By this stage, many of us are aware that the menstrual cycle affects female physiology and this can have knock-on impacts, from injury to training adaptation. Despite knowing this, many professionals who work with women struggle to have these conversations. As a physio, I used to think it wasn't within my scope of practice to discuss it. I’ve known many coaches who felt like it was unprofessional or “too personal”. In particular, male professionals can feel daunted by the prospect of discussing what is often considered a taboo subject. The reality is, female athletes will only learn through the professionals they work with. Our discomfort at discussing the topic is a direct barrier to women optimising their health and performance, so it's time we started working through this.
The first step is education. If you don't have a basic understanding of female/male physiological differences and the menstrual cycle, you won't feel comfortable discussing it with clients. Too often we decide that a client's failure to progress might be down to “woman problems” only after we have ruled out the areas of health we are well versed in, like nutrition, training load management, sleep hygiene etc. This is not good enough. If you are not willing to learn, or you expect your female clients to figure out their physiology for themselves, then I strongly recommend you stop working with female clients.
Reframe your outlook
Even amongst those who do have a good understanding of this topic, talking openly with female clients about the menstrual cycle can still seem daunting, especially for male coaches and health professionals. It’s important to remember that just because you don't have a menstrual cycle does not make you unqualified to discuss it with female clients. Do not assume that you know less about the science behind the menstrual cycle than your female clients just because you have no first-hand experience of it. As I mentioned earlier, if you are willing to train female clients, you need to be willing to discuss this with them.
It’s not about sex
Female menstruation is still a major taboo in the sports industry. Perhaps it’s because we learned about the menstrual cycle in conjunction with sexual education in school. It is perceived as an unprofessional or inappropriate conversation to have as if asking a client about their cycle is the same as asking them about their sex life. We have to separate the two and reframe our outlook. The menstrual cycle is just a fluctuation of hormones and physiological events. It is a valuable barometer of health and performance.
How to start the conversation
Once you have educated yourself and reframed the role of the menstrual cycle as a marker for health, you are ready to talk to clients. But how do you start the conversation? I recommend discussing it alongside other health questions. I ask clients if they have any general health concerns or take medication. Sometimes they might mention contraceptive medication here. If they don’t, I then ask directly if they use any hormonal medication or devices. Based on the answer, I will explain my reasons for asking and start a conversation about hormones and physiology. I aim to educate them and make them feel comfortable. I also encourage them to ask questions if they have them and mention that I may ask about their cycle in the future. This makes it easier for me to broach the topic again without alarming the client. It can also be helpful to have some written or online resources to refer your client to. This improves their education and their willingness to discuss it in future.
And now you are ready. Check out other blog articles here and my Instagram page @thephysionomad for more info on working with the female menstrual cycle.