Normalising the conversations around women’s health in sport

Dr Stacy Sims, along with the human performance company Whoop and Voiceinsport, have decided enough is enough when it comes to limited research and research opportunities for women, especially when getting active. Sims brings her experience as a nutritionist, former athlete and researcher into women and performance, looking at the menstrual cycle and its effect on training. The aim is to empower female athletes through education, content and research.

What first got you interested in studying women?

“I was a young athlete and an exercise physiology undergrad where we were learning about physiology, training, recovery, manipulations for adaptations, but when push came to shove, the info did not make sense in application to us women on the rowing team. I had always been a question-asker, and the answers were not there when I started asking questions. There was the blatant ’women are the same as men’, ‘women are anomaly sometimes, so we throw that data out”, and of course the big one ‘why do you want to know about women, we don’t know enough about men?’”

How would you educate young girls about the menstrual cycle?

“We start by normalising the conversation in middle and high schools with initiatives like free period products. This opens up equity across all girls so that there is no taboo and the need to stay home due to lack of period care.

When we see the division of girls and boys sport at 11-12 years old, we also see the misstep of training, where youth male sport protocols are applied to youth girl sports. But if we talk about changes occurring and why we focus on mobility, functional strength, intensity and drills; this comes into the natural conversation around puberty and menstrual cycle. The biggest change we’ve seen is when it comes from the girls themselves, starting with a reading group with books like Yumi Stynes’ Welcome to your Period and Kaz Cooke’s Girls Stuff.”

What general tips would you have for girls and pre-menopausal women for keeping their bodies regulated?

Every woman’s cycle is their own lived experience, and we actually do not talk about this or what is “normal” regarding the actual bleed patterns. We know roughly 35 per cent of female athletes suffer from heavy menstrual bleeding, which interferes with daily life functions, but there is a significant lack of conversation around this, and there is simple medical help to give these days back. When female athletes track their cycles, it is recommended to track to understand where they are in their cycle and add layers of how training felt, monitoring sleep and moods. This will allow her to optimise the days of feeling bulletproof and dial it back (without guilt!) on days where she may feel a bit meh.

The one critical thing that needs to be made crystal clear is that ‘performance’ is different from ‘training’. There is no negative part of the cycle for performance; the psychological supersedes the physiological. Training is different in that we use the fluctuation of the sex hormones to optimise their ergogenic effects. When estrogen and progesterone are low (follicular phase), women are resilient to stress, sleep better, recover better – this is the time to push the training loads. Around ovulation, with the surge of estrogen, this is a time to really push muscular work.”

How dangerous are missed periods?

“If there are three or more missed periods in a row (and pregnancy has been ruled out), this is amenorrhea – a significant sign of a misstep in the endocrine system. It is dangerous, as the health ramifications are pretty severe – low bone density, psychological impact (more anxiety, depression, mood disorder), gastrointestinal issues, cardiovascular risks factors increase; and it is caused by a downregulation of the luteinising hormone pulse, and subsequent stop of ovarian hormone production. The period is an ergogenic aid in that it tells you that you are adapting well to training and life stress; and that you can cope. When amenorrhea comes into play, it is a sign of an unhealthy athlete, and there needs to be medical help.”

How exciting is it to have Whoop and Voiceinsport investing in research for women?

“Women in sport have long been on the back foot of equality. Whoop has the opportunity to tailor and direct research in women of all ages and levels of sport and the partnership with the Voiceinsport platform to reach girls and women in sport in a safe, empowering environment. The Women’s Performance Collective is a remarkable collection of experts who bring many facets and perspectives to research. Our shared goal is to create equality and answer the hard questions, to normalise the conversations around women’s health, performance, and potential in sport.”