NOTE: I am providing fair warning that this post is about menstruation. If you do not want to read about menstruation, my own or in general, I suggest you find more interesting things to read.
FULL DISCLOSURE: I am not a trained medical professional. If this is news to you, wrong blog. Herein lies my experiences and personal thoughts, nothing more, nothing less, that are part and parcel of my quest to be a professional athlete and reach my athletic goals. Stand around in a group of female athletes long enough and the topic will assuredly turn to the interaction of menstruation and training/racing, as both are fundamental parts of who we, as female athletes, are. Menstruation should be nothing to be ashamed of or embarrassed by; just the spoonfuls of our days and ways. But it does embarrass, frustrate, and evade the understanding of some - including sometimes myself. So I have decided to share what I do understand and what I have grasped in the hopes that someone else or all of us can feel a little less embarrassment.
As far as I understand and have experienced, the process of menstruation is pretty much based on feast versus famine: either a female's body thinks it - along with what it "sees" of the outside world: namely nutrition and stress load - is in a good enough position to support a 9-month gestation or it doesn't. If the hormonal switch is flipped to "procreate," things percolate and the uterus gets lined. If the hormonal switch is flipped to "survival mode," other things percolate and the woman's uterus does not get lined. Assuming the "procreate" setting and no fertilization, a period results.
[Notice that at no point did ovulation get mentioned. Not only am I not a doctor, I am definitely not a fertility expert.]
I'm sure - in fact I know! - that other things affect the menstruation cycle, like hormones and glands and tubes and the Interwebs and other things, but I didn't put them there or see them put there, so to me they just ARE. I assume, for better or worse, that mine exist and function. What I do put there or see put there is - and have figured out, through roughly 16 years of non-elective experimentation (hey, I just realized I have been an athlete longer than I have been menstruating...go me!), matter in the whole process - are: sleep; nutrition, both at a macro- and micro-level; and stress, of every kind and creation.
One micro-level nutrient I have come to realize plays a HUGE role in this whole Broadway musical choreographed by the Wizard of Oz is Iron. This stands to reason considering the main ingredient of the lining of the uterine wall, which decomposes and leaves the body as the "period" itself, is blood. And what is the main ingredient of blood? Iron.
And what is one of the main transporters of oxygen to working muscles and other organs? Iron.
And what do working muscles do without oxygen? Not much, or even less than that.
And So Begins The Great Female Athlete Cold War: The War She Has With Herself
When the Body tries to determine feast vs. famine, it takes into account both its iron stores and iron consumption. At least with my body, I can tell that if the Body thinks there is a huge demand for iron and a relatively low supply, it decides that lining the uterus with its precious iron is too risky. The uterus isn't lined and there is no period that month.
The Body would rather keep the already-alive body alive rather than potentially bring life to another body.
If the Body thinks there is a demand that the supply can match (extra points if matched through REGULAR consumption of iron sources), it decides lining the uterus is a pretty evolutionarily ok thing to do. The uterus is lined and there is a period that month (assuming no fertilization).
In this case, the Body is willing to share the wealth with a potential literal hanger-on.
About This Once-A-Month Thing
We (all females) are all taught that we are to get our periods once a month, like clockwork or the turning of the calendar's pages. The consistency is supposed to tell us that we are healthy, our pipes are working fine, and that we are not pregnant. Good news for some, bad for others.
Except that hormones - and how they respond to iron and other nutrition - have evolved over millions of years and Ironman racing is barely 3 decades old (and actually older than women competing the marathon in the Olympics). So the Body is all like "WHOA! What is this swimbikerun stuff that you want me to do at the same time as I prepare to create, house, and deposit tea-cup humans?"
Which makes the once-a-month thing about as old-fashioned as women doing endurance sports is newfangled.
By training as much as we female athletes are wont to do, we are constantly placing our bodies on the razor's edge between feast and famine. The process is so delicately balanced to begin with, and balanced so delicately upon a few things which are simultaneously engaged in a tug-a-war with other things in our bodies - not to mention that many of these things are directly involved in the training we elect to do - that we can't help but throw our bodies out-of-whack and confuse ourselves in the process.
And I used to think putting on a sports bra while sweaty was the biggest challenge I would face as a female athlete.
So When Should I Expect Aunt Flo?
I have an female endurance athlete friend who hasn't menstruated in 12 years. 12.Years. I occasionally go a month or two without getting my period. I think the longest I have gone is 6 months way back in high-school when I was a highly functioning and highly stressed double-sport athlete who had no concept of athletic nutrition.
What I have noticed is that instead of losing it completely, my period generally takes on a new consistency of it's own: in-sync with my training. If only house-training pets were that easy.
But I should point out that I do not believe my period syncs to my training schedule solely based on the physical output of my body, but based on the interaction of the physical output of my body with the inputs into my body. My training is inextricably linked with my nutrition, sleep, and stress level, so of course syncing to training is really just because training is a package deal, like the operating system that runs the MacBook of my life.
And I'm extraordinarily lucky to do what I do and still get a generally regular period! I believe a lot of that is descending from what I call "polar bear genes," genetic material that determines I should carry a layer of subcutaneous fat necessary for Eskimo living - despite not being an Eskimo and living in the antithesis of their climate. Due to this readily available energy source, and for better or worse, my Body thinks the outside world is a pretty darn generous and hospitable place and is happy, pretty regularly, to go along with a million years of evolution. Little does it know the immediately outside world most of the time is a bike saddle...not very hospitable.
