In Australia, professional athletes and menstrual cycles have a dedicated initiative at the Australian Institute of Sport (AIS). The AIS Female Performance & Health Initiative was established in October 2019 and offers education on the menstrual cycle, menstrual abnormalities, puberty and hormonal contraception for athletes, coaches, parents, sporting organisations and support staff.
Its stated aims include identifying existing research on female athlete health and performance and establishing a roadmap for future research. This guide sums up what studies with elite athletes have found so far.
Quick answer: Elite athletes commonly report period symptoms they believe affect performance; in one study, 93% of international rugby players had cycle-related symptoms. Studies measuring performance find only a trivial change across the cycle, and the AIS now runs education on the topic. Periods that disappear during training deserve a doctor's check.
How common are period symptoms in elite sport?
Very common, going by the research available. When researchers interviewed 15 international rugby players for a 2020 study in the British Journal of Sports Medicine, nearly all (93%) described cycle-related symptoms, a third perceived heavy bleeding, and two in three believed their symptoms had impaired performance. Around two-thirds managed symptoms with self-medication.
A 2024 study of 128 British track and field athletes found a similar pattern, with bloating, lower back pain and pelvic pain reported most often and 76.8% saying their cycle had a negative effect on performance.
Can athletes plan training around their cycle?
They can track it, but there's no evidence-based template to follow yet. A 2020 Sports Medicine meta-analysis combined 78 studies involving 1,193 women with regular cycles. It found performance might be trivially lower in the early follicular phase, the phase that begins on the first day of a period, compared with other phases.
The authors graded their evidence as low quality and recommended basing decisions on each person's response rather than general rules. For more on everyday exercise through the month, read our article on how your menstrual cycle affects your workouts.
What does a missing period mean for an athlete?
It's a signal to get checked rather than a badge of fitness. The Better Health Channel page on absent periods defines secondary amenorrhoea as periods stopping for 3 or more months after being regular. Excessive exercise, low body weight and poor nutrition, including eating disorders, and severe anxiety and stress are among the listed causes.
Treatment depends on the cause and may include nutritional advice, lifestyle changes, hormone therapy or specialist care for an eating disorder.
Why do athletes stay quiet about period problems?
Stigma and performance pressure both play a role, according to a 2021 focus group study with Dutch female athletes, most of them from endurance sports. Some said doctors, coaches or teammates had treated losing their period as normal. Others felt ashamed, didn't know the long-term consequences, or feared being asked to change their training or diet. The researchers called for education for athletes and coaches and multidisciplinary care.
When to see a doctor
See a doctor if:
- you have missed 3 or more periods in a row, or had fewer than 9 periods in a year;
- your periods haven't started by 16 to 17, or their pattern has changed;
- a period lasts more than 8 days, or periods come less than 3 weeks or more than 2 months apart;
- severe period pain disrupts your daily activities.
These points come from the Better Health Channel and healthdirect. You can also call healthdirect on 1800 022 222.
Frequently asked questions
What is the AIS Female Performance & Health Initiative?
It's a program run by the Australian Institute of Sport, established in October 2019, to improve knowledge and support around female athlete health. It provides education on the menstrual cycle, menstrual abnormalities, puberty and hormonal contraception, and aims to identify research and set a roadmap for future studies in this area.
Is it normal for athletes to lose their period?
It isn't something to ignore. The Better Health Channel lists excessive exercise and low body weight with poor nutrition among causes of absent periods, and advises seeing a doctor after 3 missed periods in a row. Dutch researchers found athletes sometimes delay help because missing periods has been treated as normal in sport.
Do athletes on the pill notice fewer period symptoms?
Not according to the 2024 British track and field study. Athletes using hormonal contraception reported similar bleeding, pain and cyclical symptoms to those who weren't, and 80% of users and 78% of non-users felt their cycle hurt performance. Talk to your GP about which contraception suits you.
Should coaches ask athletes about their cycle?
Researchers think support teams should. The rugby study authors recommended that clinicians and support staff profile and monitor athletes' menstrual cycles and build awareness, and the Dutch study urged education for coaches and federations. Dutch participants also described shame and fear of being judged, which is why the researchers called for breaking the taboo.
Training or competing mid-period? The Lunette period cup is reusable and can be worn for up to 8 hours, and Size 1 is the one Lunette suggests for strong pelvic floor muscles. Compare Size 1 and Size 2 in our menstrual cup size guide.
We share this as general information only, not medical advice; please see your GP or a sports doctor if training is changing your periods.
