This blog post was written by Harriet Brown - follow her IG @harrietbrown for more.

Period talk. Let’s talk about female athletes and our menstrual cycles.

Female athlete health is passion of mine. Over this past year I have spoken to numerous schools and sporting clubs about female athletes and menstrual cycles. I have been met with wide eyes and amazed looks from the majority of the girls. For most girls, it’s the first time they are hearing this information. This needs to change!

I have surveyed 250 female athletes between the age of 13 and 28. I asked them if they were comfortable talking to their coach about their menstrual cycle. The results indicated that 41% said they were not, 32% said it depended on which coach, and only 11% said yes. These statistics whilst disappointing, are not surprising. The majority of coaches in sport across Australia are male. Of the 36 sports in Australia that have high performance funding, only 9.2 per cent of national teams have female head coaches. As an example, since moving to the Gold Coast I have had 13 coaches and only one of them female (my current coach Naomi Flood). However, this gender difference shouldn’t stop the conversation.

An all too common dialogue when I present to school groups and sporting clubs is:

Male coach: ‘I’ll just leave the room while you girls talk about periods’
Me: ‘Actually, please stay. This information is about female physiology and is really important for you to learn so that you can understand your female athletes better and feel more comfortable to have these conversations with your athletes’
Male coach: ‘Oh okay then, I didn’t realise. I just thought they would want their privacy when talking about periods. But I am keen to learn.’

Conversations about periods and menstrual cycles need to become normalised. I have recently seen some positive changes in this area. When I was a younger athlete (~10 years ago) there were two misconceptions about periods that I now look back on with wild disappointment ‘if only we knew what we know now’. However, it’s also encouraging to see how far we have come since then.

Misconception #1 – If you don’t have your period then you’re super fit!

If a female athlete lost her period, it once was considered a sign of being super fit. This was celebrated and glorified in changeroom chat. I clearly remember speaking with all of the girls after training one morning and a few of the girls said they always lose their period in summer, it’s how they know they are super fit. One girl even said she hadn’t had her period for 5 years. I thought to myself, I must not be fit enough, I need to train harder. I was studying Exercise Science at the time, yet still had no idea of the danger of this misconception. Little did I know that a loss of period in female athletes is most likely due to overwhelming stress on the body from training hard and not eating enough, a phenomenon known as REDS (Relative Energy Deficiency Syndrome). This can result in stress fractures, over training and longer-term health issues. Sadly, I know too many women who have had to quit sport due to issues with REDs, most of which could have been avoided had the right conversation occurred. Let’s start having this conversation.

Misconception #2 – Go on the pill to have a regular cycle

The second misconception is that going on the pill will fix an irregular period. Many of the younger athletes who weren’t getting a period or who had an irregular period were prescribed the pill (oral hormonal contraception) by doctors in attempt to make them have a regular period. I have spoken to many female athletes about this and the story is often the same. The reason why this may be a harmful approach is that many young female athletes, who are risk of REDs, are prescribed the pill with no way of tracking if they have a healthy period or not. The pill suppresses the natural menstrual cycle and replaces it with a 28 days artificial cycle. Monthly bleeding when taking the pill is just a withdrawal bleed and not actually a real period. Therefore, taking the pill may mask any underlying conditions or issues, hence the reason should no longer be the go-to for athletes with an irregular period nor should it always be first line contraceptive method for athletes.

However, the pill may be prescribed to help treat medical issues, so can actually be helpful for some female athletes. Please have that conversation with your GP and explore all options first. There are many different contraceptive options available.

What we know now…

If you don’t have a healthy menstrual cycle you are not a healthy athlete! This may sound a bit drastic but it’s not, it highlights the importance of understanding your body and knowing what’s normal and what’s not.

So, what is a healthy menstrual cycle?

• A healthy menstrual cycle can vary between athletes and between cycles.
• Having a period roughly every 28 days but this can range between every 21-35 days.
• Bleeding lasts around 4-7 days.
• Some mild cramping on days 1-2 is okay, however, should never be unbearable.
• Losing around 30 - 60ml of blood.
• Typically, your first period comes at around the age of 12-13, however, may start as late as 15-16 years.
• During the first couple of years after getting your first period, your period may be irregular.

What’s not normal?

• A missed period. This could be due to stress, illness, poor nutrition or pregnancy etc.
• If you miss your period three consecutive times, it is important to go and see your doctor.
• Period pain that stops you performing normal activities or attending school, work or training is not normal.
• Soaking through one or more super pad or tampon more than every hour.
• If you haven't started your period by age 15, it's time to see you doctor to get this checked out. A delayed period could be a slower start to puberty or another medical reason.

Please go and see your doctor or speak to someone who specialises in this area if you experience anything that might not be normal.

Female athlete health and the menstrual cycle is a growing research area. There is so much we now know but still so much more to learn about how our menstrual cycle impacts our training, performance, recovery and nutrition. I am so passionate about this topic becoming a common conversation between female athletes and their coaches. I would love for all female athletes to be informed, knowledgeable and comfortable speaking about their periods and menstrual cycles. After all it’s our body and our physiology.

I will leave you with a couple of my favourite tips:

1. Start tracking your menstrual cycle; cycle length, duration, amount of blood as well as any symptoms you notice.
2. Start tracking your training around your menstrual cycle, notice any patterns in how you feel during different phases of your cycle and note any changes in performance, strength, speed and recovery etc.
3. Be aware and informed before you make any decisions regarding contraceptive methods.
4. If this flags any concerns, please speak to someone you feel comfortable with about your menstrual cycle; this may be your family, coach, doctor, exercise physiologist or dietitian.
5. To learn more, there are some great resources and modules in the Female Performance Health Initiative: ais.gov.au/fphi.

This blog post was written by Harriet Brown - follow her IG @harrietbrown for more.