Female Athlete Canvas

Female Athlete Health

Presenter: Emma McCrudden, BSc, MSc, RD

Learning Objectives

  • Key phases of the menstrual cycle and hormonal fluctuations: Understanding the hormonal dynamics, including estrogen and progesterone, and their critical role in training and performance.

  • Common menstrual irregularities in athletes: Identifying issues like oligomenorrhea and amenorrhea, which can impact training loads and highlight potential health concerns.

  • Effects of Hormonal Contraception on Menstrual Function: Awareness of how various contraceptives may alter menstrual patterns and affect overall athlete health and performance capabilities.

  • Research on macro, micronutrients, and supplements: Evaluating the limitations in current nutritional research and the need for female-specific studies to optimize health and performance.

  • Implications of menstrual-related symptoms on training: Understanding how conditions such as PMS, menstrual cramps, and fatigue can negatively impact training schedules and competition performance.

Participation Statistics

CANADIAN YOUTH REPORT

  • Organized sport participation statistics by demographics:

    • Boys (ages 6-18): 68% participation.

    • All Girls (ages 6-18): 63% participation in weekly organized sport

      • Drop out after 16

    • Can Play Racialized Girls: 59% participation.

    • Low-Income Household Participation: Notably low at 50% for girls, indicating socio-economic barriers to participation.

  • Age-related Declines: Participation drops significantly after age 16 due to various social, cultural, and systemic factors.

  • Disability Participation: Disparity remains, with only 54% participation rates among girls with disabilities.

Document Overview

  • Yearly Summary of Documents related to Female Athletics projected up to 2025, focusing on trends, health impacts, and participation initiatives.

Lifecycle Context

  • Reference to the various life stages affecting female athletes, including puberty, reproductive years, pregnancy, and menopause, and their implications on physical performance and training requirements.

  • Women’s hormones change frequently and they change performance, power, speed, strength

  • Adolescence —> females menstruate, males have testosterone

  • Pregnancy = hormonal shift

  • menopause, estrogen plummets

RED-S Overview

  • Resources for practitioners focusing on Relative Energy Deficiency in Sport (RED-S) as it relates to female athlete nutrition and hydration preferences, addressing dietary needs for carbohydrates, proteins, and fats while ensuring adequate hydration and energy availability.

  • RED’s occurs more females than males

  • Iron BC mentrual cycle, anemia higher in females than males

  • Macronutrients Same for women and men based on BW

  • Ostoporosis higher in females than males (estrogen declines during menopause —> bone density too)

  • No sport related supplement differences for males and females

Performance Considerations Related to Menstrual Cycle

  • Impact of Menstrual Cycle Phases: Detailed insights into how different phases influence various facets of athletic performance:

    • Cardiovascular function: Changes in blood flow and heart rate.

    • Metabolism: Variations in energy utilization and fat storage.

    • Exercise Recovery: Hormonal impacts on muscle repair and recovery time.

    • Respiratory function: Potential changes in breathing efficiency and endurance performance.

    • Immune function: Increased susceptibility to illness during certain menstrual phases.

    • Cognition and Musculoskeletal Adaptation: Influences on focus, injury recovery rates, and strength training adaptations.

  • No data that says when a woman menstruates she will reduce performance. However, it is essential to consider individual variations and the potential for women to perform at their best regardless of their menstrual cycle phase.

  • Temp increases, does that affect metabolism?

Menstrual Cycle Facts

  • Menstruation typically begins around ages 12-13, marking the onset of reproductive health.

  • Mentruaral cycle: Time between first day of bleeding to the day of the next bleed.

  • Cycle Duration: Normal durations range from 21 to 35 days, with ovulation usually occurring mid-cycle.

  • Average Period Duration: Lasts between 2-7 days; variations among individuals can affect athletes differently.

  • Brain initiates menstrual cycle

  • Ovulation occurs when egg leaves ovaries and lutinizing hormone peaks.

Hormones Involved in Menstrual Cycle

  • Primary Hormones:

    • Estrogen: Key for building and maintaining the uterine lining (peaks RIGHT BEFORE Bleed then drops during bleed)

    • Progesterone: Maintains the lining (peaks AFTER bleed)

  • Additional Hormones:

    • FSH (Follicle-Stimulating Hormone): Stimulates growth and maturation of ovarian follicles.

    • LH (Luteinizing Hormone): Triggers ovulation and is critical for the menstrual cycle's regulation. Peaks at ovulation ~ 14 days

Normal Menstrual Cycle Characteristics

  • Insights from Chidi-Ogbolu N and Baar K (2019) on normal cycle variations, indications of health, and performance readiness.

