Physiologically, the female athlete has to deal with menstruation. Stress, diet, overtraining and other factors can alter the normal menstrual cycle and hormonal balance. This article provides a brief overview with tips on how to
manage month to month.

Onset of menstruation is typically between the ages of 13 and 16. A disruption of the normal menstrual pattern can be due to training overloads, caloric deficits, or a host of clinical problems. (Never assume that menstrual irregularities are due to training. Always consult a physician.) When this happens, the normal cycling of estrogen is upset, and estrogen is an important hormone for more than just reproductive health. Iron deficiency anemia is the most common nutritional deficiency worldwide and is particularly common among females. Low serum ferritin concentrations ( <20 ng/ml) are indicative of depleted iron stores and this can hurt performance due to needless fatigue. If your iron losses are high (via heavy menstrual periods) and iron intake is low (because of eating little or no red meat), be sure to get routine blood tests and consume an iron-rich diet (via ironfortified breakfast cereals and breads).

Energy intakes are generally higher in the premenstrual phase and some female athletes also have food cravings as their period approaches. Include protein at all meals and snacks to temper or stop the cravings. For example, try cottage cheese & peaches, or peanut butter & an apple, plain yogurt with raisins & almonds, or half a turkey sandwich.

Fluid retention is common in the days leading up to a period because certain hormones cause the body to hold salt. Limit the amount of salt in your diet by choosing low salt snack foods, soups and sauces. Try not to add salt to food at the table and avoid eating too many high processed foods. Foods at restaurants usually have more salt than you would include at home, so try not to eat out too often.

Reduce your intake of fat, caffeine and alcohol. Moderation of these foods is healthy in the long term and for management of premenstrual syndrome (PMS).

Be sure you are getting your required levels of calcium by having at least 3 servings of low fat dairy per day (1 serving = 1 cup milk or calcium-fortified beverage or ¾ cup yogurt).

Other common symptoms of PMS include moodiness, fatigue and constipation. Make sure you have a fibre-rich diet by eating lots of fruits, vegetables and high fibre breads, cereals and whole grains. Aim for at least 6 servings of fruits and vegetables per day.

Stay hydrated by drinking enough water to keep your urine pale in color.

Take a daily multivitamin and mineral supplement that provides all the B vitamins, calcium and iron.

Keep training as you are able, and get at least 9 hours of uninterrupted sleep at night.

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