Thursday, June 19, 2014

Girl talk

I love bad joke eel...sorry.

One of my friends recently posted a recap of her Ragnar relay experience. She commented that was on her period during the race...which made things that much more challenging. I bet! Logistics, pain, just yuck.

Another one of my friends was running a marathon and passed out. She was on her period.

This got me thinking about running and periods. Just Google menstruation and running and a ton of blog posts pop up. This is a big topic. For women. Men, you can be excused.

So what's a woman runner to do?

In my practice as a PNP, I do physical exams on kids of all ages up to 21. With girls, starting at age 9-10, I always talk about periods. Pre-puberty, I get to do a lot of what we medical folks call "anticipatory guidance", and we talk about changes to their bodies and what to expect. Most of the girls are pretty receptive, and I'm always surprised how much these young girls already know! I try to keep the discussion positive, but let's face it, who looks forward to bleeding every month? Periods are part of life but something that women love to hate. One thing I always say is that every woman gets their period and it's a club that no one really wants to be in. Truth!

I mean look at all the nicknames for it: Aunt Flo, Flo, on the rag (hate that one!), my friend (with friends like that, who needs enemies?), that time of the month, the blogger called it "riding the crimson tide", but she's from England and I'll excuse her for that! Anyways, none of them were really positive. Because really, what is so great about bleeding for 5-7 days every month? Some lucky women have a really easy time with their periods. But I have found over the years that is the exception. Most women have pain, fatigue, nausea, diarrhea, and mood swings with their periods. It's tough for women because advertisers really stress how their products can help you take your period in stride and go about your everyday activities as if nothing was bothering you.

Full disclosure: I always had bad periods. When I did get my period (every 6 weeks if that), it wasn't heavy but I had terrible cramps. Sometimes I vomited from the pain. Luckily, ibuprofen came out around that time, and once I was able to choke down those giant pills, I had some pretty good pain relief. It wasn't perfect, but I could function. I tried oral contraceptives and that definitely helped but I didn't like the idea of taking daily medication, and after several years, I stopped taking them. For several years after I gave birth, my periods weren't too bad. They were regular, and I could get by with ibuprofen on the first day. But in my 40s, everything changed. My periods became more and more painful again. Running became difficult, and I started having trouble even running 3 miles most days because I was so fatigued. I was diagnosed with a uterine fibroid and about 6 years ago, finally had a partial hysterectomy to remove it when it became so large I had trouble urinating. 

Eight weeks after that procedure, I ran 5 miles pain free and haven't looked back. I feel like a different person. Not only do I not get a period anymore, I have so much more energy. I'm running faster and farther than I have in years. I packed up all my pads and tampons and gave them to my friend, the mother of 2 girls. We laughed about it, but she told me how lucky I was not to have my period anymore. I completely agree.

I don't advocate such an extreme procedure for horrible periods, but for me it was life changing. Many of my friends who are in their 40s who have had similar issues have also undergone a procedure called uterine ablation, which basically compresses the uterine lining and reduces monthly bleeding. If you're done having kids, why not? Quality of life is a big deal here.

Jenny Hadfield wrote a great blog post on running and menstruation. Being an elite runner, she was really concerned how her cycles affected her training. She began keeping a symptom log and found that there were some key changes to her HR and pace during certain days of the month. Typically, the last 2 weeks of the month were more challenging due to cyclical hormonal changes. Interesting, because although I no longer get my period, I do still have my ovaries and so I do go through a monthly cycle. I just don't notice the extreme ups and downs that I did prior to my surgery.  She also talks about a "cut back" week if you are one who experiences bad cramps and /or heavy bleeding. Which is a great idea unless you are training for a race or your race just happens to fall at "that time of the month". Since women bleed 1 week out of the month, there's a pretty good chance that a race may occur during your period.

Another great article was published in Competitor magazine earlier this year. The article (written by a man, I should add) is more technical but talks about the physiology behind the cycle and why women should train differently than men. Turns out that depending on what time of the month it is, your heat tolerance could be lower due to fluctuations in hormones. Women are more susceptible to heat related illness than men. The author states that training helps improve a woman's ability to tolerate hot conditions. Anemia can be an issue in all runners, but especially women who bleed heavily during their periods. Anemia can contribute to fatigue because red blood cells carry oxygen to the brain and if you have less of them, well, it just makes sense. Glucose metabolism is also affected and he advocates a high carb diet. Hooray for carbs!


Do you notice changes in your running related to your period? What do you do to alter your training, if anything? Do you plan your races around your cycle?


  1. I always find it hard the day before and the first day of. I do always feel much better afterwards and it really helps my cramps to be active. It's that first few minutes that sucks.

  2. I have heard from another friend that getting a hysterectomy was the best thing she had done for herself. Obviously it can have its downsides too. At 52 I'm still cycling, had my period for my last big skating test, I was not pleased!

    1. Do you feel like it affected your performance? Some women don't seem to be bothered by it. Me...a different story!