Female Athlete Health in Saudi Arabia

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Table of Contents

Background
Literature Review
Methodology
References

Background

The progress of women in sports is great, and the current world witnesses multiple Olympics’ shifts. Several decades ago, one of the passages of Title IX changed athletic opportunities for females. Today, women from different countries can compete in athletics as well as men. Elliott-Sale et al. (2020) discussed that female participation rose from 2.2 percent in Paris in 1900 to about 48.8 percent in Tokyo in 2020. Female athletes have made enormous leaps in competition and athletics. The improvement of physical activities comes with a variety of positive effects, including an increase in self-esteem, body image, and female wellbeing. However, most sports put a heavy emphasis on athletes in regard to their sporting performance. Although physiological changes occur in male and female athletes, the man’s body cannot experience the same physical transformations as the woman’s body does in terms of menstrual cycle (MC) and menstrual disturbances. In Saudi Arabia, female athletes face a number of obstacles in their professional growth, including religion, culture, and education level, and human health remains a significant distinctive feature.

Literature Review

Menstrual Cycle

The menstrual cycle (MC) is a common hormonal process in the female body that prepares the system for a possible pregnancy. It results from ovarian, hypothalamus, and hypophyseal hormones that initiate and maintain various changes in the female reproductive system. The cycle has two main phases, the luteal and follicular, associated with hormonal fluctuations. The female procreative hormones affect the reproductive and cardiovascular systems, thermoregulation, and other metabolic parameters (Julian et al., 2017). Scarce data on the MC effects and reproductive hormones on sports performance can be found in current studies (Elliott-Sale et al., 2020). Therefore, much attention should be paid to the monthly cycle characteristics and the ways of how female athletic performance may be challenged.

MC and Injury

Precise understanding of MC effects on sports performance is critical for coaches and professionals to prescribe appropriate training and ensure the wellbeing and health of the participants. Estrogen affects the cardiovascular system, brain, and metabolism, while progesterone influences energy fuel, thermoregulation, and ventilation (Romero-Moraleda et al., 2019). Some studies have cited higher cardiovascular training during the luteal phase in moderate physical exercise (Julian et al., 2017). In the mid-luteal phase, the time to exhaustion decreased in hot conditions due to the elevated temperatures. More studies are needed to explain MC outcomes in relation to prolonged exercise performance (Julian et al., 2017). Being related to hormonal changes, MC also explicates ligament laxity and tendons as estrogen decreases stiffness and directly affects performance and injury rates (Chidi-Ogbolu & Baar, 2019). Increased estrogen levels can decrease female power and determine physical abilities, which results in serious ligament injuries and traumas. Lin et al. (2018) indicate that injury rates in sports highly depend on sex characteristics: while male athletes sustain injuries from interpersonal contact, female athletes suffer from playing equipment. Abnormal menstrual patterns provoke low bone mineral density.

Saudi Female Sport and Physical Activity Background

Although the benefits of physical activities have already been identified and discussed in many international studies, the participation of Saudi females in sports was considerably restricted until 2018. For a long period, before the 2030 Vision, more than 78% of Saudi women and adolescent females remained physically inactive (as cited in Al-Hazzaa & AlMarzooqi, 2018). Physical education was not allowed in public schools and turned out to be a priority for male students only. The suppression of women’s interests in sports had a serious impact because it was forbidden for them to visit sports stadiums and observe the events without mentioning direct participation restrictions.

Modern Female Athletes

Now, Saudi females have far more chances to compete in sports and competitions than before. After Vision 2030, sports in Saudi Arabia have undergone a paradigm shift. Al Ruwaili (2020) investigates the role of sport in increasing physical activity and its positive outcomes in health implications. In 2012, one of the most provocative events happened when Sarah Attar participated in the London Olympics, promoting the idea of human rights through the prism of neoliberal feminism (Stevenson, 2018). Her decision to break the rules and follow sports standards served as a significant shift in understanding the worth of female sports in the 21st century.

