Women are just as passionate about their exercise as men, but they face some unique problems. Here are some thoughts for you on your running journey!!

Women are different from men.

As simple and intuitive as that sounds, there is so much behind it. From head to toe – and that includes what’s on the inside – the mental, physical and physiological make-up of the woman makes her unique when she exercises.

Major physical differences between women and men
Area of difference	WOMEN generally have …
Bones	Smaller and shorter bones (relative to body length) with lower bone mass Broader pelvis with thighs that slant in towards the knees Narrower shoulders and wider carrying angle of the elbows
Body composition	Higher percentage of body fat More rounded body contours with greater subcutaneous body fat, especially in the buttocks Less muscle in relation to body mass
Fitness	Lower capacity to carry oxygen in the blood Higher heart rate and lower lung capacity Lower maximum aerobic capacity Smaller lung and heart volume Lower muscle strength

The main challenges that women face when they become involved in regular exercise – particularly at higher levels of frequency, intensity and time duration – are related to menstruation, the ability to get pregnant, exercise when they do get pregnant, and bone conditions such as osteoporosis. Let’s have a look at each of these in turn and de-mystify the issues on the way to creating solutions !!

Irregularities of menstruation 

Sometimes called “disorders” of the menstrual cycle, these arise from participation in physical activity, exercise and sports. Some common menstrual irregularities include:

1. Delay on onset of menstrual bleeding. This affects girls who have been involved in high performance exercise and sports, either before the onset of menarche or soon after it. This is commonly seen in young dancers, gymnasts, runners and other high intensity sports. It is not clear if such delay has any ill-effects but it does cause concern, usually amongst parents of the child rather than the soon-to-be teenager herself.
2. Irregular or no menstruation. Active sports women have a higher incidence of oligomenorrhea (irregular periods) and ammenorrhoea (no periods, or less than 3 menstrual cycles in year). Such conditions are more common in certain sports such as long-distance running, and cycling. While some women deem this a wonderful freedom from monthly inconvenience, it is of great concern to others. There arises a difficulty in using non-barrier or chemical methods of contraception, and uncertainty over getting pregnant. 

The cause of such irregularities can largely be traced to alterations in the levels of certain hormones in the body. And these are themselves related to certain factors such as:

Dietary inadequacies. One of the universal problems for sports people (irrespective of gender) is meeting the energy and other nutritional needs to sustain a sport involvement. Inadequacies in the amount of calories consumed, as well as protein and calcium, are key factors in menstrual irregularities. This is made worse when active women adopt dietary patterns for the purposes of weight loss, or according to some fad.

Low levels of body fat. There is a clearly recognized fact: women athletes with lower body fat levels have a higher occurrence of menstrual irregularities. There is no magic number to the body fat level that must be maintained to avoid this, as there is so much variation between women. But if this is a suspected cause of menstrual irregularities – and possibly in conjunction with diet lapses – an immediate approach would be to encourage a gain in body fat to see if this corrects the menstrual disorder.

Amount of exercise & stress. Menstrual irregularities are more common in women athletes who are under stress or who engage in higher intensities or frequency of exercise. The stress may arise from many sources, including the stress of higher-intensity exercise itself. Both the raised stress levels and the higher volume of exercise result in increased levels of certain hormones that may interfere with menstruation.

More problems for women … 

Arising from the irregularities of the menstrual cycle, women then face 2 major problems: inability to conceive and have children, and osteoporosis. Now, there is some suppressed mirth out there as you read this, as some women would be most happy not being able to conceive. But for their counterparts who do want to raise a family, they should know that women who exercise intensively not only have menstrual irregularities but also have menstrual cycles in which the ovaries do not produce what is needed for pregnancy to occur (called “anovulatory” cycles).

The other problematic condition is one in which the density of the bones reduces. This usually occurs in the first few years after menstrual irregularities start, and can lead to the conditions known as osteopenia and the more serious osteoporosis. In simple terms, the bone is weaker in these conditions and may increase the risk of fractures in older age. But there is a more immediate threat: with less minerals in the bone, women athletes are also at a higher risk of developing stress fractures.

Catch phrase: You may have heard of something called the Female Athlete Triad. This is a combination of disorders of international concern. It refers to women who are actively engaged in exercise and who have 3 disorders that are inter-linked: menstrual irregularities, eating disorders, and osteoporosis.

So what to do ??

Before you panic and start to deny your female status, let’s sit down and talk about some practical things you can do to manage these conditions. First of all, not every active woman athlete is necessarily going to develop any of these problems. Careful attention to training volume, good nutrition (to meet energy and nutrient needs), and the use of a training/health log will contribute to good health.

Uses of the health/training log

Record details of §  exercise : when, how hard, how long you exercised §  nutrition: calories, nutrients, vitamins, minerals §  health: illness, injury §  menstrual cycles §  body characteristics: weight, body fat, etc   Use the log to: §  Adjust your training load to avoid over-training §  Plan gradual training increases & progression §  Monitor signs of over-training (illness, injury, menstrual cycle changes) §  Note changes in menstruation, etc

If you think that you are possibly having a problem related to your active lifestyle of sports and exercise, you may want to discuss this with someone with professional training and knowledge in the area. Management of womens’ problems related to exercise involves a true team approach: the sports medicine doctor, gynecologist, nutritionist, and perhaps even the endocrinologist.

Your first stop could be the sports doctor who will have an understanding of both your sports, exercise & fitness, and the problems of women who exercise. If you have a training log, bring that along as well. A detailed review of your concerns and possible factors that may need to be modified or managed will form the basis of a planned approach to being where you want to be. (A quick tip: you might also want to manage any sports-related aches and pain at the same time).

The important thing to do is to be aware that such problems arise, take stock of your own situation, and then step out positively in overcoming and managing them. Remember that what may be a problem now may be the path to performance improvement in the future.