Learn more about women’s menstrual cycle and how it might affect the performance

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An important subject that is not much talked about is the menstrual cycle among women. Do you as a coach periodize the practice with the cycle in mind? Should you take your players period into consideration when you do your tournament planning? And in what way do the menstrual cycle actually affect the body? I asked Laura Legoupil, strength and conditioning coach and physiotherapist for WTA / ITF Junior players about the subject and how much she takes these things in consideration in her work.

Av: Linus Eriksson

Please tell me shortly about your background and your position and work right now?

I’ve played tennis since I’m a kid and I’ve always wanted to turn this passion into my job later. I was also interested in a lot in the human body from a young age. With these two ideas in mind, I turned first towards a medical approach with my physio degree in 2014. I specialized in sport physiotherapy and decided to combine injury prevention/rehabilitation and sport performance by taking two degrees in strength and conditioning coaching. 

In 2018, I started to work full time with professionnal tennis players (from WTA Top 50 to ITF Juniors). 

I’m now based in Lyon working in private with WTA and ITF Junior players.

Do you and the tennis coaches take female players menstruation cycle into consideration when you schedule and plan the players practice and tournament schedules?

With high performance athletes, the stress imposed on the body with practice/tournaments and travelling is already high. 

We also know that menstruation cycles are often associated with symptoms happening in the pre-menstrual week and first days of the cycle.

Those are regrouped under the term of premenstrual syndrome. They can be both physical and/or emotional. They also vary from an individual to another, and from a cycle to another. Here are some examples : 

– muscle pain

– lower back pain, abdomen pain

– cramping

– bloating

– fluid retention

– headache

– constipation, diarrhea

– mood swing

– irritability

– anger

– food craving

– tiredness, fatigue

– tension, anxiety

Therefore, it is important to manage the load during these periods as the body sometimes can’t work at 100% of his capacitites. 

Unfortunately, it is not as easy as it looks like to take menstrual cycles in consideration for planification.

Indeed, for most of the females, we know menstrual cycles are an average of 28 days so it is easy to predict when premenstrual syndrome can appear.

For high-performance athletes, irregularity of menstruation or even absence of menstruation make it harder to plan. This can be caused by too much stress put on the body leading to a chronic fatigue.

I would recommand an adaptation when you are in a practice period, and you can react at the apparition of first symptoms. You can adapt/lower the load to prevent risk injuries (some ideas would be to do 1 tennis session instead of 2, no heavy lifting, reducing eccentric work…).

But if the player is in a tournament, it is not as easy to adapt. You have to play in despite of the symptoms and find the way to put the player in the best conditions possible. Therefore, it is important to know what can help or be unhelpful. Tips are related to each player as the symptoms are not the same for everyone but some common tips can help :

– iron/magnesium supplementation

– drinking more water

– compression stockings 

– having sufficient sleep

– avoid inflammatory food

Do you ask the professional female players about their menstruation cycle?

I always do as I want them to feel open to talk about it, without having the feeling to be judged. I truly believe in practicing hard, but I also believe in practicing smart. That is the reason why I want them to understand there is no shame at saying that this particular day, they can’t push more than what their body allows them to do. On the contrary, it is really important for us coaches to listen to them as we can adapt our practices and minimize the risk of injuries.

An idea for the athlete would be to keep track of the cycles and note the symptoms happening. It can help understanding more the side effects and when the athletes feels at her best or on the opposite, really tired. From that, you can then search from tips to lower the side effects.

I also think it is a discussion that should be incorporated in players education from a young age so it doesn’t become a taboo subject and make the communication easier.

In what way to the menstruation affect a females physical strength before, during and after a period?

During a menstrual cycle, sex hormones (estrogen and progesterone) levels vary. Those variations cause changes in the body and can have an impact on performance. 

A regular menstrual cycle is normally divided into phases. Day 1 to day 5 is the menstruation (bleeding phase, beginning of follicular phase), low estrogen and low progesterone levels. During the follicular phase, high estrogen level peaks around day 10 to day 14 while progesterone remains low. Then ovulation happens and it is followed by luteal phase, associated with high level of estrogen and rising level of progesterone.

Even if the litterature has not shown strong evidence of menstrual cycles affecting performance, here are some of the effects that hormones might have on the body :

– Body temperature increases with high progesterone level (luteal phase). Therefore, oxygen delivered to the muscle can be lowered as blood is directed to the skin to help down-regulate the body temperature. It can cause fatigue, cramping, and higher heart rate.

– Carbohydrates are used more efficiently in the follicular phase as fats are used more efficiently in the luteal phase.

– High estrogene level decreases stiffness. It is related to a higher risk of musculo-skeletal and joint injuries (ligaments).

We should keep in mind that those effects can vary a lot from an athlete to another, and also from a cycle to another cycle.

Besides that, it is important to know with young athletes when they start to have their menstrual cycle as it represents a window to develop more certain qualities such as strength, aerobic power and maximum speed.

Can menstruation affect a players recover between pratices and matches? How can we as coaches help a female player speed this up?

The menstruation can indeed slows down the process of recovery between practices and matches.

Any tips that works for a specific player is good, but I would suggest to put even more attention to the basic principles : having sufficient quality and quantity sleep, drinking enough water and keeping a proper diet. 

Concerning the diet, it helps to eat high-fiber food as it lowers down estrogen and progesterone levels. It is also important to avoid inflammatory food (like white sugar or fatty food for example) and cafeine.

Wearing compression stockings can improve blood flow and oxygen delivery, speeding up recovery process.

What affects can using p-pills have over your performance and body? Some players use p-pills to schedule and move their menstruational period or to avoid having their period at all. Whats your thoughts about this and what affect will this have over your body and performance?

The pill is based on releasing lower and constant synthetic doses of estrogen and progesteron. It can help in preventing/reducing the apparition of premenstrual syndrome. Therefore, there is not as much as hormones levels fluctuation compared to a regular cycle. It also helps regulating the cycles and avoid the irregularity/absence of menstruation.

Based on scientific litterature, it looks like it doesn’t have any impact on body performance, or very small impact. 

However, I think it is important that the player surrounds herself with a medical team who can help her choose the best option for her, and also taking the right pill if she decides to take it. Indeed, side-effects can also be associated and must be considered. 

Sometimes my feeling has been that the/my player have used her period as an excuse on and off the court to not give absolutely 100%. What is your thoughts about this?

I think it is good to have in mind that mood swings can happen around that time. And it can be hard to understand that menstrual cycle can have an impact on how someone behaves or feels a bit down for a short period of time. That being said, if you find a player uses it too much as an excuse, it might be interesting to understand the reason behind it. You can try to discuss openly with her so the player feels more involved in the process, and then try to find both solutions together. 

Other stuff you want to add?

Even if the science is helping more and more with recent studies on the subject, there is still a lot that needs further investigation.

We should always prioritize an individual approach to see what works and what doesn’t work with an athlete.A good communication inside the team is always the key to insure performance optimization and injury prevention. And if you don’t have answers to some questions, don’t hesitate to ask specialists to help you getting the best help possible.

If you want to follow more of Laura’s work, follow her on Instagram: laura.legoupil

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