Are sport scientists finally addressing the elephant in the womb?

Leah Monsees
Dept. of Sport Sciences, Malmö University

Shark Week. Aunt Flo. Code Red. Shame surrounding menstruation reflects a deeper and ongoing problem affecting millions of people every day. Albeit growing up fairly liberal, I, too, have found myself trying to hide tampons while sneaking into public bathrooms more than once – as if I were concealing something illegal. I did it, and so did my friends, my colleagues and even my own mother. God forbid anyone knew we were bleeding.

As a girl who grew up playing all kinds of sports, I quickly realized that menstruation to me wasn’t just about bleeding for three out of twelve months every single year but also about performance. However, it wasn’t until many years later that I finally started to understand the real impact my menstrual cycle had on my body within a sporting context. That it wasn’t just about “a few days a month where exercising kind of sucked”, but that it was more complex than that and really something that had affected me every single day for the past 20-something years. In and outside of sport.

It is within this context that Menstruation and the Menstrual Cycle in Sport, Exercise and Physical Activity, edited by Petra Kolić and Christopher I. Morse and published by Routledge in April 2026, becomes particularly relevant. It offers a timely and much-needed contribution to a slowly but growing body of research at the intersection of menstruation and sport.

Structured into an introduction, followed by thirteen chapters, and a conclusion, the volume covers a wide range of contexts and perspectives, including elite sport, recreational exercise, and sport-for-development settings. Aside from explaining what menstruation is from a more physiological perspective (e.g., Chapter 1), the book addresses key themes such as the impact of the menstrual cycle on exercise performance for both able-bodied and disabled menstruators (e.g., Chapters 10 & 12), menstrual health monitoring (Chapter 6), nutrition (Chapter 2), injury risk (Chapter 3), stigma (Chapters 7, 11 & 13), coach-athlete relationships (Chapter 9), and menstrual health literacy and education (Chapter 5 & 8).

It carefully balances scientific explanation with applied and lived perspectives, particularly by moving from physiological foundations in the early chapters to the lived realities of athletes and exercisers in later sections.

Further, the volume brings together contributions predominantly from scholars based in English-speaking countries (including the UK, Canada, New Zealand, the US, and Ireland), alongside a few researchers from Sweden, Norway, and Germany. While this largely Western perspective is noticeable, it is also explicitly acknowledged within the book itself (see, for instance, p. 208). Although the contributors are predominantly based in Western countries, the book does not limit itself to Eurocentric or merely Western perspectives. For instance, it incorporates discussions from non-Western contexts (e.g., Zambia in Chapter 5) and engages with diverse sporting practices such as karate (Chapter 11) which, as most of us know, has its origins in Japan. Nonetheless, and with most research today, we can always strive to include more diverse perspectives and contexts, but I also acknowledge that a volume of 13 chapters will never be able to represent all voices.

Notably, the book is refreshingly modest in its claims. As the editors themselves argue “we are careful not to claim that this book represents exhaustive coverage of all topics” (p. 2), thereby acknowledging both the limits of the volume and the evolving nature of the field. This transparency strengthens the book’s credibility and, most importantly, positions it as part of a broader, ongoing scholarly conversation.

One of the book’s key strengths lies in its accessibility. It provides a solid entry point into the physiological processes associated with menstruation without overwhelming readers who may not have an extensive background in medical, biological or human physiology. At the same time, it does not oversimplify the topic either. Instead, it carefully balances scientific explanation with applied and lived perspectives, particularly by moving from physiological foundations in the early chapters to the lived realities of athletes and exercisers in later sections.

Relating to this, and spending some time reflecting on this kind of structure of the book, placing the chapters focusing on the more physiological aspects of menstruation in the beginning of the volume before going more specifically into more sociological views and contributions in the later chapters, I could not help but wonder whether such structure could reinforce an implicit hierarchy of knowledge – or a logic of “biology first, experience second”. Now, I would like to point out that I do not mean to bring this up as a criticism of the editors or of the volume per se, but rather that I believe that this is a discussion to be had in the sports sciences in general.

