Women's Health

Acne, osteoporosis, incontinence, menstrual problems - learn more about some of the most common health issues affecting female runners


Posted: 10 September 2009

Apart from the sort of injuries that can plague all runners – shin splints, black toenails, tendonitis – there are some health issues that are more prevalent in women runners, and some that are exclusively female.

Acne

Women runners can be plagued by skin breakouts on their face, hairline, upper back, chest, upper arms and buttocks. Sweat production combined with hair follicles or friction caused from rubbing clothes is a formula for acne. Increased temperature and humidity exacerbate the problem, as do products such as sun screen and make-up, which sweat off on to the skin and clog pores.
To fend off acne, follow these steps:

  1. Minimise the use of make-up and hair-care products before running. The best make-up for running is no make-up at all. If time allows, wash your face before running, and again after you run before re-applying make-up.
  2. Use a sunscreen specifically formulated for the skin on your face and neck. Choose a gel or lotion for the rest of your body, rather than a cream.
  3. Wipe acne-prone areas with an astringent pad or towelette immediately after running. (Once your body's natural oils cool, they harden, leading to plugged pores.)
  4. Change out of sweaty exercise clothes straight after running, and shower as soon as possible.
  5. Cleanse acne-prone areas thoroughly. Gentle exfoliation can help, but don't scrub to the point of aggravating your skin.
  6. If you are prone to acne, consult a dermatologist about the use of prescription medication.

"The Pill"

Researchers disagree about the impact of the pill on athletic performance. Though most studies have shown the pill has no effect on performance, some research indicates it may cause a slight reduction in aerobic capacity.
On the other hand, some runners feel the pill helps performance by reducing menstrual symptoms. These runners prefer taking the pill so they can control their cycle and don't have to race when they are having their period. Although it is safe to manipulate the timing of your period, experts generally agree this practice should be reserved for major competitions and done only a few times a year. Ultimately, you need to decide for yourself whether taking the pill makes sense for you. For every runner who swears by it, there is another who insists she feels and performs better without it. If you run recreationally, you probably don't have to worry about any athletic impact of the pill. On the other hand, if you race competitively and don't want to risk sacrificing aerobic capacity, you might want to consider using another method of contraception.

Incontinence

Women are more prone to stress incontinence because of their anatomy. It's estimated that one in two women experience some level of urine leakage and it is annoying and disconcerting.
Although running does not cause incontinence, the activity – as well as that of other exercises and sports – can induce urine leakage in women who are already prone to it.
Many women find relief by strengthening the muscles in the pelvic area with Kegel exercises. To do these, contract your pelvic muscles as if you are attempting to stop a flow of urine. Hold for a few seconds, and then release, and repeat for up to five minutes. For greater effectiveness, do this exercise in a variety of positions: sitting, standing, lying down. There are also several devices that can be bought over the counter or with a prescription that help control leakage. Talk to your GP about what might work best for you.

Menstrual Problems

Although some women complain of discomfort during their periods, it is generally accepted menstruation has limited impact on exercise performance. Women have run well, set records and won championships at all phases of the menstrual cycle. Clinical studies have shown no change in heart-rate, strength or endurance during the cycle. Exercise can improve your feelings of well-being before and during your period. Some doctors even prescribe exercise for women who suffer discomfort at this time of the month. Research has shown moderate exercise can alleviate physical pre-menstrual symptoms, including breast tenderness and fluid retention. Working out regularly is also thought to relieve the mood disturbances characteristic of premenstrual syndrome.

A potential problem for runners is the cessation of menstruation. Women who run strenuously may be at higher risk of having "athletic amenorrhoea", or irregular or absent periods. Training stress, performance pressure, low body fat and inadequate nutrition are all possible contributing factors. These elements create an equation of energy balance, and when it tips towards the negative – whether from running itself or from associated stress – some women will suffer menstrual irregularities. Young runners, those who train at intense levels and those with a history of menstrual irregularities are most likely to suffer from these problems.

One of the most serious consequences of amenorrhoea is osteoporosis, which happens because female hormones, which protect calcium in bone, are in short supply. An early onset of osteoporosis can lead to a greatly increased risk of stress fractures and acute fractures, and since decreased bone density is not easily reversed, it might last for the rest of your life.

An additional concern is lack of ovulation. Because women can menstruate even when not ovulating, the presence of a period does not guarantee a healthy menstrual cycle. A lack of ovulation can signal insufficient levels of progesterone, which can lead to over-stimulation of the uterine lining, putting you at risk of endometrial cancer.

If you suspect you are not ovulating, track your temperature as if you were trying to conceive. A woman's body temperature is generally lower at the beginning of her monthly cycle and higher for the last two weeks. The increase in temperature occurs at the time of ovulation. To track this cycle, take your temperature first thing in the morning, before you wake. If your results don't follow the pattern, the chances are you aren't ovulating. A complete lack of pre-menstrual symptoms is another clue. If your conditions point towards any sort of irregularity, consult your doctor.

Osteoporosis

Weight-bearing exercise, such as running, can help build and maintain bone density levels in women, but women who have abnormal menstrual cycles, that can arise from the combined physical and mental stress of over-training and disordered eating, may not gain these benefits.

Several studies have shown women who have disrupted menstrual cycles suffer more stess fractures than their counterparts with normal cycles. These women typically exhibit lower levels of bone mineral density. Although it's generally accepted that hormonal disruptions and premature loss of bone density are linked in female athletes, the cause and effect relationship is not clear. For example, some researchers think the kind of women drawn to intense exercise is more likely to exhibit stress in all areas of life, which could affect hormone levels even without exercise.

Experts agree women must act to protect themselves from early-onset osteoporosis. It's particularly important as once she is past her mid-thirties, a woman can no longer build bone mass, but only maintain her reserves. You should take every precaution to ensure you are not losing bone mass. That means eating a properly balanced diet – in addition to all the important nutrients, and calcium in particular, you should make sure you are consuming enough fat and calories overall to sustain your level of exercise. Monitor your menstrual cycle, and if there are any irregularities consult your doctor. A bone test might be in order.


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