The Blood, the Silence, the Game: How Menstruation Still Benches Girls Worldwide

By Fakorede King Abdulmajeed | Fuxma Media | September 15, 2025

For as long as women have competed, there has been a shadow cast across their performances, not by opponents, not by crowds, but by their own physiology. Menstruation, a natural rhythm of the body, has remained conspicuously absent from the language of sport. It has been relegated to whispers, sidelong glances, and euphemisms that do little to capture the physical and psychological toll it can exact. For generations of female athletes, this silence has meant learning to endure in private, to improvise coping mechanisms, and to carry on as if nothing were wrong, even when cramps, fatigue, or hormonal shifts left them diminished.

The silence is not incidental. Sport was historically imagined as a male domain, and when women were finally admitted onto its grand stages, it was with little consideration of their biological realities. For decades, training regimes, competition calendars, and even medical research were built on male bodies. Women were expected to adapt, to conform, to excel within frameworks never designed for them. In this context, menstruation became the unmentionable, a detail too inconvenient for coaches, scientists, or federations to address. The result has been a paradox: women pushing the limits of human endurance while their most routine biological cycle remains understudied, misunderstood, and stigmatized.

Occasionally, athletes have broken through the silence. At the 2016 Rio Olympics, Chinese swimmer Fu Yuanhui stood before cameras and admitted, almost apologetically, that cramps had hindered her performance in the relay. Her words ricocheted across social media, striking a chord because they pierced through a taboo. In 2002, Paula Radcliffe ran the London Marathon on the first day of her period, battling abdominal pain as she surged to a world record. Her achievement was framed as heroic, but the quiet subtext was this: menstruation had become another obstacle she had to conquer alone. British tennis player Heather Watson, meanwhile, after bowing out of the Australian Open in 2015, told reporters that “girl things” had left her drained, giving language to an experience countless women had endured but few had named in public.

The science of menstruation, though patchy, reveals why these admissions matter. The cycle is not a monolith but a series of phases, each carrying its own implications for performance. During menstruation itself, plunging estrogen and progesterone often leave athletes depleted, their endurance tested by cramps, fatigue, and blood loss. Paradoxically, pain tolerance sometimes rises, meaning athletes can endure discomfort even as their energy weakens. The follicular phase, which follows, is often described as a window of strength: estrogen climbs, mood improves, recovery accelerates, and many athletes feel physically sharper. Ovulation, arriving around the midpoint, brings a surge of estrogen and testosterone that can heighten power output but also induce bloating, elevated body temperature, and injury risks. The luteal phase, with progesterone dominant, is perhaps the toughest: fatigue deepens, coordination falters, and mood swings intensify, leaving athletes carrying heavier burdens at critical points of their calendar. For a discipline as performance-heavy as sport, these fluctuations mean battling their own physiology before even facing an opponent.

These fluctuations are not merely anecdotal. Injury data reveals an ominous correlation: women are more likely to rupture their anterior cruciate ligament during phases of high estrogen than at other stages. The hormone, while beneficial for recovery, can loosen ligaments, undermining joint stability at the worst possible moments. Researchers have begun to link menstrual variability to performance in sports like football, tennis, and athletics, suggesting that ignoring the menstrual cycle is no longer tenable. And yet, institutional measures remain scarce. Even in elite contexts, the menstrual cycle often goes untracked, unspoken. For many athletes, it remains the exception rather than the rule. Most teams still prescribe identical workloads regardless of physiology, treating women as though their hormonal fluctuations were uniform.

Behind the physiology lies the question of resources. Elite athletes in wealthier nations increasingly benefit from innovations: apps that track cycles with forensic precision, customized sports bras designed with period proof layers, clubs like Chelsea Women and the U.S. Women’s National Team factoring menstrual data into hormonal data. For these players, menstruation is slowly being folded into the calculus of performance, treated as another variable alongside recovery times or fitness benchmarks. Elsewhere, the gap is starker. In resource-poor settings, the struggle is basic: many athletes cannot afford sanitary products. In Kenya and Uganda, athletes have described missing training because they cannot afford sanitary pads. In rural Africa, entire careers are derailed by the absence of a hygiene facility as basic as running water.

