Sometimes one’s period shows up right before a match or during a training session with full main character energy and suddenly everything feels just a little more overwhelming than it should. And this often times reflects a shared reality for many female athletes, not just an isolated experience.
Research shows that 41%–66% of female athletes report that their menstrual cycle negatively affects their training and performance (Bruinvels et al., 2017; Findlay et al., 2020), often accompanied by cramps, lower back pain, fatigue, bloating, and an overall drop in energy that makes even routine movements feel heavier.
And it’s not just about how it feels, there’s a physiological basis behind it. Hormonal fluctuations across the menstrual cycle influence cardiovascular function, thermoregulation, metabolism, and energy availability, all of which are critical to performance (Brown et al., 2020). Changes in body composition throughout the cycle may also contribute to altered performance. Increased body mass is linked to impaired aerobic and anaerobic endurance capacity(McNulty et al., 2020)
Importantly, the impact is not purely physical. Menstrual dysfunction can shape how athletes experience sport emotionally, influencing motivation, confidence, and overall well-being, yet this dimension remains underexplored (Mountjoy et al., 2014). For many athletes, it’s about managing both physical discomfort and mental fluctuations while still being expected to perform.
Menstruation itself is not a single moment, but a cycle. Each phase brings distinct hormonal changes that can influence performance. The menstrual (early follicular) phase is often associated with lower energy and discomfort. Around ovulation, higher estrogen levels may support better coordination, strength, and readiness for high-intensity activity. In contrast, the luteal phase is often linked to increased fatigue, higher perceived effort, and mood changes. These shifts highlight that performance is dynamic and varies across individuals.
Despite growing awareness, menstruation remains underrepresented in sport science research and practice (Brown et al., 2020; Bruinvels et al., 2016; Findlay et al., 2020). The deeper issue lies not in the menstrual cycle itself, but in the culture surrounding it. Sport systems have long been built around male physiology, leaving gaps in how female athletes are supported. Conversations around menstrual health are often limited by stigma, lack of education, and discomfort. Athletes may hesitate to speak openly, while coaches and practitioners often lack the confidence or knowledge to engage in these discussions.
This is where menstrual health literacy (MHL) becomes critical, the ability to access, understand, and apply knowledge related to menstrual health. As Nutbeam and Lloyd (2021) suggest, health literacy develops progressively, and the same applies within sport. Without adequate MHL among both athletes and support staff, menstrual health remains overlooked rather than integrated into performance planning.
Encouragingly, the landscape is beginning to shift. FitrWoman, a menstrual cycle tracking app, helps athletes and support staff track symptoms, performance, and recovery across the cycle. This supports more individual training plans and clearer decisions. Federations like FIFA now include menstrual health in athlete wellness programs. Elite athletes are also speaking more openly, which helps normalize these conversations.
But tracking alone is not enough. The next step is using this information in a way that actually supports athletes day to day. That means adjusting training when needed, improving recovery strategies, and creating space for honest conversations. It also means handling personal data with care and building trust between athletes and support staff. More research on female athletes is still needed, and coaches need better education to understand and apply this knowledge.
At its core, this is about doing sport better. When systems begin to account for how female bodies function, athletes are not limited, they are better supported. Recognizing this does not change what athletes are capable of; it allows them to reach it with fewer barriers.