The battle before competition: India's women athletes talk about periods and how they fight the pain
Swaroop Swaminathan tells the story of how Increased awareness, technology and better support system
have allowed India’s elite women athletes to manage their menstrual cycles in a holistic way
August 13, 2016. Fu Yuanhui, one of China’s best backstroke specialists, begins the 4x100m medley final for her country at the Rio Olympics. She completes her two laps in 59.53 seconds, the second last at the first changeover. They finish fourth.
By Yuanhui’s high standards (her best 100m backstroke time is 58.72 seconds), it’s well outside her best. Speaking after the race, she goes to a place where women athletes seldom go. “It’s because I just got my period yesterday, so I’m still a bit weak and really tired,” she says. “But this isn’t an excuse for not swimming well.”
It shatters a glass ceiling because women athletes don’t talk about menstruation after an event. It’s considered taboo.
The wider community considering it taboo is one thing. In India, conversations around menstrual cycle were considered so taboo women’s athletes wouldn’t even discuss it with their coaches.
That is slowly changing.
The women’s hockey team is expected to update a Google document each day. One of the questions is, ‘was today your first day of periods?” The completed form is accessed by Wayne Lombard, the side’s scientific advisor. They are also actively encouraged to keep track of it through various period trackers apps on their phones. If they can’t get the hang of technology, they are asked to put tick marks on a calendar in their dorm rooms.
This kind of arrangement is not unique to the members of the women’s hockey side. The holistic nature of planning can be seen across different disciplines as well as organisations. Just ask Neha Aggarwal, head of partnerships and communications at Olympic Gold Quest (OGQ), one of several bodies established for the purpose of helping India’s athletes excel (in Japan, almost a dozen women’s athletes have direct links to OGQ). “We have been tracking periods of athletes, and our nutritionists and sports sciences team. We work closely with them,” she says. “There is a certain level of trust, we are able to help them manage periods.”
It’s a sentiment that’s echoed right across the board. How are the organisations helping? By spreading awareness. There’s a wide range of options available depending on the athlete’s own experiences in dealing with periods. Take the example of one of the most prominent of India’s women’s athletes at these Games. During her periods, she experiences painful cramps and heavy flow. In competition, she has no choice but to take painkilling medication. Painkillers, however, isn’t common. Athletes who experience normal periods tend to go without them, even during something as big as the Olympics.
Saumya Khullar, who works with the Boxing Federation of India (BFI), illustrates with examples.
“Options for Athlete A... I know if she uses a hot water bottle, she will be fine,” Saumya, who worked with JSW Sports before moving to BFI, says. “That and some sort of diet modifications few days prior and during her periods. That’s sorted. Take another player, Athlete B. It might be that she has to rely on pain medications after discussing with the team doctor. Maybe there is another player, Athlete C, who could have more aggressive symptoms... then there are conversations around manipulating that. That needs to be discussed with the doctor and the athlete themselves.”
The work starts months in advance. It includes finding out if they suffer from iron deficiency as well as seeing if they regularly miss periods. Saumya, who also monitors the menstrual cycles of all her athletes, individually gets in touch with the ones who have been missing their periods.
“A full series of decisions and interventions will take place to find out why they are missing periods... that’s the important part. Getting a period is okay but if you are not getting it, that’s something that can have short and long-term consequences.”
Because Indian women are more prone to iron deficiency (considered a major public health issue in the country), they are screened for anaemia. “The way symptoms present themselves could also be systemic,” Saumya says. “Because we know that iron deficiency anaemia is a public health issue, women are all the more prone. Even going to that level and identifying if an athlete is anaemic because if she is... then either she is experiencing heavy menstrual bleeding or her symptoms are exaggerated. Correcting all of that before the competition cycle is way important. In a nutshell, preparation should start months before the actual competition.”
There is also more care shown towards diet just before and during menses. “If there is an athlete who is predisposed to have gut issues before her menses, then I would recommend her to start taking probiotics, garlic and banana just to promote good gut health. During menstruation, they need to be consuming energising food such as potatoes, spinach, brown rice and lentils,” Saumya explains.
The main message, though, is ‘keep a tab on your menstrual cycle’ as research, both old and new, indicate chances of picking specific injuries increase during specific phases of the cycle. For example, a study by the British Journal of Sports Medicine suggests that “muscle and tendon injuries may occur approximately twice as often in the late follicular phase (follicular phase is the time from the first day of a period till ovulation). Another study, put out by the Orthopaedic Journal of Sports Medicine, suggests “an association between hormonal fluctuations and ACL injury.”
ACL injuries are still regarded as the worst injury an athlete can pick up.
Neha is laughing on the phone. She is answering a question on how the awareness was back in her time (she represented India in table tennis at the 2008 Olympics) and now. “When I was competing, I had no idea that we should be tracking our cycles,” she says. “There is a correlation between periods and performance. Nowadays, athletes are tracking their periods.
“It’s a world of difference between then and now. It used to be called ladies problem (laughs).”
She’s been asked by coaches ‘kyon off lena hai? Achcha, ladies problem?’ “There were no conversations. Now, at least we are talking about it. At that time, nobody knew that these things should be written about. No Indian coach was sensitive, they didn’t know much. There was no support system. A physiologist or nutritionist wouldn’t guide us.”
Women athletes who felt they could power through, powered through. If they wanted to postpone their periods, they did. Some trained and competed on their periods even if they were feeling like hell because the alternative was telling their coaches they were suffering from ‘ladies problem’.
Some, like Taruka Srivastav, a part of India’s soft tennis squad at the 2010 Asian Games, had no choice but to turn to her mother, a gymnastics coach, for advice. “I have always experienced heavy periods,” she says. “There are medicines which can delay (periods) but might mess up with your hormones. So I never took medicines. I would be very conscious of my diet. Only vegetarian food. No coffee. Plus I trained to play during my periods. Many women use tampons and find them much better as you can play more freely.”
Eleven years later, Saumya is ‘optimistic’ but says ‘there is a long way to go’. “We need to sensitise not just the male coaches but the whole ecosystem around athletes. It’s a normal physiological phenomenon that an athlete is going through every month so we cannot ignore basic physiology. There are places where it’s still considered taboo but athletes are becoming a lot more aware themselves and are speaking up.”
When elite male athletes feel pain or see blood, they strap their thighs, tape their fingers and continue. If it becomes unbearable, they walk off. Women will not have that chance. Or that choice. Like Yuanhui, they will have to play through pain and blood. For a few days every month right from the time they turn 12 or 13 or 14 for the entirety of their adult life.