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“Unbearable pain”, “fatigue”, “fear of the spot”… When the menstrual cycle disrupts the performance of athletes

“In this match, it was quite difficult to show my level today, because I had a very bad stomach, I didn’t have the necessary energy. (…) You see, these are small things of girls!” After jostling the world number 1, and future winner of the tournament, by winning the first set, the Chinese Zheng Qinwen (47th in the WTA), collapsed against the Polish Iga Swiatek, in the round of 16 of Roland-Garros, May 30. In a press conference, the player mentions, without naming her, her other opponent of the day: the rules.

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Largely overlooked in the sports world, the repercussions of the menstrual cycle do exist. Sleep disorders, fatigue, exacerbated hypersensitivity, bloating, weight gain, stomach and back pain, muscle cramps… These symptoms, which vary depending on the athlete and the cycle, can have a significant effect on the performance of athletes.

“Menstruation has not been shown to induce a drop in performance in the athlete, unless she has cycle disorders, i.e. very painful periods. And if she has very painful periods. abundant, this can be a source of anemia, and therefore fatigue”, explains Carole Maître, gynecologist at the National Institute of Sport, Expertise and Performance (Insep), who trains future French champions.

These symptoms usually appear in the days before the onset of menstruation. “While you put in a great performance a few days before, everything changes”, says tennis player Marine Partaud. The misadventure happened to him at the W25 tournament in Périgueux, at the end of June. After reaching the semi-finals, the start of his cycle changed everything. “I woke up on Saturday morning, I was not in good shape. My warm-up was totally different from the previous days”, explains the one who was the 319th player in the world on July 20.

“I had bad movements, heavy legs and a headache. I was very tense, less reactive, less energetic and less concentrated. I was more emotional and more nervous, and we know that in tennis it’s is complicated if you don’t control your emotions.”

Marine Partaud, tennis player

at franceinfo: sport

Marine Partaud lost 6-3, 6-1 in the semi-final of the tournament against her compatriot Selena Janicijevic. “It reduced my abilities, she believes. If I had been like the day before or the day before, without these symptoms, there would clearly have been more matches.

“It’s always a disadvantage”, confirms gymnast Marine Boyer. “When I have them and at the same time I have a competition, I try to convince myself that I am performing just as well. But the week before, everything happens suddenly: the fatigue, the irritability, and the the fact of not being able to do a sequence, whereas a week earlier, you realized it easily”, says the bronze medalist on the beam and silver in the all-around team competition at the European Championships in 2018.

Beyond physical pain and fatigue, there is also “this embarrassment” described by athletes. “Mentally, instead of being 100% on your competition, you always have this fear in mind that when you land a powerful blow, you feel that it’s flowing. And if I stain myself, I’m exposed, because in the ring, everyone is looking at me. It parasitizes you”, testifies the former boxer Sarah Ourahmoune, Olympic vice-champion at the Rio 2016 Games, and world champion in 2008.

“In competition, we are in leotards and you don’t want your tampon thread or your towel sticking out. It’s embarrassing, because we should be focused on our performance, but we necessarily think about that”, confirms Marine Boyer.

Recently, the day after the start of the Euro on July 7, English footballers asked their equipment supplier to no longer supply them with white shorts. “It’s very nice to have a [telle] held but sometimes it’s not practical this time of the month”, said Beth Mead, the Arsenal striker, in the columns of The Telegraph.

For many athletes, and this from adolescence, the pill often imposes itself as the best solution, to combine cycles and a high-level career as well as possible. The pain is generally reduced, and the plus cycles are more regular and less abundant. “You have to be aware that the symptoms related to menstruation should, at best, not be present, or in any case, certainly not bother you during the practice. If the pain is moderate or severe, you have to go and discuss it with a specialist”, advises Carole Maitre.

For a long time, Marine Boyer suffered from “unbearable menstrual pain, stomach and back”. “I couldn’t train or even walk. It could last the week of my period.” At the time, the young athlete hesitated for a long time to take the pill, for fear of gaining weight in a sport where every gram counts. The persistence of pain convinced her. “Today I still have pain, but it’s nothing like before. Despite what you think, it’s not normal to have menstrual pain,” says, too, Marine Boyer.

But the pill is not suitable for all athletes. Skater Maé-Bérénice Méité, six-time French champion in the elite category, had to deal with side effects, which appeared after a week. “I had gained weight, including two bra sizes. I said to myself: ‘If I can’t lose this weight, concretely, I won’t be able to skate anymore'”, she remembers.

