As the game has grown so has understanding of the effects of menstruation on elite athletes even if there is still a way to go for sports science

Midway through the 2019 Women’s World Cup in France, several members of the United States team came together for a selfie – taken by star striker Alex Morgan. Gathered on the pitch during a familiarisation session, the players each held up four fingers. To an outsider, this might have signalled the team’s winning intent – the Americans would go on to win the World Cup for the fourth time.

The signal was in fact far more personal. Due to a cutting-edge sports science program, the players knew that they were in the fourth phase of their menstrual cycle – a phase which can be disruptive to peak physical performance. But by deploying tailored interventions backed by scientific research, the US women’s national team had sought to gain the upper hand – over rival teams and their own bodies.

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