Madrid.- Amenorrhea, oligomenorrhea, luteal phase dysfunction … are medical terms with which most athletes are familiar, particularly high-performance athletes who know how the continuous search for excellence affects their bodies.

They are all related to the menstrual cycle, a cycle that undergoes multiple alterations during the competitive life of an athlete. The abrupt interruption of physical activity, such as that now suffered by athletes due to the forced confinement in their homes, can end or at least lessen these irregularities. The cycle experiences a ‘new normal’ to which it is not accustomed.

“Sport is what causes the anomaly,” explained Dr. Pedro Manonelles, president of the Spanish Society of Sports Medicine and director of the International Chair of the same specialty at UCAM.

“If the state of alarm is prolonged, as it seems, more than two months, it is easy for many athletes to improve or normalize their menstrual situation during that time,” said the doctor.

The arrival of menarche (date of the first period), the return of menstruation after a stage of amenorrhea (absence of it) or the return to the 28-day cycles and the end of oligomenorrhea (longest menstrual cycle of the usual) are situations for which athletes living in isolation due to coronavirus should be prepared.

“Menstrual disturbances come with exercise at a very high sports level or with very strict weight control. The alteration is directly proportional to the level of exercise,” said Manonelles in a telephone conversation from Zaragoza.

“It is curious that the changes in this case are reversed: the decrease in activity is what brings normality,” he said.

“It all depends on the exercise that the athlete does at home, which is where she should be now, but it will hardly be comparable to her usual activity. It will necessarily have been greatly reduced,” said the doctor.

Therefore, it is normal that “the effect of menstrual disturbance disappears or greatly decreases.” If they are maintained, the disturbances revert or improve, “he stressed.

The hormonal changes that a woman may experience also depend “on the intensity of the exercise and on the body morphology of the person who practices this sport. It is not the same,” she said, “an ultramarathon runner as a gymnast.”

LucĂ­a Guisado, Spanish coach of artistic gymnastics, indicated that her athletes have not referred to her during this stage any incident related to the rule.

But remember that when some of them were not yet menstruating, they had precisely their first period “coinciding with a break for some reason, such as injury or vacation.” The weight gain that athletes usually experience in this period without competitions or training also affects the female menstrual cycle.

“These days you can get a little fat and amenorrhea has to do with the percentage of body fat,” recalled Dr. Manonelles, so the rule may reappear in athletes who had lost it.

It can also vary, although on this the professor assured that there is little literature, “the amount of menstruation”. In the event of an extraordinary increase, it must be borne in mind that “increased bleeding increases the level of iron loss”, with the consequent risk of anemia.

As for the sports performance of women during their menstruation, “in some it decreases and in others it even improves, the behavior is variable”.

“If menstruation greatly affects performance, you can change the date of the period,” she said. It is usually made with contraceptives. “But now it doesn’t have to be done, since there is no competition,” added Dr. Manonelles, who was a doctor for the national team and women’s basketball teams.

“If there is already an athlete on regular hormonal treatment, all you have to do is stick with it,” he said. Pedro Manonelles pointed to another factor that, together with the decrease in physical activity, can alter in these days of confinement the menstrual cycle of athletes: stress.

“The psychological stress that confinement brings also influences. A woman affected or worried about the possibility of not going to a competition or about the risk of missing a scholarship may perfectly suffer menstrual changes because of it,” said the specialist.

Natalia Arriaga

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