10/01/2021 11:19
This month’s blog focuses on women in elite sports and gender differences and gender specific issues such as the menstrual cycle. I was inspired by Becky Hammon becoming the first ever female NBA coach, which you can read about here!
This study stood out for a couple of reasons - it is a recent study and 3 out of the 5 people who conducted it were female. It’s also done on elite rugby players, and this is a sport in which fuelling is taken seriously and so many aspects of fitness are needed, strength, stamina, cardiovascular, and mental toughness!
The aim of this study was to explore the impact of the menstrual cycle on physical and psychological performance. What is notable about this study is that it does not look at relative energy deficiency and lack of fuel or leanness in sport - it is just the general effect of the menstrual cycle on elite athletes in a performance sport at the substantial health and good nutrition. It was undertaken due to other studies on endurance athletes, such as female elite rowers and runners, which found that performance was negatively impacted at certain points throughout the cycle.
This study is therefore really useful to us in looking at how to work around the menstrual cycle with our training!
Who did they study?
The study interviewed 15 female rugby players at an international level, between the ages of 25 and 31. None of the participants identified themselves as amenorrheic (however there was no in person hormone or any other type of physical testing done), and although some reported irregular cycles in the past, the majority of the participants reported a regular cycle.
What did they learn?
The researchers interviewed the participants individually and looked at themes which came up across all interviews.
In the days preceding and at the start of menstruation, 93% of the athletes reported that they suffered from physical symptoms such as abdominal cramps, and psychological symptoms such as worry, distraction, negative mood swings, and feeling tearful and emotional.
There was a theme across all the athletes that they were often worried in advance of menstruation because of the discomfort they knew it would cause in sport. The participants who were on hormonal contraceptives noted less discomfort than those who were not.
Players reported being worried during training camps at the effect that the pain would have on their body, having it always in the back of their mind which distracted from performance, and during games while wearing white shorts.
In terms of completing sessions, several players said that they were unable to complete higher intensity training during this initial phase, and those that did complete sessions felt that at this time they did not perform to their best effort. The word ‘lethargic’ to describe energy levels came up several times in interviews also.
One athlete noted that she often saw a large difference in the week before the onset of menses - saying she felt much stronger the week before!
So what does this mean for us?
Discomfort and psychological issues are prevalent around menstruation and it is something that affects women in all walks of life, whether they are athletes or not!
We can see that elite level athletes who are probably incredibly resilient and tough (rugby players are very used to being in pain through sport!) still face the same issues that the everyday woman does in terms of period pain and feelings of lethargy, inadequacy and anxiety due to hormonal effects of the menstrual cycle.
It also demonstrates how individual pain is to women - athletes reported different types and levels of pain. We can see that the use of a hormonal contraceptive also alleviated some of the discomfort, but importantly not in all cases.
Most importantly I think it demonstrates that it is so important to be aware of the timing of the menstrual cycle when undertaking exercise. For the majority of us in the general population, it is a huge reminder that we cannot go all in all the time.
I’m going to repeat this louder because it’s so important.
We cannot go all in all the time.
One thing I actually really love about the outcome of this study also is that this led to recommendations being made to the governing body of being aware of athletes being at certain stages in their cycle, and was laid out as below.
I think this is an example of a big step for womankind, but there is still lots of work to be done to get past the taboo of talking about our menstrual cycle and realise that until we actually start talking about it, it will become more difficult to train around it correctly.
ACUTE & CHRONIC RESPONSES TO EXERCISE - DIFFERENCES MALE & FEMALES
Physiological sex differences affect the integrative response to exercise: acute and chronic implications, 2020. Andsell, Thomas, Hicks, Hunter, Howatson, Goodall.
Another review I came across was looking in depth at gender as a physiological variable in sports - basically meaning that we need to see the impact of sports on a body in terms of gender! We cannot talk about common injuries and energy systems across both genders - we need to talk specifics when it comes to the physiology of men and women in exercise. This is a meta analysis of many studies.
When we are given a training programme, we characterise it in a certain way - are we training for strength, hypertrophy or endurance? Are we going to failure or should we keep a rep in reserve? Are we fueling intra-workout? What kind of RPE, percentage, or effort level are we putting in?
Do we ever really consider that we may want to think about the differences in how our bodies respond to these different training methods based on gender?
Here are some of the interesting findings from this review which may make you think a little differently about your training programme…
Fatigue and training volume
Female vastus lateralis muscles (your largest muscle of four which makes up your quads, the outside of your thigh) have a 7-23% greater proportional area of type 1 fibres in comparison to men! This means that our thighs have a greater time to fatigue and can endure relatively intense exercise for a longer duration. For women, we may need a bit more volume in our leg day to achieve the same relative strength gains as the guys.
Endurance capacity
Women have less glycolytic capability and more oxidative capability than men - in very simple terms, this means we may be minimally better than men at using fat for fuel than carbohydrates. Perhaps your guy friend who is on the same endurance program than you can benefit from a few more carbs, while we may be suited to a higher ratio of fat in our diet for endurance.
We may be better at running off of our oxidative energy system - that slow burn - than men. In fact, there is research into endurance running that suggests the longer the distance covered, past the marathon and into the ultramarathon, women’s performance increases relative to the mens as the distance increases.
Pacing
Ever thought you may have been a little bit more out of breath than your male friend you train with when you do high intensity exercise, even though you are roughly as fit as each other?
Women have smaller lungs and airways, which leads to our lungs having to work a little bit harder at high intensities. This is where it might do us some good to learn to not go off too hot at the beginning of a workout!
Muscle power output
How about muscular contraction and the role of our nervous system? Interestingly enough, there is no difference between men and women in voluntary activation - the way our nervous system sends messages to our muscles to contract.
HOWEVER, remember that menstrual cycle we have?
In the middle of our cycle when oestrogen is greater and progesterone lower, our voluntary activation is higher (more efficient and faster muscle contractions!). When we are in the mid-luteal phase, those voluntary activations are lower.
CNS fatigue
While our muscle contractions might not be as on point for some parts of our menstrual cycle therefore, our levels of central fatigue (the fatigue of our nervous system to send messages to our muscles) are actually not affected any differently (as long as we are adequately recovering through good nutrition and sleep).
Final thoughts
Lots of information across these two big studies, however, there are a few main points that we can take home…
We are making leaps forward in implementing strategies and changes in order to train correctly around our menstrual cycle and gender differences.
It is still difficult for athletes to talk about these things with their coach, but the research that is coming out now is helping us make some positive changes.
There ARE gender differences in training - but there are always going to be more INDIVIDUAL differences. You need to train in the way that is best for YOU.
It is up to us to put the information out there and get people talking!
Chloe Salter
I am a PN qualified nutrition and CrossFit coach who is passionate about helping you reach your goals. I have been overweight and want to use this to guide and educate you on how to eat to perform at your best. I am based online and at Shapesmiths in London.