How Olympians manage their periods

Assumption women are at a disadvantage when menstruating is being challenged by athletes and science

Emily Campbell has a contingency plan in place if her period arrives on or in the days leading up to Aug 11, the date when she will become a two-time Olympian. Team GB’s only weightlifter in Paris, in keeping with true British spirit, will simply keep calm and carry on.
“Nine times out of 10, it’s mental,” says Campbell. “It’s just saying to your brain, ‘This isn’t convenient right now, but you’re going to be all right’. Maybe take a couple of paracetamol for the cramps. But it’s business as usual.”
Mindset might trump menstruation but periods can present nightmarish challenges for Olympians. Britain’s Dina Asher-Smith spent seven months planning for her cycle ahead of the delayed Tokyo Games in 2021. A year later, she pulled up with cramps in the 100 metres final at the European Championships and called for more research into how menstrual cycles can affect performance. “If it was a men’s issue, we would have a million different ways to combat things,” she said at the time.
Historically, the contraceptive pill has been a trusted method among sportswomen to limit the impact of their period on performance, with a quarter of respondents in this year’s BBC Elite British Sportswomen’s Study admitting to manipulating their monthly bleed. But amid a rise in cycle-tracking apps and small steps forward in menstrual health research, periods are starting to be hailed as a superpower.
Campbell, who came off hormonal contraception because she wanted her body to be “natural”, has a track record of performing well when on her period. “At the 2022 Commonwealth Games I was on my period and I had one of the most perfect performances of my career,” she says. “A lot of the time you get defeated in your head; you think because you’re on your period you’re going to be a mess. You’ve lost half the battle before you’ve even started.”
British long-jumper Jazmin Sawyers has spent most of her career learning to harness the peaks and troughs of her cycle. Ever since withdrawing from a meet in Boston in 2017 after experiencing chronic menstrual pain that left her unable to walk, she began tracking her cycle. “Whenever I’ve got a major competition, my period will come,” says Sawyers. “My body just has a response to tense situations.”
Sawyers will miss the Paris Olympics after rupturing her Achilles earlier this year, but is using her downtime to front a new campaign with Always to help educate young girls about menstrual health. New research shows that 66 per cent of girls and women believe that being on their period puts them at a competitive disadvantage in sport, but Sawyers wants to flip that narrative.
“When you speak to young girls, they don’t always know that you can have your best performance at any stage in your cycle,” she says. “There’s so much negative language around periods so they can be seen as something that will only hinder you. But actually, if you work with your body and you track, that can help you understand what you need to do to get the most out of your cycle. I’ve had PBs at every stage of my cycle and I’ve been on my period at every major championship I’ve ever done. It’s doable, and I love telling young girls that.”
Former US footballer Megan Rapinoe is another hoping to break the taboo with a new campaign for underwear company Knix that aims to normalise conversations around periods and sport.
The science, while scant, is throwing up fresh evidence challenging the view that women are at a disadvantage on their period, with one study showing that women have quicker reaction times when they are menstruating. The research, conducted by the UCL Institute of Sport, Exercise and Health and published earlier this year, saw 241 women complete a range of cognitive tests similar to those used in sport settings. The women reported feeling worse during their period and thought performances would suffer. However, reaction times, attention to detail and spatial recognition were heightened during menstruation, but slower in the second half of the cycle after ovulation, known as the luteal phase.
“If it’s true that sport-related spatial cognition does change consistently throughout the cycle, then maybe that does support the idea of having ‘priming drills’ in the luteal phase before an athlete goes into a competition,” says Dr Flaminia Ronca, the study’s lead author, who points to a small body of evidence that shows progesterone, the hormone that rises after ovulation, has an inhibitory effect on the cerebral cortex, resulting in slower reaction times.
Menstrual health has long been a neglected area of sports science and academics remain split over whether phase-based training – when a woman trains according to what stage of her cycle she is in – has added benefits. Some 50 million women are thought to use period-tracking apps to help understand their cycle as well as to manage menstrual symptoms and their fertility. But their reliability in relation to athletic performance continues to divide opinion.
“The tenuous assumptions that are made from tracking apps are becoming increasingly noisy,” says Richard Burden, the female athlete health lead at the UK Sports Institute. “We’re not questioning anyone’s intentions with period-tracking apps but the scientific robustness is just not there. 
“Someone tracking their menstrual cycle on an app purely by writing down when their period is and then noting when their next period is does not allow us to phase their cycle, because we have no information on the key characteristics that will allow you to do that. You’re purely guessing that ovulation happens halfway through and then a few days after that progesterone starts to rise. If you’re assuming everyone has the same hormonal profile, you’re completely missing the point.”
Over the past Olympiad, Burden has been overseeing a project called Hormonix, run by the UKSI, that uses saliva samples to monitor hormones across the menstrual cycle. It is designed to detect any abnormalities across an athlete’s menstrual cycle that might impair performance.
Last week, UKSI announced a partnership with technology giant Intel, which Burden says will “rocket boost” its hormonal profiling project. The next step will see saliva samples, which are seen as a less invasive way to measure hormone levels than blood draws, cross-referenced with training and wellness data obtained from athletes wearing fitness trackers, along with the use of AI.
“The whole idea of Hormonix was to take needles out of people’s arms so they could just dribble into a tube so we could obtain hormone values that way,” explains Burden. “That is continuing, but it’ll be a case of trying to understand the data we get from data trackers that the athletes wear and how that might be integrated with menstrual cycle data, all done in an ethical, data-secure way.”
Periods, once sport’s greatest taboo, are now the focus for female Olympians in their pursuit of success.