MANY WOMEN athletes say their menstrual cycle impacts upon their training and performance. Last year British tennis player Heather Watson made headlines around the world when she attributed her Australian Open loss to her period, finally breaking silence on what has become one of the biggest taboos in sport. Yet precisely why elite performance often – but not always – suffers is not yet clear. That is part of the reason why my own research group – a collaboration between UCL and St Mary’s University and supported by Orreco – is aiming to shed more light on this area.
As scientists, what we do know is that heavy menstrual bleeding raises the risk of a woman losing excessive amounts of iron, present in blood, on a monthly basis. Iron is an essential micronutrient vital for metabolic and physiological function. If iron deficiency is left untreated, it might progress to iron deficiency anaemia. This is where oxygen transport is compromised among other factors, which will cause fatigue and negatively affect health and performance.
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However, even in top athletes, awareness of the link between menstruation and iron deficiency is poor. Latest evidence suggests that around half of exercising females may have a compromised iron status. As recently reported in AW, numerous other factors such as sweating and foot-strike haemolysis, can cause athletes to experience small iron losses while training, increasing their susceptibility to a low iron status.
However, the impact of iron deficiency and the criteria used to define it are ambiguous. The prevalence of iron deficiency is greater in female athletes, likely due to the menstrual cycle, and this risk is more pronounced in those who have heavy menstrual bleeding. Our research has revealed heavy bleeding to be common in marathon runners, affecting more than one third (36%), and, perhaps surprisingly, this was equally as common in elite level athletes (37%).
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