What To Do When Aunt Flo Is Your House Guest
I once read article in Cosmo magazine that outlined the "rules" about when women c(sh)ould shave. To paraphrase, women should not shave before exercise (clogs the pores so your body cannot regulate its temperature as well), after exercise (more blood is close to the skin so nicks bleed longer), or in the days before or during their period. In other words, if we played by the "rules," female athletes would be the hairiest people on the planet.
Perhaps the only hard and fast rules I have about shaving are 1) not when I have goose-bumps and 2) not the night before a race. Other than that, they are my armpits, legs, and genitals, I will shave them when I want, not when a magazine tells me.
I feel like similar urban legend-ish myths exist about how to behave - or curb behavior - while menstruating, or simply being a fertile woman. For example, for a long time urban legend said that if women competed in long distance running races, their uteruses (uterii?) would fall out. Hence no Olympic marathon for women until 1984.
It's true that throwing down tons of training while one's body is actively sloughing iron like it's going out of style is not biologically sound. But if a woman is in the "feast" position to get her period regularly, keeping iron levels (relatively) high during menstruation and then replenishing the supply even more adequately post-period should not be that much of a challenge. Easier said than done.
Or actually easy as easy said: find a piece of high-iron food stuff and nibble on it. Tuna, liver, dried thyme, apricots, lentils, sun-dried tomatoes, BEEF, roasted pumpkin seeds, edamame....the list continues. Notice that both animal and non-animal sources are available; the iron in animal sources is just more readily absorb-able to your body.
Or take an iron supplement BUT NOT AT THE SAME TIME AS CALCIUM SUPPLEMENTS (since in the case of absorbing non-animal iron sources, these two butt heads and iron absorption loses). The devil is in the details, always.
I know women who experience severe cramping, severe fatigue, over-tiredness (different than training fatigue, but the two can certainly sum together), and other exciting and fun things over the days before and during their period. Similar to the shaving "rules," I don't think of my reaction to these symptoms strictly from the "I am menstruating" mind-set. If I am experiencing severe stomach issues of a non-menstrual nature, do I train through them? If I am severely fatigued from non-menstrual tiredness, do I train that day? I know I may be simplifying matters some, and discounting the symptoms of women who experience PMDD, but if endurance sports is your job or something you prioritize above other things, special respect does not necessarily need to be paid to Aunt Flo. Tell the woman to cook her own breakfast!
Another way to think about it: How sick down you have to be to stay home from work? Does it matter if it is an ear ache, diarrhea, or the flu?
And even an another way to think about it: on the occasion that I get menstrual cramps, the physical exertion of training actually makes me feel better. Homeopaths would be so proud.
When Aunt Flo Visits Without RSVP-ing
The downside of my period being in-sync with my training is that I get it when I don't want it: around races. To understand why, I go back to The Chemistry.
During training cycles, my Body - and the iron, other food, and stress-level-moderating sleep I put into it - is too busy keeping up with me, swimbikerunning, recovering, and doing it all over again day after day. When I take a true recovery week or start tapering, my Body is like "Dude! You mean I get to eat the same amount of food, or more, and sleep the same amount hours, or more, and swimbikerun less? All hands on deck!! Flip the switch to procreate! Flip the switch to procreate!" I can just hear the drums. I think Piggy uttered the same words just before they killed him.
The Choose-Your-Own-Adventure of Righting The Ship
I know many women who use conventional medicine - or the convenient by-product of trustworthy contraception - to assure themselves that they will never get their period before or during a race.
I also know several women who, and instances in which women, got their periods in the middle of races. Yeah, not the most fun thing in the world, but probably something most of us who don't use conventional medicine will experience if we race enough.
I have also heard accounts of women who have tried to use conventional medicine to bring consistency and plan-ability, not to mention reliable contraception, to their periods, only to experience HUGE mental and physical down-sides: uncontrollable mood swings, cramps, bloating, digestive issues, you name it.
And this is where I get nervous and draw my personal line: I have worked hard to know my body as intimately as I do, a knowledge that warns me about injuries, highlights training problems, and let's me know when and how to fuel myself. I am not willing to give away that knowledge solely in order prevent the possibility, however big or small, that at some point in my career I will have to take an extra long transition to change a tampon or finish a race with blood on my legs. The short-term embarrassment over a bodily function 50% of our species experience I can deal with; losing my feel for my own body I cannot. I imagine it would be like suddenly having to drive a car with a kaleidoscope attached to my face.
The Instruction Manual
Nobody's body comes with an instruction manual. Here is what I have tentatively written in my own:
If I haven't eat red meat or an iron-dense food source in a while (definition of a "while" is days to weeks), I will get my period 36-48 hours after eating one, as long as I am not training big volume.
If I get into a serious nutritional - most notably, fat consumption - hole (think days and weeks, not hours or a day) and get out of it one fell swoop (ex. buffet meal, wedding reception, week-end vacation), I will get my period within 36-48 hours, no matter what training cycle I am in.
Chances are good (80-90%) that if 30 or more days have passed since my last period and I take a recovery week, I will get my period by Thursday. Since the timing isn't food related and my Body is essentially doing this to "keep me regular," the period will be light and short.
You will notice, or at least I have noticed, that the most consistent thing I can say about my period as a female athlete is that it is always sitting in wait, ready for me to give it what it needs to get along with its evolutionary business. It's like Audrey II: "Feed me, Kelzie!" Sometimes it does just get fed up and proceed of it's own accord, but most of the time, if it does not get what it needs, that month gets skipped, simple - or not so simple - as that.
Sixteen years on, and other than that, all bets are off.