Nutrition and hydration offer another layer of complexity. Blood loss during menstruation depletes iron, leaving athletes susceptible to anaemia, which dulls endurance and accelerates fatigue. The careful inclusion of iron-rich foods; red meat, leafy greens, lentils becomes essential, yet access to such diets is uneven. Hydration, too, is precarious: hormonal changes alter fluid retention, meaning cramps and dizziness often coincide with periods of intense training. Some athletes turn to hormonal contraceptives to regulate or suppress their cycles, choosing predictability over disruption. For others, menstrual cups or tampons provide freedom of movement in high-intensity competition. But these choices are rarely straightforward. Contraceptives alter hormone profiles, sometimes helping, sometimes hindering. Tampons are impractical where water and hygiene facilities are scarce. The solutions are shaped as much by geography and privilege as by physiology.

The stigma, however, is universal. In many male dominated coaching environments, menstruation is treated as irrelevant or awkward, a subject to be skirted rather than understood. Female athletes often describe a reluctance to admit when they are struggling, fearing their pain will be interpreted as weakness or excuse making. The psychological toll is immense. To perform at the highest level requires not only physical strength but mental clarity; yet for many athletes, menstruation brings a cloud of self doubt, frustration, and shame. Younger athletes, in particular, are vulnerable: without education or open dialogue, they may internalize the idea that their biology is a liability, something to hide rather than manage. For some, this becomes a tipping point, prompting early dropout from sport.

The research gap underscores the institutional neglect. Sports science has overwhelmingly studied men, with women often excluded from trials because their hormonal cycles were deemed “complicated variables.” The irony is staggering: by avoiding complexity, science abandoned half the athletic population. Only recently have researchers begun to map how menstrual phases interact with training loads, recovery rates, and injury patterns. The knowledge emerging is both empowering and infuriating, empowering because it validates what women have long known about their bodies, infuriating because of the decades wasted in silence.

Change is stirring. Athletes themselves are driving the conversation, using interviews, documentaries, and social media to strip away taboos. Serena Williams has spoken about broader issues of women’s health and performance. Megan Rapinoe and her U.S. teammates have embraced cycle tracking as part of their preparation. Grassroots organizations are distributing free products to young athletes and lobbying for policy shifts that treat menstruation as a public health matter. Sportswear companies are experimenting with gear designed specifically for menstruating athletes. Each step is incremental, but collectively they signal a cultural shift: menstruation is no longer being treated solely as a private inconvenience but as a central factor in athletic equity.

Still, the undertow of neglect remains strong. In many federations, menstrual health is absent from policy. In schools and academies, young athletes receive little formal education on how to manage cycles in tandem with sport. In medical literature, women remain underrepresented in trials that could refine training and injury prevention strategies. The struggle continues not because menstruation is insurmountable, but because the infrastructure of sport has yet to take it seriously.

For all the advances, the truth is that menstruation remains a hidden frontier in sport. Athletes push themselves through cramps, fatigue, or dizziness not because it makes them tougher, but because silence has left them with no alternative. The cost is unevenly distributed: the marathoner with access to elite physiologists may adjust her training seamlessly, while the schoolgirl in rural Africa may miss matches for lack of sanitary pads. At the pinnacle of performance, fractions of a second or centimetres can separate victory from defeat. To ignore the role of menstruation in shaping those margins is to wilfully overlook a fundamental element of female athleticism.

A sporting world that aspires to fairness cannot persist in this neglect. Coaches must be educated, federations must fund research, products must be made accessible, and stigma must be dismantled. Menstruation is not a weakness to be endured in silence but a rhythm to be understood, respected, and managed. Only then can sport claim to treat women not as anomalies in a male system but as athletes in their own right, competing not in spite of their biology but in harmony with it.

The hidden struggle is, at last, being brought into the light. The question now is whether sport will embrace it or continue to leave half its athletes fighting battles they should never have had to face alone.