How menstruation and sleep impact female athletes

If you’re a woman participating in sport, chances are you’ve experienced a period while in training or competition. And most of us would agree menstruation – which can cause bloating, cramps, fatigue, and mood changes – is the kind of distraction when exercising that we could do without!

For an inconvenience that (generally) comes once a month, it’s little talked about in the sporting sphere. Research suggests that 67% of female athletes don’t discuss menstrual cycle issues with their coach.1 Among those that do, more than half initiated the conversation.¹

One key performance factor we tend to overlook in sports is the effect of menstruation on our sleep. Up to 7 in 10 women notice sleep changes ahead of their period.²

But how does it affect athletic performance? Read on to learn more, including tips on how to get good rest throughout your menstrual cycle.  

The impact of menstruation on performance

Many women in sports believe that the menstrual cycle harms their performance. Among elite female athletes, 50-67% think they perform worse when menstruating.3 Meanwhile, menstrual-related symptoms are reported to cause 40% of female athletes to either miss or modify training.¹

Different phases of our menstrual cycles have the potential to affect strength, as well as aerobic and anaerobic performance (endurance and short burst activity).⁴   

The link between menstruation and sleep issues

Studies show sleep can worsen in the late luteal phase of the menstrual cycle.5 During this stage, you might experience premenstrual syndrome or PMS and find it harder to fall asleep and stay asleep. It’s been reported that women with PMS are at least two times more likely to experience insomnia.⁶

Many female athletes believe their menstrual cycle impacts sleep. For example, one study of elite English footballers in 2021 revealed that, during menstruation, more than half of the players claimed to experience decreased sleep quality before their performance.⁷

Further, a 2020 Japanese study revealed that when going through a menstrual cycle, female athletes are:⁸

• Likely to have trouble falling asleep
• Tend to sleep less than usual
• Have less deep sleep during their periods when worried about sanitary products

How sleep affects performance

Athletes need good quality sleep to rest and recover before and after athletic performance. Research shows that athletes who achieve better quality sleep can have greater accuracy, speed and reaction times in sports such as basketball,⁹ tennis¹⁰ and swimming.¹⁰

Studies also suggest that sleep quality can be linked to injuries.¹¹ Just as athletes in training need to consume more calories to fuel themselves, they need more sleep to allow their bodies to repair themselves. Muscle tissue repair is especially important if you work out a lot.¹²

Changing attitudes towards menstruation in elite sports

It’s an exciting time for women’s sport. We’re witnessing record attendance and viewership numbers at the elite level in sports such as football¹³ and basketball.¹⁴ Sponsorship deals are also on the rise.¹⁵

With more exposure, many women in elite sport have spoken out in recent years about the impact of menstruation on performance and calling for more research into the area.

One of the first women to break the sporting taboo by talking about her period was Chinese swimmer Fu Yuanhui at the 2016 Rio Olympics. Since then, many other women have called for more research into the impact of the menstrual cycle on exercise, such as British sprinter Dina Asher-Smith who pulled out of a race last year after suffering leg cramps while on her period.¹⁶

Recently we’ve seen many Australian athletes call for greater awareness, such as Olympic swimmers Cate Campbell17 and Brooke Hanson,18 as well as Australian surfer Tyler Wright.¹⁹ 

The use of menstrual cycle tracking in sport

As athletes, coaches and sports scientists begin to realise the influence of the menstrual cycle on training, performance and recovery, menstrual cycle tracking is gaining significant attention.

By tracking the menstrual cycle, athletes can identify fluctuations in hormone levels, such as estrogen and progesterone, which can impact energy levels, strength, endurance and mood.⁴ This knowledge allows athletes to tailor their training and nutrition plans, optimising performance during specific phases.

For example, during the follicular phase of the menstrual cycle, when estrogen levels are rising, women may experience increased endurance,⁴ making it an ideal time for cardio-focused training. 

More and more elite sports teams are now regularly keeping track of the different phases of the menstrual cycle. For example, Chelsea Football Club in the UK uses an app to help monitor players’ menstrual cycles. Players use the app to record when they have their periods and any symptoms they experience. If there are changes in sleep, recovery, or performance, the team can adjust the player’s sleep routine, training or diet.²⁰

Tips for athlete to help improve sleep and manage menstruation

1. Sleep hygiene: Prioritise good sleep habits, including keeping a consistent sleep schedule, creating a conducive sleep environment, practising relaxation techniques, and limiting exposure to electronic devices before bedtime.

2. Nutrition and hydration: Maintain a balanced diet and make sure to drink plenty of water every day. Your nutrition can impact hormone regulation and well-being.²¹

3. Menstrual tracking: Use apps or calendars to monitor your menstrual cycle, noting sleep disturbances and other symptoms. This may help you plan your training schedule and prioritise rest during more challenging times.

4. Communication and support: Open up a dialogue with your coach, trainer and/or healthcare professional about menstruation and its impact on your sleep and performance. This can help you get the necessary support, such as adapted training programs.

5. Sleep interventions: Speak to your doctor if you’re concerned about your sleep, particularly if you’re regularly experiencing sleep disruptions during menstruation. 

The relationship between menstruation, sleep, and female athletes is a complex interplay that we’re only beginning to understand. By acknowledging the influence of hormonal fluctuations on sleep quality, female athletes can take proactive steps to optimise their performance.

Empowering athletes through education, support, and tailored strategies can go a long way in helping them manage sleep disruptions during menstruation and minimise their impact on athletic performance.