Knowledge Gaps

  • Historical stigmas surrounding menstrual health have limited athletes' understanding and management of their health, creating a need for better educational resources and open discussions about menstruation in sports.

  • Considered a performance barrier

  • higher risk of burnout in female athletes if women are trained the same way as men

Menstrual Categorization System

  • To find women to research you have to diferentiate females based on WHICH contraceptive if any they use, is their period regualr?, etc.

    • Hormonal contraceptive use.

    • Cycle regularity.

    • Ovulation status.

  • Emphasizes the relevance of tracking menstrual health changes for ongoing performance assessment.

  • Potential drugs have been taken off the market (80%) because people reported adverse effects, but these were never tested on women

Anovulatory Cycles and Periods

  • Stresses the importance of medical evaluations for irregular cycles, defining terms such as oligomenorrhea (infrequent periods), polymenorrhea (frequent periods), and amenorrhea (absence of periods).

Impact of Menstrual Symptoms on Athletes

  • Statistics indicate serious consequences on performance:

    • 80% of athletes report worsened performance due to menstrual symptoms.

    • 90% of elite athletes experience menstrual symptoms impacting their training.

    • 1/3 have heavy mentrual bleeding

    • 77% resort to medications for symptom relief, highlighting inadequate support systems.

    • 82% Lack of open communication between athletes and coaches regarding menstruation needs urgent attention.

Performance Considerations Overview

  • Summary of critical considerations linking menstrual cycles to physical performance, emphasizing the need for tailored training plans that accommodate these variations.

Symptoms During Menstrual Cycle

  • Symptoms categorized by phases:

    • Ovulatory Phase: Includes breast tenderness, bloating, fatigue, and mood fluctuation, temp. increases, increased mucous, pelvic/abdominal pain.

    • Before and During Period: Common symptoms include menstrual cramps, increased irritability, and headaches, mood, fatigue, headaches, acne, lower back pain

Medical Reasons for Concern

  • Clarification of criteria for diagnosing primary amenorrheano menses for 15 years

  • secondary amenorrhea (3-11 consecutive months no perido)

  • oligomenorrhea (>35 days)

  • Anoulatory - bleed but no ovulation

  • polymenorrhea (<21 day cycle)

  • menorrhagia excessive bleeding) Importance of Normal Menstrual Cycle

  • Reflects on how normal menstrual cycles are indicators of adequate energy availability, immune function, and homeostasis, essential for athlete health.

Hormonal Contraception and its Impact

  • A significant 70% of female athletes use hormonal contraceptives, which can deeply influence their menstrual cycle experiences and overall well-being during competition.

  • bleed on on the pill is a false/withdrawl bleed. NOT A TRUE Bleed due to drop in estrogen in the pill

  • Progesterone and estrogen stay low on contraceptive, basically no production of FSH or LH

Profile on Hormonal Contraception Studies

  • Summarizes research findings regarding the hormonal effects on performance, suggesting the need for more targeted studies to understand these impacts.

Current Nutritional Research

  • Covers contemporary publications that examine nutrition practices linked to the menstrual cycle, advocating for more female-inclusive research methodologies.

  • WEAK EVIDENCE

Literature Audit on Supplements

  • Identified a stark underrepresentation of women in performance supplements research, underscoring a pressing need for more comprehensive studies focused on female athletes.

Key Nutrition Recommendations

  • Highlights challenges in carbohydrate intake and effective protein recovery strategies tailored for female athletes during the different menstrual phases, stressing hydration and anti-inflammatory nutrition.

  • Women may have lower glycogen stores in menstrual cycle and higher in luteal phase (ON A NATURAL CYCLE)

  • oxidize carbs same rate as men (30-90g/hour)

  • women often underfuel in recovery window

  • High progestoeron oxidized more protein during luteal phase

  • antiinflammatory diet benficial in late luteal phase (polyphenols & Omega 3’s)

  • vit d = key role in estrogen production

  • IBS during menstrual phase, add fiber, hydration and foo to ensure they are fuelling well

Menstrual Cycle Tracking

  • Strong recommendation for athletes to track their cycles, symptoms, and performance responses to better manage their health and training outcomes.

Summary of Menstrual Cycle Knowledge

  • Reinforces the need for a deeper understanding of menstrual cycles in a performance context, with practical strategies for tracking and adapting training policies accordingly.