Credit: Nicolas Hoizey via Unsplash

Things we’re leaving in 2022… The culture of silence surrounding female athlete health

By Claire Thomson

It’s been a year of celebration for women’s sport and the kickstarting of an important conversation.

2022 has been the year for female sport, yet until very recently menstruation remained a taboo subject and research on the science of sport is still heavily skewed towards male athletes, with the imbalance leaving large gaps in knowledge about female sports and sports-related injuries. In 2016, Chinese swimmer Fu Yuanhui missed out on the Olympic podium as she held onto her stomach following her race as she said: “I feel I didn’t swim well today. I let my teammates down. My period came last night and I’m really tired. But this isn’t an excuse, I still didn’t swim as well as I should have.” Over six years on and the sentiment is still too prevalent in the world of sport.

In August 2022, the culture of silence, fear and shame around female athlete health that has swept through elite sport for so long started to make some noise. The cry kickstarted when Dina Asher Smith and Daryll Neita qualified for the 100-metre final of the European Championships in Munich, in what should have been a show of British sporting dominance, only for Asher-Smith to be forced to slow and Neita not quick enough for gold, both because of cramps. In a later interview, Asher-Smith, the European gold medallist from 2018 revealed how “girl stuff” had prevented her from sprinting into athletic history and shared her frustration at the impact of period symptoms on her sport. If it were a men’s issue, she argued, it would have been fixed by now, calling for more research to be done on the menstrual cycle and its impact on performance. 

Praising Asher-Smith, Scottish long-distance runner Eilish McColgan was one of the next to follow suit, speaking out about having to withdraw from two competitions due to period pain in her career. The Commonwealth Games gold medallist took to Twitter to voice her opinion, in turn receiving a remarkably unhelpful response from a male follower. She said: “His solution was to not bother competing when it’s my time of the month and to just schedule another race. As if I could simply call up the Olympic Games and ask them to move my event to the following week to fit my cycle. The mind boggles sometimes… but it also just shows me the complete lack of awareness that some people have.” 

The conversation has continued. With around 5000 euphemisms worldwide for periods, one of the first changes to raising awareness of female athlete health was to say the word “period” without permission or budget. As part of The Well HQ’s “Call it What it is” campaign to standardise the language of the female body, 50 top female athletes, including double Commonwealth champion Hannah Miley, spoke out about the impact of periods on performance and ways in which messages about periods can become stronger. Speaking to Sportsmail the Scottish swimmer admitted to having relied on the contraceptive pill for 15 years without a break to try and control her period. It was only when talking to a research scientist later that she discovered that being on the pill for that length of time could have mashed potential health problems and largely disrupted the body’s natural hormone production. Miley is now delivering workshops around the country aimed at highlighting the issue. 

Finally, changes have truly been made. There has been increasing discussion about what female players feel comfortable wearing while on their periods, so much so that various teams in both the Women’s Super League and Scottish Women’s Premier League have recently changed their kit colours after concerns were raised about players having to wear white shorts. Organisations such as Netball Australia and Manchester City have also changed their kits, allowing women to feel more comfortable when playing sports. However, most notably, after much backlash, it is the updating of the oldest and arguably most prestigious tennis tournament in the world’s 145-year-old rulebook that has shown what difference the conversation around female athlete health can make. For female athletes and those that have periods, the strict and unprogressive dress code raised questions of inclusivity and attitudes towards women in sport. Coming into force this year, Wimbledon officials are expected to change the rule on women having to wear “all white” underwear to allow for darker colours to be worn.

Most recently, the England women’s football captain, Leah Williamson disclosed in a candid interview with Women’s Health magazine increasing the visibility of women’s health issues that are so poorly understood in sport that she suffers from endometriosis, a painful and debilitating condition that can lead to infertility. Endometriosis is a condition where tissue similar to the lining of the womb grows in other places of the body, such as the ovaries, fallopian tubes and bladder. Like a period, it bleeds every month but with no way for the blood to escape. Chelsea manager, Emma Hayes, was admitted to hospital this year too for an emergency hysterectomy because of an “ongoing battle” with the disease, which is often downplayed by GPs and notoriously difficult to get a diagnosis for. However, what was most alarming about Williamson’s interview is not that she feared that her condition would jeopardise her participation in last summer’s Euros, but that a recent concussion had contributed to an increase in menstrual pain. With the risk of concussions greater in contact sports such as football, the Lioness has drawn attention to a health issue unknown to most. 

The demand for more research is increasingly being heard with sports science companies now offering consultancy packages to help athletes “work proactively” with their menstrual cycles. Sports institutes in several European countries have also started projects to provide athletes with strategies ahead of the 2024 Olympic Games in Paris. But even if periods are given more attention in sport, what can anyone actually offer athletes struggling with their periods? In an area still full of unknowns and unanswered questions, there is the belief that understanding the menstrual cycle will not just free athletes from symptoms, but allow them to reach new, record-breaking heights. 

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