Unveiling the Silent Struggle: How Menstrual Disorders Impact Elite Female Athletes and Why They Remain Undiagnosed

United Kingdom - Ekhbary News Agency

Unveiling the Silent Struggle: How Menstrual Disorders Impact Elite Female Athletes and Why They Remain Undiagnosed

In the world of professional sport, where resilience and strength are celebrated, some of the most fundamental challenges faced by female athletes often remain hidden in the shadows. More than one in ten women suffer from a condition related to their period, a figure that significantly impacts performance and well-being, particularly in elite disciplines like cycling. These disorders can not only disrupt daily lives but can also prematurely shorten promising sporting careers. Yet, there remains a striking lack of research and understanding regarding how these conditions affect athletes at the peak of their performance.

Professional cycling, like many other sports, was historically perceived as a male-dominated domain, leading to a significant historical neglect of female health. In recent decades, however, women's cycling has experienced unprecedented growth, with pioneers like Demi Vollering openly discussing her period after races, and figures such as Lizzie Deignan and Ellen van Dijk demonstrating exceptional performance during and after pregnancy. The taboo surrounding women's health is slowly dissipating, giving way to a more open dialogue about topics including menstrual cycles, pregnancy, Relative Energy Deficiency in Sport (RED-S), and eating disorders.

However, this progress is not without significant caveats. While the conversation has improved, many aspects of female athlete health remain largely unresearched or misunderstood. Athletes often lack sufficient knowledge about their own bodies and how to effectively manage these conditions alongside the rigorous demands of training and competition. Meg Smith, a doctoral researcher and Female Athlete Health Consultant at Loughborough University, notes, "There is still a strong tendency to minimize extreme pain or a 'just push through' culture that compels athletes to ignore symptoms." This culture, which normalizes pain, fatigue, and discomfort, can be incredibly detrimental, leading to delayed or missed diagnoses.

Among the most prevalent yet poorly understood issues are reproductive or menstrual disorders such as endometriosis and Polycystic Ovary Syndrome (PCOS). Endometriosis is a condition where cells and tissue, which should grow in the lining of the uterus, instead grow elsewhere in the pelvis and abdomen, causing severe pain and heavy periods. For athletes, the persistent pain can be debilitating and performance-hindering. Jo Perkins from The Well HQ, a British-based project focused on female athlete health, explains, "Endometriosis is highly under-reported, especially with female athletes. It is common to see minimisation of their extreme pain, or the 'just push through' culture." This can result in missed training sessions, suboptimal performance, fatigue, and significant psychological impacts such as anxiety around races, selection, contracts, and the fear of heavy bleeding or extreme pain on competition days.

PCOS, a hormonal condition characterized by higher levels of hormones, including testosterone, and multiple cysts on the ovaries, can cause heavy periods, weight issues, excess body hair, and fertility problems. While higher testosterone levels in men's sport are often associated with improved performance, Perkins emphasizes that this should not be viewed as a positive for women. She elaborates, "Although some studies show increased androgens could present some benefits in terms of maximum oxygen uptake and better performance, having PCOS is far from being a positive thing – it’s a health condition that negatively affects many areas of these athletes’ lives." Challenges include insulin resistance, irregular cycles, fertility issues, and mood changes, underscoring the need for specialized support.

Furthermore, other conditions like adenomyosis and fibroids can also cause heavy or painful periods. The issue of missing or losing periods altogether, a common occurrence in elite athletes, can lead to severe consequences such as RED-S and bone density problems. These wide-ranging problems necessitate an individualized approach; they should not be lumped together or treated as a single entity.

Meg Smith asserts that these conditions "absolutely exist within sport, including at elite level, but they are significantly under-recognized and under-diagnosed." This gap is attributed to a combination of factors, including delayed diagnosis, symptom masking (particularly through hormonal contraception), and a sporting culture that normalizes pain and fatigue. Symptoms such as low energy availability, gastrointestinal issues, pelvic or lower back pain, and performance fluctuations are often mistakenly attributed to training load or competition stress rather than an underlying medical condition.

Addressing these issues requires a cultural shift within sport, where the health and well-being of female athletes are prioritized. There must be increased funded research, improved education for coaches and athletes themselves, and better support systems that enable early diagnosis and effective management. By breaking down taboos and fostering an environment of openness and understanding, we can ensure that female athletes receive the care they deserve, empowering them to reach their full potential unhindered by silent health struggles.

Ekhbary News Agency