Tracking her menstrual cycle meticulously is a priority for Eloise Hayward. Four years ago, the Great Britain sevens player suffered significant ankle ligament damage on the rugby pitch just a couple of days before her period was due.
“In the warm-up I remember feeling a bit loose,” says Hayward. “There’s a fine line between feeling loose and primed and game-ready. During the match my ankle went.”
While Hayward acknowledges that her training load may have played a role in the injury – at the time she was switching between rugby league in the summer and union in the winter – she firmly believes that the timing of her injury was more than mere coincidence.
Hayward, who recently joined Leicester Tigers, was in the luteal phase of her menstrual cycle, the fourth and final stage of a woman’s cycle when levels of relaxin, a hormone known to increase ligamentous laxity, begin to rise. Although female athletes are still under-researched in sports science, there is a growing body of evidence indicating that this hormone increases the risk of ligament injuries.
Hayward’s own injury sparked her interest in how menstrual cycles affect athletic performance. Her university dissertation, published earlier this year in the International Journal of Environmental Research and Public Health, examined how elite women’s rugby players perceive menstrual cycle risk.
Fear of losing place if take time off
Out of 150 elite rugby players from the top two English rugby divisions, the RFL Women’s Super League and Premiership Women’s Rugby in union, 90% believed that the menstrual cycle negatively impacts performance. Moreover, 86% felt uncomfortable skipping training due to their menstrual cycle, fearing losing their position in the squad or facing judgment from others.
Players reported reduced appetite, nausea, fatigue, strength decline, heightened emotions, and poor focus during their period.
“If you’re going into a tackle and you’re not fully committed to it because you’re in pain or have symptoms, or you’re psychologically not present, you’re more likely to get injured,” says Hayward, who found some players’ anonymous comments “mindblowing.”
One player stated: “My coordination, power, and endurance are worse, and I’m more anxious and fearful of contact situations [when on my period].”
Anxiety about leaking through kit was also a significant concern, with one player mentioning: “White shorts can have a big impact as there is always a fear of leaking through clothes, but this fear is exacerbated when wearing white shorts. Also, the feeling of being unhygienic, having to go to the toilet several times before kick-off, it can be stressful to cope with on top of match day.”
Monitoring menstrual cycles in elite sports is a relatively new practice, but it is increasingly linked to success on the field. The United States women’s football team garnered global attention for implementing an innovative period tracking system that was credited for their 2019 World Cup win.
England’s Lionesses utilized the powers and challenges of periods during their victorious European Championship run in 2022, utilizing the popular FitrWoman app. This period tracking app is used by numerous professional female athletes worldwide, from LPGA Tour players to WNBA athletes to Chelsea footballers.
In rugby, there has been less of a systematic approach to monitoring menstrual cycles, but the Welsh Rugby Union has made strides in this area. Last year, the union partnered with Vodafone to provide women’s team players with cutting-edge technology to monitor their menstrual cycle data in detail.
‘It’s been massive for this player’
Unlike standard period tracking apps, the Player Connect app allows variables such as mood and sleep levels to be cross-referenced with a player’s menstrual cycle phase. “The app has been excellent in correlating mood, energy, and sleep with the phase, providing us with useful graphs and data to assess trends,” explains Jo Perkins, the WRU head women’s physio.
The app is beneficial for players who are not on contraceptive pills, meaning that not every member of Wales’ 37-player Six Nations squad is able to utilize it. A quarter of the 150 women surveyed in the BBC’s Elite British Sportswomen Study reported taking contraceptive pills specifically to manage the impact of their period on performance.
Nevertheless, the app has been transformative for some players. Perkins shared the case of a player who experienced fatigue, illness, low mood, and low energy consistently during a specific phase of her cycle for months.
“The app allowed us to intervene during that phase with an increase in carbohydrates and cooling strategies like ice towels, cooler drinks, and cooler rooms to assist with sleep,” says Perkins. “This resulted in the player feeling better and, most importantly, improving their wellness at that time. It’s been a game-changer for this player.”
The use of fem tech like this is not yet prevalent throughout the sport, and Hayward believes more can be done at the domestic level to educate women about their menstrual cycle so they can adjust their training accordingly.
“At clubs I’ve been with, there have been inquiries about our periods or symptoms,” says Hayward. “That’s great, but what are clubs doing with that information? It’s just two questions. Could they invest in a year’s subscription to a menstrual cycle app?”
Rugby is starting to recognize the power of periods, but there is still progress to be made across the sport.
