Qinwen Zheng this week wished she were a man. The Chinese tennis star was on her way to a stunt against title favorite Iga Swiatek at Roland Garros when she was suddenly overcome by cramps in her stomach. Her period had started. ‘The first day is always so hard, I have a lot of pain. I couldn’t play my tennis anymore, I couldn’t run well because of the pain. In those moments I really wish I was a man so that it wouldn’t bother me.’
Zheng’s openness about the incident is special. For many sportswomen, it is taboo to openly link a poorer performance to the monthly cycle. British long jumper Jazmin Sawyers called on top athletes to be more open five years ago, despite her fear of negative reactions. Will this make me the menstrual girl? Perhaps.’
There is no doubt that Zheng and Sawyers are no exception. Recent research among Dutch top athletes, by sports doctor in training Merel Wielink, shows that 28.6 percent indicate that they perform less during menstruation. The women suffered from abdominal pain, breast tenderness, mood swings, fatigue or back complaints. 11.5 percent indicated that they had sometimes missed a training or competition due to menstrual complaints. A 2015 British study found that 41.7 percent had underperformed.
retain moisture
That does not surprise former national athletics coach Grete Koens. ‘I see more often negative than positive effects of menstruation on the performance of my athletes,’ says Koens. ‘They often have stomachaches, backaches or heavy legs. You see that girls are also a bit heavier on the day before they start menstruating, because they retain more fluid then. That has a huge influence on running, where weight plays a major role.’
Koens herself remembers well how she was attacked by extreme abdominal pain during the European Championship in 1994, a day before she had to run. ‘I got the federal doctor out of bed at the time, because I didn’t know what to do. I was given a paracetamol. That didn’t help at all. I walked like an elephant. At that time, little was known about how to deal with it.’
Koens believes that there is still too little attention for this subject in top sport. She thinks this is because almost all coaches are men, even though Dutch women are more successful in Olympic sports. ‘As a woman it is easier to discuss this with a woman. Men don’t understand well. They think: there you have such a nag again.’
The solution is different for everyone. In any case, Koens ensures that the training sessions are less demanding when her athletes are suffering a lot. She does not advise on contraception, she leaves those conversations to the sports doctor. “Some girls are really bothered by it. Sometimes hormones are a solution to regulate the cycle, but I don’t get involved in that.’
saddle pain
Emma Paternotte, a gynecologist in training at the Elisabeth-TweeSteden hospital, hears about top athletes with gynecological complaints through her network. ‘These are the complaints that other women also have. Sometimes they have a lot of trouble with their menstruation. Or they want to know how to maintain a healthy cycle so that they can conceive after their career. But it can also be about saddle pain in cyclists.’
Paternotte and two colleagues are setting up a knowledge center that focuses on top sport and gynaecology. ‘If an athlete has a heart problem, he or she immediately knows which cardiologist to go to. But in this area there is not yet a central place where people can go with questions. We think that’s a shame. So much is not yet known about this subject.’
Recently, a football club in Bruges hired a menstrual coach to guide football players in their training. The coach looks at the cycle of the players to advise on when it is best to train hard, and when quiet is better. There are studies that indicate that women are at greater risk of injuries, such as a cruciate ligament tear, at certain times of the month.
It is good that this is being looked at, says Paternotte. ‘Then you can adjust the training even better.’
There are also athletes who like it when they menstruate when they have to deliver a big performance. Former cyclist Leontien van Moorsel set the world hour record in Mexico City in 2003 while she was on her period. Her legs felt heavier the week before her period. When that was over, she could handle more.
Is she an exception? Too little research has been done to know whether menstruation can also have a positive effect on sports performance, says Paternotte. ‘When you’re in pain, you release endorphins. You may be able to tolerate other pain even better as a result. But unfortunately we still know too little about that.’