In society and research, menstrual health is often framed primarily as a matter of physiological optimization before being understood as a lived, embodied, and socially mediated experience. While an initial grounding in bodily processes is arguably valuable for understanding menstruation in a sport science context, this ordering also reflects a broader epistemic pattern in how menstruation is often conceptualized: one in which biological/physiological/medical knowledge is treated as foundational, while experiential and sociocultural knowledge is more easily positioned as secondary rather than constitutive of the phenomenon itself. From my own experience as a woman who has been menstruating for some time (and I do not aim nor claim to speak for others here), I recognize that hormonal processes are often positioned as explanatory for what is happening to me, yet in practice my understanding and relation to it is grounded more in the lived, affective experience of these changes than in their physiological description.

Moving on, and while the volume offers a rich and multidisciplinary account of menstrual cycle considerations in sport and exercise science and even situates it in different cultures (e.g., Chapter 5), it remains notably limited in its engagement with sport governance and policy frameworks. Questions of how national and international governing bodies structure menstrual health practices specifically in relation to sports are largely absent. As a result, the book tends to situate menstruation primarily as an individual or interpersonal concern, managed by athletes, coaches, or practitioners, rather than as a phenomenon shaped by institutional decision-making, resource allocation, and regulatory priorities within sport systems. Given the scope of the volume, some omissions are inevitable (as also noted by the editors themselves); however, the limited engagement with sport governance and policy frameworks is particularly notable and would further contextualize the need for future research on menstrual health in general and, particularly, in sport.

A further limitation of the volume is its lack of engagement with the historical development of sport science’s treatment of menstruating athletes, or the institutional histories that have shaped current knowledge production. I believe that such perspectives could have added to the book by further contextualizing why certain physiological and performance-oriented questions dominate (or remain absent from) the field today, and how earlier medical, cultural, and regulatory assumptions about menstruating bodies continue to inform present-day research agendas.

A more fundamental critique that this book raises, however, is not directed at the editors or contributors themselves, but rather at academia and society more broadly. Given that menstruation and menstruating bodies in motion are by no means new phenomena, it is striking that the release of a volume like this still feels like a milestone in the 21st century.

While I applaud Kolić and Morse for getting this volume together now, it is at the same time also a sad manifestation of the longstanding marginalization of women’s experiences within research agendas. Topics related to menstruation have historically been underfunded, overlooked, or treated as niche concerns, and the relative scarcity of large-scale, well-funded research in this area reflects broader structural inequalities in terms of whose bodies and experiences are considered worthy of scientific attention. Moreover, the lack of sustained investment has limited the development of longitudinal data, diverse samples, and context-sensitive approaches that could better inform practice and ultimately the wellbeing of menstruating athletes. In this sense, the significance of this book is twofold: it is both a valuable scholarly contribution and a reminder of how much ground still remains to be covered within and outside of the sport sciences.

Finishing on a more positive note, a particularly compelling feature of the book is its commitment to fostering critical thinking. Rather than ending chapters with definitive conclusions alone, the contributors pose reflective and rather challenging questions to the reader. These include, for example, how to prevent menstrual cycle-related injuries, how better to support adolescents facing menstrual barriers to sport participation, and what ethical considerations arise when implementing menstrual health monitoring at scale. Other questions interrogate the role of coaches, the influence of gender dynamics in communication, and how feminist frameworks might reshape how menstruation is understood in sport contexts. This approach encourages readers not only passively to absorb knowledge but actively to engage with ongoing debates.

Concluding then, I argue that Kolić and Morse succeeded in making a complex and stigmatized topic both accessible and intellectually engaging. With its combination of scientific grounding, applied relevance, and critical inquiry, the volume makes a meaningful contribution to this emerging field. I have no doubts that it will be of particular value to researchers across multiple disciplines, practitioners across various sporting contexts, and students interested in sport, gender, political and/or medical sciences.

Most importantly, I hope that this book will be one of many more to come daring to address the elephant in the womb and inspiring others to follow suit.

Copyright © Leah Monsees 2026