You may be one of the millions of mere mortals watching the Olympics from the couch, in awe of the marvels of the human body and the lengths to which the athletes can push themselves. With all due respect to the male participants, the women at the 2021 Olympics in Tokyo are mind-blowingly fierce, competing in numbers almost equal to the men. At least twelve Americans are doing it as mothers. And all of the women are doing it while managing their menstrual cycles in one way or another. How does it affect them, and how do they deal with it? Not surprisingly, there is not a wealth of research, but the good news, it’s increasingly getting attention.

While the menstrual cycle has been inadequately studied in general, doctors caution against drawing similarities between the general population and athletes. Many people use period tracking methods, including apps, but those typically track bleeding, emotional health, and symptoms. The English Institute of Sport (EIS) recently began work looking to see how the levels of estrogen and progesterone change during the cycles of elite athletes specifically by using regular saliva testing.

“Just because you have a normal cycle length, doesn’t mean that your hormones are behaving in a normal fashion.”

Dr. Richard Burden, co-lead for female health at the EIS, told The Guardian, “There’s a very thin layer of evidence to suggest that there may be ways in which you can manipulate training based on where someone is in their menstrual cycle. The problem is that if you’re not measuring the hormones, you don’t actually know what’s happening. Just because you have a normal cycle length, doesn’t mean that your hormones are behaving in a normal fashion.” Researchers hope to draw some links between hormone levels and performance, as well as injury and recovery. To read more about their work and to review some of the case studies, click here.

All of the evidence from that study and the work that continues after the Tokyo games could provide some insight for France in 2024. For now, however, athletes have a range of methods for managing their periods while training and competing. We may not hear much about the fatigue, cramps, or headaches female athletes are contending with during competition that are a result of their periods, but that doesn’t mean it’s not happening. Last year Chelsea Women, a professional soccer team, altered its team training to account for players’ menstrual cycles. The hope is to use cycle tracking to inform training and nutrition, which in turn might affect performance and cut down on soft tissue injuries. “We have to have a better understanding of that because our education failed us at school; we didn’t get taught about our reproduction systems. It comes from a place of wanting to know more about ourselves and understanding how we can improve our performance,” says team manager Emma Hayes.

Simply talking about the issues surrounding menstruation is one of the most powerful tools athletes have. Swimmer Fu Yuanhui lost a critical race in the 2016 Olympics in Rio, but she became a hero to many with her straight talk about why her performance may have suffered. A subtitled video shows her telling an interviewer, “Actually, my period started last night, so I’m feeling pretty weak and really tired.” While she is open about the struggle, she still apologizes to her teammates, who she feels she let down.

Talking… encourages more talking. That revelation from Fu Yuanhui is what retired Japanese swimmer Hanae Ito credits with giving her the confidence to talk about how her period affected her Olympic experiences. “I’m not going to say I would’ve won a gold medal (in Beijing) if I knew then that there were options to deal with period-related weight gain, acne, and other issues I was having, but I definitely think I would’ve performed better,” Ito told Kyodo News. Ito believes that suffering in silence does not help anyone. She now works in the Tokyo Olympics, and Paralympics organizing committee PR department and is “helping athletes, parents and coaches understand female-specific issues and promoting the health and wellbeing of Japanese sportswomen.”

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