Menstrual Myth Buster

For some baffling reason, periods still seem to be a taboo topic in sport and there are still plenty of myths that surround them. I’ve broken some down below as best I can, setting the scene with my own experience of periods and the Contraceptive Pill.

I started taking the Contraceptive Pill (which I’ll just call, the Pill) at age 18. I was a busy university student, running up to 70 miles a week and learning how to take control over new aspects of my life. I’d had consistent monthly periods since my first one at age 15, with no adverse effects other than a bit of bloating, cramps and heavy legs. At the time, I was becoming increasingly mindful of how I could maximise my performance in sport. Since so many of my athletic peers were taking the Pill to ‘regulate their periods around competitions and training', I was keen to explore an opportunity to do the same.

So, when I suggested it to my GP and naively explained my sporting background, I was pleased when he promptly printed off the prescription. Back then, I was totally oblivious about the crucial role my period had to play, not just in my sport but every aspect of my life. I simply felt, like everyone else seemed to, that life would be easier without them. And, since I had a steady boyfriend, it seemed like the best option for birth control. Besides, what harm could it do?!

Here are the myths I bought into:

Myth #1: It would be advantageous to tailor my period around my sport

  • The Pill can certainly suppress some symptoms that may accompany your period, but let’s be clear: it's not tailoring your period around sport. It's switching off your period completely. This can actually cause more harm than good – especially in the case of RED-S where the Pill masks one key red flag: menstrual dysfunction.
  • In my experience, the very best way to tailor your period around sport is to learn how your endocrine system actually works and how you can use it to your advantage. Head here to find out how, or hear it summarised by professional triathlete Gwen Jorgensen here.

Myth #2: The Pill will regulate my hormones and benefit my performance

  • Again, the Pill works not by regulating your hormones but by switching them off and providing artificial ones to mimic them.
  • As explained here, these hormones are what drives the advantageous adaptations to training. They assist your bone health, protein synthesis, tissue repair and muscle name just a few things. Why oh why would it be advantageous to lose them?

Myth #3: It’s normal not to have periods whilst I'm training at this level

  • Some athletes, coaches and even doctors may try to reassure you it's normal for 'athletes in training' not to have periods. I can’t tell you how many people (besides myself) led me to believe that my missing periods were nothing to worry about, or encouraged me to go back on the Pill to 'start them up again' (yet another myth) when I expressed concern about their absence. The bottom line is: it is never normal not to have a period at any level of training.
  • Losing your period is a warning sign for a more serious issue with serious consequences. Your hormonal system is out of whack and your body is trying to tell you. Please look into this further. It is never worth ignoring.

Myth #4: Elite athletes don’t have periods anyway

OR: It’s going to be impossible for me to have periods and be at the top of my sport, so I might as well carry on without them for as long as I can...

  • Incorrect. Although it’s not often spoken about, many people who succeed in high level sport do so with a fully functioning menstrual cycle.
  • The same ladies who are successfully navigate professional sport with periods are likely able to do so because they're in tune with their bodies, understand each phase of their cycle and monitor their hormone levels carefully with blood tests (as explained here) or via tracking apps like this one. Thankfully, you don't need blood tests or high tech equipment to benefit from the very same information when resources like Fitr Woman can help you find it for yourself.

Several years later, I realised the harm using the Pill had done. It had covered up a crucial metric of my health, masking the missing piece of the RED-S puzzle I’d been failing to put together: my natural menstrual cycle. By the time I'd finally come off the Pill (for no reason other than no longer needing it for birth control), far more concerning health issues (or so I thought) were standing in my way of success, including anemia, fatigue, constant string of illnesses and my first bone health injury (a metatarsal stress fracture), so I had barely even noticed the absence of its return. Besides, I’d heard somewhere that periods could take some time to start up again, so I didn’t bother investigating it until at least a year passed by... Here are some more traps I fell into:

Myth #5: Getting my period back isn’t a priority right now

  • If your period isn’t a priority, then neither is your overall health and performance. For as long as you choose to remain in a state of amenorrhea, you are denying yourself an opportunity to be the healthiest, happiest, most successful version of yourself.
  • The longer you remain without a period, the higher your chances are of suffering illnesses or injuries that can take away your sport for longer than it may take to get your period back. Now is the time to make this your priority.

Myth #6: The Pill can boost my bone health, so I don’t really need to regain my period right now

  • Whilst it's true that estrogen is low among athletes with amenorrhea and the Pill does provide some synthetic estrogen, there is no scientific evidence to suggest this is used by the body to protect your bones. Besides, estrogen is only one of the many factors that maintain normal bone mass, so even if this was the case, it’s absolutely no substitute for a natural period.
  • While there is some evidence to suggest that a combination of Estrogen and Progesterone or the Pill may help prevent further bone loss, studies are inconclusive about whether they help actually gaining bone density. If regaining your period is a feasible option then please, take it.

Myth #7: I can use the Pill (or progesterone tablets) to kick-start my menstrual cycle

  • Since the Pill prevents your natural periods, this notion doesn't make as much sense to me as addressing the underlying cause does. Yes, progesterone tablets may cause a bleed since your body responds to the drop in progesterone levels when you stop taking it, but again, this doesn’t improve your natural hormone status – required for your menstrual cycle.
  • There may be certain circumstances in which it's appropriate to use Estrogen and Progesterone but this should be discussed with a medical specialist before determining whether it’s the best course of action for you. The strong likelihood is that the very best course of action for you to take might not be what you want to do – discussed in more detail here.

Myth #8: The Pill is my only option for birth control

  • At this point, I so wish I could share a simple solution for natural contraception that requires minimal effort and maximum convenience, but I’ve long since given up searching for one. Until there is more research and development in this area, it’s unlikely this will change any time soon but all the more reason for you to learn more about your menstrual cycle before making any decisions on what to do for birth control.
  • There are more natural alternatives to the Pill, such as condoms, the hormonal IUD (Mirena), spermicide gel and the 'temperature method' which I wouldn't want to advise on. Ultimately, if you have a loving partner who is willing to play their part in preventing unwanted pregnancy, I'm sure you can come to some sort of solution.