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Coaching Female Participants

An introduction to menstrual health and its impact on female participants, first in a series on the topic from the Welsh Institute of Performance Science's Natalie Brown

Sport and physical activity participation is influenced by many interacting factors from a biopsychosocial perspective (biological, psychological and sociological). Those three domains have become a popular way of characterising human development. For more on this, read our guide, Understanding the BioPsychoSocial Model.

Within this complex and dynamic development, there are some factors specific to women that may impact participation and performance in sport and physical activity. Research has questioned approaches to training female participants in the same manner as their male counterparts due to the anatomical, physiological and endocrine differences between the sexes.  

Females are not smaller male participants. Coaches should understand female-specific factors and issues to support their health and performance and incorporate this into practice design, training and coaching.

Female specific factors include:

  • Bra/breast health.
  • Pelvic floor health.
  • Menstrual cycle.
  • Hormonal contraceptives.

Key Facts

  • Breasts are made of fat and glands, not muscle.  
  • The only thing supporting the breasts during movement is the skin, which is why a good fitting sports bra is essential.  A well-fitted sports bra can reduce breast pain, decrease the risk of damage to the breasts (e.g. skin stretch) and improve running and breathing mechanics. 
  • Breasts can change size and shape across the menstrual cycle and pain may be experienced in the pre-menstrual phase. Some females benefit from a different size and/or type (compression, encapsulation, combination) of bra at different times of the cycle. It is important to educate female participants on the importance and benefit of a well-fitted sports bra.
  • Stress urinary incontinence (SUI) is the involuntary leakage of urine.  
  • A rise in pressure within the abdominal cavity occurs with activities such as holding deep breaths, heavy lifting and high-impact exercise (e.g trampolining).  
  • Although SUI is common in some sports, it should not be normalised. In sport, sudden intra-abdominal pressure increases may cause SUI caused by either a weakness of pelvic floor muscles compared to deep abdominal muscles or due to overactivity of the pelvic floor, leading to fatigue. 
  • Females should seek medical advice if they are experiencing urine leakage or other symptoms of pelvic floor dysfunction.
  • Is a repeating pattern of fluctuating hormones (oestrogen, progesterone, luteinising hormone and follicle stimulating hormone).  
  • The hormones levels will differ in each individual, influencing how a female feels, both physically and emotionally.  For example, a female may experience stomach cramps, bloating and changes in mood during the late luteal (premenstrual) phase of their menstrual cycle. 
  • The menstrual cycle is a good sign of health in females and closely linked to increased injury risk and relative energy deficiency in sport (RED-S). 
  • There are different forms of hormonal contraceptives, including oral contraceptive pills (the combined pill or mini pill), implants and intrauterine devices (coils).  
  • Females may use hormonal contraceptives to avoid pregnancy, control symptoms such as having bad cramps or to control timing of periods.  
  • Females may experience withdrawal bleeds. This is not classed as a period and is not indicative of a normal menstrual cycle.  
  • Some females may experience symptoms whilst using hormonal contraceptives, for example headaches and changes to mood. It’s always good to seek medical advice to see if there is a better option for the individual.

More from Natalie Brown

This is the first resource in a series on menstrual health developed with Natalie Brown


Related Resources

  • Talking Talent: BioPsychoSocial

  • Menstrual Cycles and Participation


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UK Coaching Team