We have the data, NOW lets use it!

Every four years (two if you’re also a fan of the Winter Olympics), we witness the embodiment of dedication and physical prowess. While some athletes come from backgrounds of privilege, giving them an upper hand in the sports world, many others fight their way from low-income neighborhoods, overcoming immense challenges just to reach the Olympics. Despite their varying salaries, privileges, hometowns, and rankings, what truly inspires me every Olympic cycle is the women+ who compete while on their periods.

British sprinter Dina Asher-Smith has called for more funding for research into female athletes' periods. Source: Getty / Maja Hitij

How?! How do they manage to step onto the field, track, or pool, battling pain, inflammation, mental fog, and still exert themselves 1,000%? To me, every one of them deserves a medal just for making it that far, given the physical challenges they might be facing.

But while I’m filled with admiration, I’m also deeply disappointed. Here we are in 2024, 124 years since women were first allowed to compete in the Olympics, and we still have zero policies addressing hormonal equity in sports. The progress made by trailblazers like Billy Jean King, Serena Williams, and the U.S. Women’s Soccer Team in fighting for equal pay, media coverage, and funding was hard-earned. Their message was clear: “We are just as good as the boys (if not better).” 

Now that we’re making strides in equality, with women making up 49% of Olympians this year, it’s time to push forward into equity (the acknowledgment that people start at different places and need different resources to be successful.) The starting point that makes us different is our 28-day infradian rhythm (hormonal cycle) that affects our brain, metabolism, immune system, microbiome, stress response, and reproductive system. In high-level sports like the Olympics, acknowledging these differences is crucial. Ignoring them can lead to medical challenges like the “Female Athlete Triad,” a condition involving three components: 1) low energy availability, often linked to disordered eating, 2) absence of menstruation, and 3) low bone density. Unfortunately, at least one of these components is present in 16-60% of female athletes.

Retired Olympic swimmer Hanae Ito talks about the impact menstruation can have on sportswomen's performance in an interview in Tokyo on Oct. 29, 2020. (Kyodo)

We now have enough research to make structural changes to training and practicing sports in ways that align with the menstrual cycle for optimal performance. Currently, the menstrual cycle is often seen as a hindrance, something to suppress (e.g., with Norethisterone tablets). But it could be something to follow, monitor, and even predict when athletes are at their muscular peak, mentally sharpest, or most capable of strong breathing patterns (just look at how the U.S. Women’s Soccer Team won the World Cup by tracking their periods). The science is there—what’s missing is the policy. So just in case someone comes asking me how to fix this problem… I wrote it out!

Here are 12 ways the Olympics and high-level sports altogether could become more PERIOD EQUITABLE:

1. Menstrual Products: Ensure that all athletes have access to free menstrual products such as tampons, pads, and menstrual cups, with dedicated stations in locker rooms and athlete villages.

2. Education and Awareness: Implement education programs for athletes, coaches, and medical staff about menstrual health and its impact on athletic performance to create a supportive environment.

3. Flexible Scheduling: Consider the menstrual cycles of female athletes when scheduling events to avoid peak performance days clashing with menstruation, possibly through personalized schedules or alternate event dates.

4. Medical Support: Provide specialized medical support for menstrual health, including access to gynecologists and other healthcare professionals to help manage menstrual-related issues and conditions such as endometriosis or PCOS.

5. Research and Data Collection: Conduct research on the impact of menstruation on athletic performance and use the data to inform policies and practices, including tracking menstrual cycles to understand their impact on different sports.

6. Accommodation for Symptoms: Offer accommodations for athletes experiencing severe menstrual symptoms, such as additional rest periods, pain management options, and flexible training schedules.

7. Inclusive Policy Making: Include female athletes and experts in policy-making processes to ensure their needs and experiences are considered in decisions related to training, competition, and healthcare.

8. Awareness Campaigns: Launch campaigns to destigmatize menstruation in sports, promoting an open dialogue and normalizing discussions about menstrual health among athletes and the broader sports community.

9. Nutrition and Hydration: Provide guidance on nutrition and hydration to help manage menstrual symptoms, with diet plans rich in iron and other nutrients that may be depleted during menstruation.

10. Personalized Training: Develop personalized training plans that take into account the menstrual cycle, allowing for adjustments in intensity and type of training to align with different phases of the cycle.

11. Supportive Apparel: Design and provide sports apparel that offers better comfort and support during menstruation, including moisture-wicking and breathable fabrics.

12. Mental Health Support: Provide mental health support to address the psychological impact of menstruation on athletic performance, including access to counselors and stress management resources.

Thank you to the many Olympians, and sports players who have fought for many years for period equity in their sports:

#FuYuanhui (Chinese swimmer) - She openly mentioned that she was on her period during an interview at the 2016 Rio Olympics after her team finished fourth in the 4x100m medley relay.

#HeatherWatson (British tennis player) - Though not an Olympian, she is often mentioned in the conversation for her candid comments about her period affecting her performance at the Australian Open in 2015.

#Dina Asher-Smith (British sprinter) - She has discussed how menstruation affects her training and performance.

#EilishMcColgan (British long-distance runner) - She has been open about how her period affects her running and has spoken about the lack of research into how menstruation affects female athletes.

#PaulaRadcliffe (British marathon runner) - She has talked about how menstruation has affected her performances, including during the 2004 Athens Olympics.

#AlysiaMontaño (American middle-distance runner) - While more known for competing while pregnant, she has also addressed menstrual health in relation to athletic performance.

#GabrielaAndersen-Schiess (Swiss marathon runner) - During the 1984 Los Angeles Olympics, she famously struggled to finish the marathon, later revealing that she was menstruating, which exacerbated her exhaustion and dehydration.

#AllysonFelix (American track and field athlete) - She has talked about the challenges of being a female athlete, including managing menstruation and pregnancy.