Run Well by Juliet McGrattan (reading books for 5 year olds .TXT) 📕

an impact on their training and performance. While this doesn’t mean you shouldn’t run during a period, HMB can make women fear blood leaking onto their clothes and it could potentially cause light-headedness and a lack of energy. It can be associated with cramping pain too. There’s also an increased risk of an iron deficiency anaemia with HMB. This may be transient or longer lasting, but can certainly reduce performance (see here).

Hormonal contraception can help to control HMB, but not every woman wants to or can use it. If you’re concerned about leaking blood, then have a look at some of the ‘period underwear’ available. These are knickers with the ability to absorb and retain blood. For lighter flows they can be used alone, but with heavy bleeding they can just give you some emergency absorption and therefore reassurance. Running skorts, skirts and dresses can hide bulky sanitary pads if that is a concern. Have a look at menstrual cups. As well as being environmentally friendly, these cups, which fit snuggly into the vagina, can hold up to two or three times as much blood as a tampon. They can be emptied and re-fitted while you’re on the go, although you will need to find a loo.

If you think you may be anaemic or heavy bleeding is affecting your daily life and hobbies, then do see your GP. You may need a blood test and potential treatment for anaemia, but options such as using anti-inflammatories or a medication called tranexamic acid to reduce blood flow can be discussed.

Real-life runners

Heavy periods left me exhausted and defeated, both physically and emotionally, and resulted in anaemia. But once my bleeding was resolved, my energy returned and I found the joy in running once again!

Deborah Halliday Mills, writer, runner and mum of boys

Q Can running make my periods stop?

A Sometimes running can lead to amenorrhoea, which is the medical term for absent menstrual periods. Amenorrhoea can be primary (periods never began) or secondary (periods started and then stopped). The definition can vary, but if you have missed periods for between three and six months and you had previously had regular periods, then you would be considered to have secondary amenorrhoea.

There are many causes of secondary amenorrhoea, including pregnancy, menopause, polycystic ovary syndrome, hypothyroidism (underactive thyroid) and stress. It can also be caused by excessive weight loss and excessive exercise, and this is where running may be relevant. If your weight is stable and you are consuming adequate calories to fuel your exercise, then your periods should not be affected, but reduce your calorie intake or increase your activity (or both at once) and you may push the body into a negative energy balance and lose your period. It can be a difficult balance to strike. Without adequate energy the body shuts down some important functions. Menstruation can be one of these. The effects can be widespread in the body and include losing bone strength and being at risk of osteoporosis (see here). The point at which this happens is different for every woman. A regular menstrual cycle should be considered as a sign of good health.

If you have amenorrhoea or your periods have become very infrequent (oligomenorrhoea), then although that may feel like a bonus for a runner – no one wants the inconvenience of bleeding – it is important that the cause is addressed, so please see your doctor to discuss it.

Did you know?

A survey published in the British Medical Journal in 2001 found that British girls today start their periods (menarche) at an average age of around 13. It’s widely believed that the age of menarche has fallen significantly over the years, but this study concluded that compared to girls 20 to 30 years ago, it has only fallen slightly and almost certainly by less than six months.

Q Running gives me spotting. Is this normal?

A Vaginal bleeding between periods is called intermenstrual bleeding (IMB). If the bleeding is just a few drops of blood then it’s called spotting. Strenuous exercise can occasionally trigger it. It’s unclear exactly why it happens but may be due to fluctuating hormone levels from the exertion. However, it’s really important that you don’t assume that this is the cause. There are lots of reasons, some of which may be serious, why spotting can happen. IMB can be due to hormonal contraceptives (particularly methods using progesterone), certain medications, pregnancy and infection. Cervical ectropion (delicate areas of cervical tissue), polyps, fibroids and, more rarely, cancer can cause it too. If you have recurrent bleeding between periods then you should make an appointment with your nurse or GP for an assessment. The nurse or doctor will examine your vagina and cervix with a speculum to work out where the bleeding is coming from. They may take some swabs to rule out infection and take a cervical smear test (if it’s due). If they have any concerns about the appearance of your cervix or are unsure about the cause of bleeding, then they will refer you to a gynaecologist. Once you have been given the all clear then you can return to running knowing that the bleeding is nothing to worry about.

Q Can I run straight after a cervical smear test?

A There’s no reason why you can’t go to your cervical screening in your running kit and run straight home afterwards. Sometimes having a smear can make you bleed a little, but this is usually only some light spotting that a panty liner can cope with, so pop one into your knickers before you leave home. Some women have a very sensitive cervix and find smear tests uncomfortable. Any discomfort is, however, usually very short-lived. If you do have any period-type aches afterwards it shouldn’t be severe enough to stop you running. The only other thing to bear in mind is that very occasionally having a smear test can make you feel light-headed and dizzy. The cervix can sometimes be very sensitive to