The biological link
The menstrual cycle is a primary indicator for Relative Energy Deficiency in Sport (REDs) and a key piece of the Female Athlete Triad. REDs is a condition that occurs when energy used is not met by energy intake, often leading to bone loss, difficulty sleeping, and higher risk of injuries to muscles, bones, tendons and ligaments. Research shows that ligaments are torn more easily during certain points of the menstrual cycle due to hormone changes Females tear their ACLs two to eight times more often than males. According to the findings of various studies, athletes who report menstrual irregularity experience a higher percentage of severe injuries than those who report regular menstrual cycles.
Social stigma
Although irregular cycles are linked to increased injury risk, various studies show that up to 40% of athletes with menstrual disorders do not disclose these symptoms. This is because of a combination of factors, including social stigmas, lack of education, and the normalization of amenorrhea (pauses in menstrual regularity or “skipping a period") in sport culture. As a result, adolescents who menstruate often deal with painful cramps and changes in hormone levels in silence, out of fear that talking about these struggles will make them seem weak to their peers or coach. Furthermore, some medical professionals, elders, coaches, teachers and other community members may hold the false belief that sport participation will cause more painful cramps, or that it is unsafe to participate in sport while menstruating.
Period poverty
Beyond biological and social barriers, period poverty is a major driver of dropout rates in female sports. Period poverty is defined as the lack of access to menstrual products and hygiene facilities, and over 500 million people are affected globally, particularly in rural areas. This leaves people who menstruate with the dilemma of having to choose between basic necessities and sport participation.
Moving forward in sport programming
There is profound opportunity for sport programmes and institutions to educate their players and participants about menstrual health. Organisations like Anantapur Sports Academy, Forsports Foundation, and Women Win are already doing this through educational events, online resources, and integrated programming. Peer mentorship and participatory learning models can create safe, culturally-grounded spaces for open discussion and education on menstrual health. Major responsibility lies with coaches and programme managers to implement menstrual cycle-informed programming and foster an empowering mentality surrounding menstruation. When embedded within sport programming, menstrual health literacy has the power to advance gender equality, increase participation in physical activity, and improve health outcomes simultaneously.
How SfD programmes can help close the period poverty gap
SfD programme staff are in a position to address period poverty and address period stigma by breaking the silence and proactively addressing menstrual health if it feels safe to do so in their context. Here are a few ideas for how to do this:
- Have period products (pads, tampons) easily available in the restroom or supply room.
- Share free brochures, books and information about menstruation. Host a workshop on making reusable pads.
- Share information about health and periods.
- Help players address pain management if they have painful cramps.
- Allow players who menstruate to modify their participation if they need to, and make it clear it’s ok to communicate about their needs.
- Share information and resources about nutrition, energy intake and iron deficiency with participants who menstruate.
- Latrines/Restrooms/Toilets should have: soap and water to wash hands water to rinse and flush toilets trash receptacles locking private toilet stalls or locking private restrooms.
Two organisations already addressing period poverty are Moving the Goalposts (MTG) and Boxgirls International. MTG’s primary focus is on infrastructure and access, ensuring football pitches have safe, private latrines equipped with soap, running water, and a steady supply of sanitary products. In contrast, Boxgirls International focuses on bodily autonomy and education. The organisation hosts how-to workshops for athletes on making reusable pads and managing menstrual pain. Through these measures, MTG and Boxgirls International are ensuring athlete safety and making sport participation for those who menstruate more accessible.
Related sportanddev articles:
- Reframing menstruation as a superpower in sport
- Menstruation and Sports: ASA’s female youth create awareness for coaches, athletes, and parents
- Empowering Ghanaian girls through football and menstrual health education
- The final taboo
- The female athlete and her body: A new age
- Interactive education through netball
Key research:
- Women athletes with menstrual irregularity have increased musculoskeletal injuries
- Menstrual Health Education in Sport for Development: A Case Study from Zambia
- What is UNFPA doing on the issue of menstrual health?
- Period poverty
- How addressing menstrual health and hygiene may enable progress across the Sustainable Development Goals
- Menstrual health: a definition for policy, practice, and research
- “They Seem to Only Know About Bleeding and Cramps”: Menstruation, Gendered Experiences, and Coach–Athlete Relationships
