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Women's health comes to the forefront in medicine

Why are sportswomen excluded from scientific studies ?

with Juliana Antero, Epidemiological researcher at the Institut national du sport de l'expertise et de la performance
On March 12th, 2024 |
3 min reading time
Juliana Antero
Juliana Antero
Epidemiological researcher at the Institut national du sport de l'expertise et de la performance
Key takeaways
  • Women are under-represented and overlooked in sport research, making up just 35% of participants in sports science studies.
  • The menstrual and hormonal cycle can have an impact on results, so a better understanding of women’s physiology is needed.
  • Oestrogens are thought to have anabolic properties that are beneficial to muscle building and recovery.
  • Training needs to be adapted to each woman’s individual profile and cycle.
  • To achieve this, research programmes are being set up to help sportswomen improve their performance by taking into account the menstrual cycle.

Women are still under-repre­sen­ted in sports per­for­mance stu­dies. For­mer sports­wo­man Julia­na Ante­ro has long been affec­ted by the stress of irre­gu­lar mens­trual cycles. In order to help spread awa­re­ness and com­bat this inequa­li­ty, she has laun­ched the EMPOW’HER research pro­gramme to sup­port all sports­wo­men1.

Why are women under-represented in scientific studies on sports performance ? 

Women account for only 35% of par­ti­ci­pants in sports science stu­dies. Most of the medi­cal, nutri­tio­nal and trai­ning pro­to­cols that sports­wo­men fol­low are deve­lo­ped for male ath­letes. Some scien­tists jus­ti­fy this absence by the influence that the mens­trual cycle can have on women’s scien­ti­fic results and per­for­mance. But that’s pre­ci­se­ly why these stu­dies are neces­sa­ry ! If we want to opti­mise women’s spor­ting results, we need to know more about the impact of female phy­sio­lo­gy on their performance.

What is the aim of your EMPOW’HER project ?

The main aim of EMPOW’HER (Explo­ring Mens­trual Per­iods Of Women ath­letes to Esca­late Ran­king) is to maxi­mise the per­for­mance of female ath­letes by opti­mi­sing their trai­ning res­ponses through adap­ted trai­ning loads, in syner­gy with their phy­sio­lo­gy and mens­trual cycle. Since 2020, we have moni­to­red around a hun­dred top-level sports­wo­men who took part in the Tokyo Sum­mer Olym­pics, the Bei­jing Win­ter Olym­pics and/or are pre­pa­ring to take part in the Paris Olym­pics. Almost a dozen dis­ci­plines are cove­red : rowing, cycling, swim­ming, skiing, wrest­ling, gym­nas­tics, and triathlon. 

Eve­ry day for a per­iod of six months, these women record their data on an appli­ca­tion : the qua­li­ty of their sleep, mus­cu­lar pains if they feel any, pains lin­ked to their mens­trua­tion, their state of stress, etc. In this way, we can observe the influence of hor­mo­nal fluc­tua­tions on the well-being and trai­ning of these sports­wo­men. In this way, we can observe the influence of hor­mo­nal fluc­tua­tions on the well-being and trai­ning of these sports­wo­men. The ini­tial results show that even mild symp­toms reduce the qua­li­ty of their trai­ning, and that they are more or less fit at dif­ferent times of the cycle. In par­ti­cu­lar, there are signi­fi­cant inter-indi­vi­dual differences

A US decree to adapt sports trai­ning to the mens­trual cycle

In 2019, the Ame­ri­can women’s foot­ball team won the World Cup for the fourth time. How can we explain the domi­nance of the Uni­ted States in a sport tra­di­tio­nal­ly domi­na­ted by Euro­pean nations in the men’s game ? In 1972, a decree was pas­sed ban­ning all dis­cri­mi­na­tion based on gen­der in schools and uni­ver­si­ties in the Uni­ted States. This was the cata­lyst that gave women access to bet­ter oppor­tu­ni­ties in sport. The team is now advi­sed by Ame­ri­can resear­cher Geor­gie Bruin­vels, who holds a doc­to­rate on the impact of iron defi­cien­cy and mens­trual cycles on spor­ting per­for­mance. The resear­cher has adap­ted the team’s trai­ning accor­din­gly. An approach that has clear­ly pro­ved effec­tive with female footballers.

Is it possible to choose the date of competitions according to your menstrual cycle ?

No, but you can adapt your trai­ning sche­dule to the dif­ferent phases of your cycle and anti­ci­pate cer­tain constraints. For example, increa­sing the ove­rall volume of exer­cise over the month by redu­cing the inten­si­ty on cer­tain days. If you take these issues into account befo­re­hand, you can even take advan­tage of cer­tain hor­mones. For example, the quan­ti­ty of oes­tro­gen is higher during ovu­la­tion. Often per­cei­ved as an obs­tacle to per­for­mance, this hor­mone has inter­es­ting ana­bo­lic pro­per­ties for muscle buil­ding and reco­ve­ry. Our hypo­the­sis is that it may be pos­sible to take advan­tage of hor­mo­nal fluctuations.

How do sportswomen approach the subject of menstruation and possible pain ?

It’s still a bit of a taboo sub­ject. The majo­ri­ty of coaches are male. Sports­wo­men feel allo­wed to talk about their inju­ries and muscle pain, but not always about their hor­mo­nal cycle.

When it comes to per­iod pains, there is usual­ly an expla­na­tion. To begin with, it’s impor­tant to seek a doctor’s advice to find the cause. Is it lin­ked to a cycle disor­der such as endo­me­trio­sis ? Could medi­ca­tion be effec­tive in relie­ving the pain ? Final­ly, are there any non-medi­ci­nal methods – although not scien­ti­fi­cal­ly pro­ven – that can relieve mens­trual pain ? Sports­wo­men need to be per­sua­ded to consult a doc­tor, a gynae­co­lo­gist or an endo­cri­no­lo­gist if they are to over­come these pains and be able to train normally.

How were you able to objectively assess performance in your study ?

For non-timed sports such as rowing and fen­cing, it was dif­fi­cult to mea­sure an objec­tive per­for­mance, so we had to rely on the ath­letes’ own com­ments. But with cycling or foot­ball, we have power or move­ment sen­sors and we can cal­cu­late the effort pro­du­ced by the ath­lete. So, we’ve been able to link this data with women’s hor­mo­nal profiles.

We are now trying to mea­sure the effect of trai­ning adap­ted to women’s indi­vi­dual pro­files and cycles. That’s the aim of our next research pro­jects. There’s still a lot to be done, for example, sup­por­ting sports­wo­men on issues rela­ted to the pel­vic floor to prevent uri­na­ry incon­ti­nence during exercise.

Marina Julienne
1https://​www​.ins​ta​gram​.com/​f​e​m​p​o​w​e​r​_​s​p​o​r​t​ives/

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