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Ups and downs are a hallmark of any athlete’s career, but for some competitors, these peaks and troughs in performance can occur more regularly, due to hormonal changes associated with their menstrual cycles.
Today, the English Institute for Sport (EIS) is looking to level the playing field by deploying regular saliva testing to track the rise and fall of two key drivers of these monthly changes: estrogen and progesterone.
Because of the hormones involved, the menstrual cycle underpins many aspects of a woman’s health, from the strength of her bones to her fertility, immune system, and mental functioning. “If they don’t have a healthy menstrual cycle, that means for some reason something is wrong,” said Dr Richard Burden, co-head of women’s health at EIS.
Some women also have symptoms related to their menstrual cycle such as lack of energy, pain or bloating. According to a recent study of female rugby players, 93% reported cycle-related symptoms and 67% believed these affected their athletic performance.
Even so, the menstrual cycle is among the least studied aspects of human biology. Last year, Chelsea Women became the first football club in the world to start tailoring their players’ training to their menstrual cycles, although there is little evidence that this is effective.
“There is a very thin layer of evidence to suggest that there may be ways to manipulate training depending on where a person is in their menstrual cycle. The problem is, if you don’t measure hormones, you don’t actually know what’s going on. Just because you have a normal cycle length doesn’t mean your hormones are behaving normally, ”Burden said.
“Also, all of the research right now is very generalized, and applying what is happening in a general population to an athlete performing at the highest level possible is not really enough.”
IST is now looking to change that, in the hope of providing more specific and individualized support to female athletes. By tracking their hormones, Burden and his colleagues hope to gain a better understanding of how athletes’ training programs affect their health or recovery from injury. If abnormalities in their cycles are detected, it could lead to nutritional or other interventions to try to correct them.
Last summer, the EIS launched a pilot study involving 15 elite athletes from eight sports, including football, tennis, rowing, cycling, gymnastics and modern pentathlon, which suggested that the tests hormones over two days could provide actionable data in real time.
Although the research is still at a very early stage, the idea is to deploy the technology more widely after Tokyo, to test if it could really improve the general health and performance of women in the run-up to the Olympic Games in Paris. in 2024.
“I think it’s exciting that the girls are talking about how their period affects them, and that we’re finding ways not to fix it, but to improve and manage the symptoms,” said the athlete from GB Pentathlon Jess Varley.
Although some athletes are already using period tracker apps, they do not measure hormones; indeed, any form of regular hormonal testing has been difficult, as until recently it required blood samples. The Hormonix system, which was developed by Kent-based Mint Diagnostics in collaboration with EIS, uses saliva tests instead.
During the pilot study, the athletes took a sample of their saliva in a tube and then stored it in their freezers until they could be collected and analyzed, after which the data was returned to them. However, Mint Diagnostics is working on point-of-care testing, where saliva samples could be loaded into a desktop machine and the results delivered almost immediately, allowing coaches to process athletes’ saliva samples and provide feedback in the process. real time on their health.
Saliva sampling is also under development to measure hormones found in male and female athletes, such as cortisol and testosterone. These could be used to monitor their response to training and recovery, and potentially improve it.
Case studies
Katy Dunne – professional tennis player
Katy, 26, had a fairly regular period until she was around 14, when she started to eat less, in addition to participating in junior tennis tournaments. As she got older, her period became more and more sporadic, until it stopped completely. A turning point came in her early 20s, when Katy’s trainers noticed that she was not gaining strength, even though she was training hard. “They kind of put two and two together and had a conversation with me about my refueling and if I wasn’t eating enough,” she said.
With professional support, Katy began to eat more and her period gradually returned. “I would say I was happy, because I hadn’t had a period, maybe eight or nine in a year,” she said.
Despite this, Katy’s trainers were concerned about the low-intensity injuries she continued to suffer: bruising on her pubic bone; groin injury; gastric fatigue; a shoulder injury – which hampered his progress in training.
“The biggest risk to performance in any elite sport is the loss of training time. The more days you lose, the lower the likelihood of getting high performance, ”Burden told EIS.
Katy was referred to Burden, who enrolled her in the Hormonix trial. This revealed that while she looked like a healthy menstrual cycle, her hormones were not fluctuating as they should.
“The menstrual cycle underpins most of a woman’s physiological systems, and someone like Katie needs all of these physiological systems to function 100% because of the training she does and the performance she does. she researches, ”Burden said. “If her hormones don’t really support this, then there may be consequences for things like her immune function and susceptibility to injury.”
Katy said, “It made me see that I needed to make another change and continue to improve the way I nourish my body. As a result, we gave more support to a nutritionist, to start improving this. “
Jess Varley – GB Pentathlon Athlete
Jess, 26, has always had a regular period, arriving every four weeks without fail. However, she had noticed that in the three or so days before her period, she suffered from stomach cramps, felt less energetic, and her athletic performance would suffer.
“The most obvious discipline she’s touched on is fencing because you have to be so mentally excited and aware of what’s going on around you, then physically explosive at the right time,” Jess said. “My fencing performance was very high and decreasing, depending on when it fell in my menstrual cycle.
Jess also took part in the Hormonix trial, which found her menstrual cycle to be quite healthy. Even so, this information was extremely helpful, as it ruled out hormonal abnormalities as the source of her menstrual symptoms. Now Jess and her support team could start adjusting other aspects of her training and diet to see if it impacted her menstrual symptoms, while also making sure these interventions didn’t affect her health.
“We tried to change my diet, so we cut out the pasta and bread, and lowered [other] carbohydrates a little, but not excessively. And because we were tracking the hormones, we knew I was still getting enough fuel from day to day to keep up with the volume of training we are doing, ”Jess said. “We found that cutting out this form of carbohydrate made a huge difference in my symptoms.
“It gave me the confidence to compete and not worry about where I am in my hormonal cycle. And to know that I am refueling correctly and to have the confidence that I can. giving the best of my ability now, anytime, which is exciting.
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