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  Menstruation and Dance

This is the first of our Wednesday Wisdom posts written on a subject chosen by you. Thanks to the parent of one of our students for requesting this one:


This post is written for girls, and women, and all who would like to better understand the relationship between menstruation and the potential effect it has on dance practice and on the body.


The first and most obvious factor, likely to have an impact on one’s health and wellbeing for dance, is the level of iron within the body. Heavy periods have the potential to cause an iron deficiency, particularly if iron loss is not matched by iron intake from your diet or from supplements. Challis and Stevens and the IADMS Dance Educators’ Committee compiled a Nutrition Resource Paper for dancers, in which they state; ‘Dancers should include normal amounts of iron-rich foods in their daily diet. Dancers who have heavy menstrual periods may need iron supplementation; this need can be confirmed with routine blood work’ (2019, p. 24). Research suggests that female dancers and athletes do not consume enough iron and are often iron deficient (Clarkson, 1998).


Iron is an essential mineral required for many important processes within the body, including forming haemoglobin, producing red blood cells and transporting oxygen to the working muscles. Iron is essential, not only for the muscular system, but also for the brain and the functioning of the immune system. An iron deficiency is likely to cause tiredness, headaches, dizziness, irritability and will compromise your ability to focus; all of which will have a detrimental effect on your dance performance. In order to guard against iron deficiency dancers should ensure they eat iron-rich foods as part of a healthy, well-balanced diet. Mineral supplements could also be taken, to compliment a healthy diet, which is paramount. Iron is better absorbed through animal products such as red meat and egg yolks, which contain high quantities of iron. Plant alternatives would include leafy green vegetables and dried fruits such as apricots, though these contain lower quantities of iron. The type of iron found in animal products is heme-iron, and it is usually better absorbed by the body than non-heme iron. The University of Edinburgh’s HOPE initiative and website, (Healthy Optimal Periods for Everyone), suggests that, for vegetarians, Vitamin C (present in fresh fruit and vegetables), may help the absorption of non-heme iron (University of Edinburgh, 2022). They also report that a small amount of research has begun to suggest that a low-fat vegetarian diet combined with calcium supplements has the potential to help with period pain, both in terms of duration and intensity.


One of the best resources I came across during my research for this subject was an article written for DANCE Magazine in March 2020, authored by Emma Sandall who teamed up with Dr Selina Shah, a physician and former professional ballet dancer, that talks you through each stage of the menstrual cycle, explaining what happens, and the potential effects this can have on you and your dancing, alongside what you can do in response to alleviate the associated issues and discomforts. The detailed hormone fluctuations are particularly insightful, as these change significantly from week to week, bringing about a variety of symptoms, including loss of appetite, tiredness, and affecting energy levels, mood, coordination and concentration levels. Here is a summary of the weeks within the menstrual cycle, but please do read the original article cited in the references (Sandall, 2020):


Week 1 begins with the period which lasts on average between 3 and 7 days. It is at this point that iron levels may be low as outlined above, causing tiredness. With oestrogen and progesterone at their lowest, the uterus contracts as the lining is broken down, which can cause abdominal cramps and discomfort. Other symptoms might include water retention, constipation, bloating and diarrhoea. Dr Shah confirms that exercise is in fact good at alleviating many of these symptoms, so no need to stop dancing. She also suggests anti-inflammatories to help with the cramps, along with a hot compress for the stomach. Dr Shah recommends avoiding caffeine as she suggests this can aggravate pain and discomfort.


Week 2 centres around ovulation, bought about by rising oestrogen levels. Oestrogen is reported to suppress appetite at this time. At this point in the cycle the authors suggest women feel at their best; confident and focused with high levels of energy. Understanding and appreciating this has the potential to assist in forward planning for creative projects and engagements. Interestingly, a small spike in testosterone during this week is reported to bring out your competitive side.


In Week 3 oestrogen drops and progesterone rises as the uterine wall continues to thicken. It is at this time in the cycle that PMS symptoms appear and women often report feeling down, teary and emotional. Energy levels may also drop. Dance and exercise are recommended in terms of “perking up the whole system” (Sandall, 2020). Dr Shah also suggests getting plenty of sleep, practising meditation, and eating small meals in order to stimulate your metabolism and raise energy levels. Complex carbohydrates and lean protein are recommended. Complex carbohydrates are turned into glucose within the body and are then used to boost energy levels. Good examples of complex carbohydrates include beans, potatoes, wholegrains and vegetables such as broccoli, green beans and asparagus. Simple carbohydrates are broken down easily by the body, whereas complex carbohydrates have more nutrients and take longer to break down and digest; they therefore help to fill you up and won’t cause the same drops in blood sugar that simple carbohydrates do. Examples of lean proteins could include chicken (skinless), salmon, tuna, eggs, liver, white-fleshed fish, cottage cheese, tofu and plain Greek yoghurt.


Week 4 is the premenstrual stage; oestrogen and progesterone eventually continue to drop. Eventually these low levels cause the uterine wall to begin to break down as the whole cycle begins again. PMS symptoms are likely to return, which could include tender breasts, fatigue, headaches and food cravings. Dr Shah suggests anti-inflammatories to assist with aches and pains, plenty of sleep and a well-balanced diet, although satisfying food cravings is perfectly acceptable in moderation.


So, in summary: to keep well and dance well during your period eat a healthy, well balanced diet; keep an eye on your iron levels during heavy periods and perhaps consider increasing iron intake through diet and/or investing in supplements; get plenty of sleep; avoid too much caffeine as it can aggravate pain; and above all keep dancing where possible.


References:


Challis, J. & Stevens, A., and the IADMS Dance Educators’ Committee. (2019). Nutrition Resource Paper. https://iadms.org/media/3589/iadms-resource-paper-nutrition-resource-paper.pdf


Clarkson, P., M. (1998). An overview of nutrition for female dancers. Journal of Dance Medicine and Science, 2(1), 32-39 http://www.jmichaelryan.com/


Sandall, E. (2020, March 16). The Surprising Ways Menstruation Could Affect Your Dancing. DANCE Magazine. https://www.dancemagazine.com/menstrual-cycle-effects/


University of Edinburgh. (2022). HOPE: Healthy Optimal Periods for Everyone. Retrieved November 16, 2022, from https://www.ed.ac.uk/centre-reproductive-health/hope





Denise Horsley, MSc. – Blommaert Ballet School Dance Science Advisor