2019-05-01_Runners_World_UK

MAY 2019 RUNNERSWORLD.COM/UK 053

PERIODISATION

over 1,000 female runners at the

London Marathon expo, she found

that 36 per cent reported HMB.

Around a third of runners also

reported a history of anaemia.

However, while half of them had

supplemented with iron, only 22 per

cent had sought medical advice.

Anaemia symptoms can include

fatiguing easily, loss of energy and

a rapid heartbeat and shortness of

breath with exercise. You can see

how it would be easy to pass this

off as lack of fitness, but as Craggs

discovered with his runner’s huge

PB, adjusting iron to normal levels

can have a massive positive impact

on performance.

But how do you know what

constitutes ‘heavy’ and whether

and stabilising the knee. Perhaps
unsurprisingly, as oestrogen
f luctuates through the menstrual
cycle, so does risk of this particular
injury – study reviews published
in Muscle, Ligaments and Tendons
Journal and The Othapaedic Journal
of Sports Medicine concluded that
the greatest risk is in week two of a
normal cycle – the days just leading
up to, and including, ovulation.
But what if it’s more than just
cramps? Much attention recently
has – rightly – surrounded the issue
of endurance athletes not having
periods for months or years on end,
and the terrible impact this can have
on their health. But at the other
extreme, heavy menstrual bleeding
(HMB) – or menorrhagia – affects
around a quarter of women. Yet
we know almost nothing about
its frequency among regular
exercisers as there’s very little
research on it. When the
research scientist
Georgie Bruinvels,
herself a 2:37
marathon
runner,
surveyed

you have HMB? Clinically, the

definition is 80ml blood loss per

cycle. But as Bruinvels says, ‘How do

you even measure that? Realistically,

who wants to measure that? And

even if you did, not all menstrual

f luid is blood – perhaps only about

half. It’s just not very helpful.’

The National Institute for Clinical

Excellence (NICE) have their own

criteria: ‘Excessive menstrual blood

loss which interferes with a woman’s

physical, social, emotional and/

or material quality of life’. This is

also vague and subjective, so when

Bruinvels was researching the area

for her PhD, she came up with her

own four-part criteria: bleeding

through clothing or bedding; passing

large clots; needing double sanitary

protection; needing to change

sanitary products more frequently.

‘Because people don’t talk about

it, they don’t know if their situation

is abnormal,’ says Bruinvels

‘Women often experience

symptoms and just

accept them and

think, “I’m a

woman,

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WHAT
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WHEN
A GUIDE TO MATCHING YOUR NUTRITION
TO YOUR CYCLE, FROM SCIENTIST
GEORGIE BRUINVELS
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