In addition, the pill does not prevent the onset of periods, and therefore pain, even if they are less intense. Therefore, athletes choose to chain platelets to delay menstruation. “For large competitions, we have the possibility of making the rules staggered, so that the athlete is not bothered by symptoms which can be exacerbated”, emphasizes Carole Maitre.

Gymnast Marine Boyer, during the French Open, September 4, 2019. (MAXPPP)

Sarah Ourahmoune used this method for 15 yearsbecause of “painful periods”. “Very quickly, my solution was to extend my pill packs when I knew I had a fight, because it was unmanageable. I didn’t want to arrive in training or competition on a period of rules”, she confides.

“With boxing, we take intense punches in the stomach. And every time we receive one, and we have our period, we have big contractions. It’s impossible to manage during a fight .”

Sarah Ourahmoune, former boxer

at franceinfo: sport

The absence of low season in his discipline did not help matters. “In boxing, we have this fear of emptiness. If I don’t go in competition, another person risks taking my place”, says Sarah Ourahmoune, who, despite everything, was afraid that these repeated disturbances wouldprevent you from getting pregnant.

Marine Boyer has opted for this compromise only once in her career. “It was for the Tokyo Games. I had no choice, I absolutely had to be at my best to perform,” she slips. A risky solution? “Not if it remains punctual”, assures the Insep gynecologist, Carole Maître.

Athletes try to do without the pill. Four years ago, French handball player Estelle Nze Minko, Olympic champion in Tokyo, decided to stop taking the pill. “I wanted to know how my body reacted without the pill. What was my real weight, my real behavior, or my feelings without hormones. I wanted to return to a slightly more natural state”, delivers Hungarian club player Gyori ETO KC.

Estelle Nze Minko during the final of the women's world championship, against Norway, on December 19, 2021 in Barcelona (Spain).  (JAVIER BORREGO / AFP)

Gradually, her stomach pains became stronger, her flow more intense, and her period longer. For her, therefore, it is impossible to anticipate before a big deadline.

“I constantly watch my schedule hoping that my period does not fall during an important match. But it’s a bit me and my luck. I grit my teeth.”

Estelle Nze Minko, Olympic handball champion

at franceinfo: sport

Maé-Bérénice Méité has never taken the pill and has learned to deal with her cycle. “I track him down. I note everything: my period start and end dates, my symptoms… When I have my competitions to plan, I can identify those where I’m likely to have my period, and anticipate by example a future weight gain, I who am very prone to water retention. This allows me to arrive each time physically and mentally prepared.”

Despite the pain of the cycle, Maé-Bérénice Méité tries to maintain training “as normal as possible” during her period. “Because in competition, I will not be able to choose”, she adds.

Faced with this problem, athletes are still too often left to their own devices, although some federations are increasingly interested in it. In boxing and rowing studies on the subject have been launched. But often very masculine coaching is a hindrance, according to athletes. “It was only at the end of my career that I had a coach who was attentive, observes former athlete Christine Arron, world champion in the 4×100 meter relay in 2003, and still holder of the European 100 meter record. If they are trained in training, they are not necessarily trained in female physiology. And we didn’t dare talk about it. I remember sessions where you had to grit your teeth. It was a double jeopardy.”

Sarah Ourahmoune (left) during the flyweight semi-final at the Rio Olympics, August 18, 2016. (MAXPPP)

Sarah Ourahmoune abounds: “Being in the France team was like a favor for us, because we represented a sport that was not practiced by women. So we didn’t necessarily want to talk about it, or show that we were women, so as not to then say, ‘That’s why we didn’t want you in the ring'”.

For her part, Estelle Nze Minko does not see any consideration of the subject in her club. “I don’t necessarily ask him to exempt me from training, but simply to feel listened to, and less judged on the performance of the day”, she lets go.

Carole Maître relies on information from “athletes, coaches and technical executives, to break taboos”. In February, the gynecologist “broadcast to all” and published on the Insep website an information document (PDF). “One thing is certain, it is that we must not close our eyes to the subject”says Christine Arron, who had a child during her career, at a time when such an event seemed impossible for a top athlete.

“We are constantly trying to optimize performance, using chips and sensors to scrutinize our sessions, through our endurance, our speed, our maximum pulsations, etc. But why not also study the menstrual cycle of athletes?, asks Estelle Nze Minko. According to the handball player, “on could thus better adapt the training sessions, and even protect against injuries”.

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