavy, iron deficiency can become a prevalent and serious problem. Symptoms of iron deficiency include fatigue, shortness of breath, palpitations, feelings of anxiety and depression and an increased need for sleep. According to Dr. Alabaster, the best way to combat iron deficiency is prevention because it is a long-term issue. She suggests eating a diet rich in iron, which is comprised of red meat such as deer, bison, lamb and beef.
Once a female athlete is iron deficient it can take six months or longer to get back to normal levels, which is why prevention and quick detection of this deficiency is crucial for girls and women. “If girls are suffering from heavy periods, that’s a big disadvantage and they need to see a doctor, there’s no question about it. It has to be someone familiar with the needs of athletes,” said Dr. Alabaster.
“If bleeding is heavy with clots, there is risk of anemia due to iron deficiency. This needs to be addressed with blood work and may need treatment with iron supplements either in tablet form or by injection,” said Dr. Alabaster. “Heavy bleeding can indicate a problem with the lining of the uterus and this might be precancerous or cancerous. When there is heavy bleeding, blood work needs to be taken to check hemoglobin and iron levels. A ferritin of less than 50 indicates deficiency and will have a negative effect on performance.”
From a coaching perspective, Dr. Alabaster urges coaches to be attentive to their female athletes’ concerns when it comes to their menstrual cycle.
“Don’t be dismissive because a lot of girls are coached by men who have clearly never had a menstrual cycle. Their understanding of what these girls might be going through may not be the best. Female coaches may have a better understanding, but if she’s never had cramps, she may not be very attune,” she explained.
Above all, Dr. Alabaster expresses the importance of seeking the advice of a qualified physician when it comes to dealing with abnormal and adverse side effects of menstruation. “For any athlete who is having problems and who goes to their coach, the coach needs to recognize that they have a medical problem and direct them to a good physician,” she said.
While periods are a necessary part of a female’s life, they should not be a detriment to athletic performance, and seeking further information on how to overcome the unfavorable effects of menstruation is vital.