December: ribs and ills and pills

Achy breaky ribs, hormonal contraception and the fertility time bomb

1. Working Well

The loudening tick of the fertility time bomb

Mid-November Baz attended a Sports Gynaecology Conference at the LTA; a fascinating, sometimes-heated event laying out issues within elite female sport right now – and what is and isn’t being done.

For example, organisations have long been able to swerve the taboo topic of fertility: female athletes have kids after they retire – it’s none of our business.

But it is. It’s everyone’s business. If we were to ask young females in sport what they’re most interested in, fertility would rank near top of the list.

And while sports doctors have some great insights on the topic, there isn’t yet a robust evidence base to inform clear and concise messaging. That leaves a gap thus women who crave more info are left to search, scroll and consume the opinions of experts … whose views are too often wide of the mark.

Conference consensus was that more education is needed but, alas, few organisations have such a pot of money set aside. You’re tellin’ us?

But if nothing else we can be glad the topic is opening up. Fertility might be a ticking time bomb at the intersection of sport, future health and safeguarding, but at least we can now acknowledge and discuss it. That has to be step one.

2. The World at Well

My breaky ribs – occupational hazard right?

Pro GB rower Hannah Scott dismissed her frequent rib injuries (two major breaks a year frequent) as an occupational hazard. Such issues and injuries are normalised in sport but don’t be fooled into thinking they’re normal.

Thanks to a British Rowing research project, Hannah discovered that her constant injuries came as a result of osteopenia, a bone-weakening condition commonly found in much older women.

What lead to her premature osteopenia? Overtraining, underfuelling, and the impact of Relative Energy Deficiency in Sport (RED-S) on body hormones.

Thankfully Hannah’s condition has reversed but we once again see the lack of real knowledge evident in even the highest ranks of elite women’s sport. And for every one Hannah with answers, hundreds more will struggling on without.

3. Racing Home

Helping parents return – this is how it’s done

People often ask us what good looks like out in the world. Well, it’s this …

While all sports find it challenging to bring back new mums, horseracing’s fairly extreme with its 4am starts, long days, risks and physicality …

Enter Racing Home, a project offering individualised mental, physical and community support to new mums vying to get back in the saddle.

After a successful pilot we hope wider rollout will ensure many more new parents can rejoin the sport they love.

4. Here Comes the Science Bit

Hormonal Contraception: the real mental health impact

PhD candidate Sofia Zettermark’s paper Coming of Contraceptive Age: An Interdisciplinary Analysis of Hormonal Contraceptives and Mental Health probes the heart of the conflict between the medical view on hormonal contraception (HC) and the lived-experience of HC users. 

Medical discourse usually holds that if HC doesn’t trigger adverse physical symptoms then it’s a-ok. But as we know, everyday women who use HC often question its impact on their mental health.

With that, Sofia conducted two nationwide (Swedish) studies and found significant associations between hormonal contraceptive use and subsequent use of psychotropic or antidepressant drugs. 

She asserts that depressive and other mental health side effects of HC are more common than acknowledged, particularly among young women. What’s more, she also challenges the very cultural / medical foundations of HC – its origins, its study and the role it plays in society at large. Fascinating. 

5. Medical BS

“Does the pill regulate my period?”

Dr Bella says: No. The pill is synthetic hormones which suppress the natural cycle. The pill doesn’t regulate periods – it stops them.

The bleed women experience on the pill isn’t a period but a ‘withdrawal bleed’ caused by pill-cycling. There are no physiological benefits to this bleed; it’s a design feature put there by the pill’s original makers to keep it near to what society knew … hence lots of women now take the pill continuously to avoid it.

Remember, a natural period is a sign of health. On the pill that sign is gone.