Imagine if Owen Farrell suffered from a condition where, each month, he had to play through painful stomach cramps, fatigue and dehydration so severe it clouded his decision making; feelings of light-headedness, dizziness, violent mood swings and bloating. Yet, he still felt he had no option but to stay silent and play on, uncomplaining.
These are the very symptoms that thousands of female athletes experience during menstruation each month, and yet it remains woefully under-discussed – a bizarre situation, given the physical toll it can exert.
“I was playing a match once and started to feel faint,” recalled one international sportswoman. “It was like there was lead in my tummy and then the cramping began. Imagine your insides twisting while something is clawing at them. It was so painful, I was starting to lose focus.
It is a reflection of the uneasiness which surrounds discussion of menstruation in sport that this sportswoman preferred not to be named for this article – with others approached by Telegraph Sportdeclining to discuss the subject at all.
High-profile interventions on the issue are certainly rare. Heather Watson cited bad period pains as a major reason for her defeat in the first round of the Australian Open in 2015, an intervention which prompted more athletes – mostly in individual sports such as tennis and athletics – to discuss their experiences.
Giselle Mather, director of rugby with Wasps FC Ladies and the first female to become a Rugby Football Union level-four certified coach, believes it remains the last great taboo of women’s sport. “It is just not often spoken about,” she told Telegraph Sport. “I have 60 athletes on my playing book, plus more that train with us, and they don’t talk to the coaching staff about it. Two have come to me this season and have told me they were off form because of a really heavy period, but it is very, very rare that they will say that.
“Maybe because it is there every month, but do we as females actually acknowledge that it can make a difference to our sporting performance? We are in the habit of just getting on with it. Your period arrives, you go ‘oh, s—!’ and you just get on with it. So, do athletes perceive it to be something that affects their performance? We certainly don’t talk about it as a female squad that often.”
The omerta is both curious – given menstruation is such an everyday issue – and potentially damaging. As Fiona Wilson, Associate Professor of Physiotherapy at Trinity College, Dublin, points out, an effect could be talented junior athletes “dropping out of sport due to embarrassment around talking about something like changing a tampon”.
She managed the symptoms of heavy periods along with a successful international rugby career, but despite consultation with doctors, physiotherapists and nutritionists, it was not until the later stages of her playing days that she alighted on simple solutions such as changes to fluid and carbohydrate intake. This delay was in part due to a lack of research in the area of the impact of menstruation on female athletes. “Eventually, we found out that the two main things your period can cause is dehydration and fatigue,” she said.
“After that, I made sure I drank a lot more fluids, especially things like low-calorie Lucozade, and then on the day of the match I drank the high-sugar Lucozade, so I got as much energy into me in terms of carbs. That would have been much better to have known years ago. More research could certainly be put into it – our medical teams could never find enough information around it.”
The silence, and lack of knowledge, around the issue has not gone unnoticed, even at the highest levels. Tracey Crouch, the minister for sport and a former football coach herself, said: “Every woman and girl should feel able to play sport whenever they want to. Periods shouldn’t be seen as a barrier to participation, nor should we feel queasy talking about this important topic. I am determined to see more women and girls play sport at every level, without fear of judgment.”
“The awareness of knowing what could happen has made the girls feel more comfortable and by feeling more comfortable, they have performed better,” he said. “That is why we want to get it out there more and try to make it a national change rather than us just doing it in our programme. It would be great to have other programmes pick it up.”
But while progress is being made on research – albeit slowly – perhaps an easier, and quicker, solution is simply to encourage more open discussion.
“It is just a part of life isn’t it?” said England women’s cricket international Danielle Hazell, when reflecting on how her dressing room deal with the issue. “I personally wouldn’t feel like I couldn’t speak to someone like a physio, the doctor or some of the girls. It is just part of being in a girls’ team, it is happening to everybody.