Saudi Female Sport and MC Experiences

When it comes to female athletes competing in sports, many factors like female physiology, including MC impact on physiological and psychological constructs, and psychological changes should be discussed. Many women report poor guidance and knowledge about menstruation biology and the lack of analysis of their personal life experiences (Brown et al., 2021). Another important factor is that not all female athletes experience physiological and psychological symptoms. The review proves conflicting results about the relationships between the MC and exercise performance because of inappropriate comparison of different hormonal environments (Janse de Jonge et al., 2019). Matsuda et al. (2020) also define that menstruation decrease serum carnitine levels, which stimulates poor endurance performance. MC-related changes have to be studied at different phases, not only the luteal phase but also the late follicular phase. Further questions arise in consideration of contraceptives whose primary aim is to prevent pregnancy. The exogenous hormones can have significant effects on exercise and sports performance, and female athletes get access to various hormonal contraceptives, both with estrogen and progesterone (Brown et al., 2021). The mechanism of actions and routes of administration differ, influencing the complexity of the issue.

Impact of Religion and Culture

Despite evident MC physiological and psychological effects, most women find it difficult to discuss their gynecological problems and ask questions to improve their knowledge and performance. Findlay et al. (2020) state that some female rugby players are challenged by keeping their menstrual-related changes with their male counterparts. Women still conceal menstruation issues, and the culture and social media have enhanced this situation. Many adverts have a consistent theme of emphasizing dirtiness, secrecy, and social embarrassments. Such common messages to the viewers and readers conceal menstruation and potentiate its negative attitudes. Some elite sports team players express reluctance and unwillingness to talk about their physiological needs with their coaches (McNulty et al., 2020). Communication plays a crucial role in discussing MC practices and promoting its awareness. However, from the religious point of view, the Prophet Muhammad and Islam do not restrict physical experiences for either men or women (Al Ruwaili, 2020). Physical strength, health, and power are vital elements of human life, and Saudi people should strive for physiological changes and improvements.

Athlete-Coach Relationships

Furthermore, high-level female athletes are likely to have male trainers, but coaches’ ability to address purely female health issues is questioned. Gender-based inequalities and no need to study such delicate theme as a part of general education contribute to the poor communication between men and women. It is important to increase the level of knowledge about the perception and lived experiences of professional players, specifying MC-related changes (Elliott-Sale et al., 2020). The absence of such discussions within a team may negatively affect female athlete performance.

Psychological Aspects in Female Athlete Development

Psychological changes related to MC and other female issues can be affected in many ways, including low self-esteem, panic about uncontrolled leaking, and poor self-monitoring. In many cases, young women are not able to control their symptoms like depression, anger, irritability, and deteriorated concentration (Abbas et al., 2020). The situation gets worse because they cannot talk about their problems due to the existing stereotypes (femininity and muscularity). To reduce the possibility of disclosure personal (usually intimate) information, athletes can miss their training sessions, which negatively influence their performance capacity and self-image.

Rationale for the Study

The current study will reveal the real-world experiences of female athletes and their coaches from an across-cultural perspective. The citizens of Saudi Arabia and the United Kingdom will be recruited to gather information about the conditions under which women join the world of sport. It is planned to focus on the opinions of female athletes as sports and physical activities are still biased and stereotyped. The concepts of masculinity and femininity have to be properly addressed to remove the embarrassment and MC-related shame. This approach will help to set new standards in Saudi female sport and empower future athletes, including children and adolescents, to promote gender equity in sports. It will also offer insight through multicultural comparison of Saudi Arabia and the UK, addressing a complex issue of global female empowerment. The results will create a background for future generations to underline the importance of physical education for all students.

Aims

The increased number of women participating in sports competitions and choosing physical activities cannot be ignored. However, despite the evident female desire to succeed in the chosen sports, knowledge and understanding of different physiological processes is required. Therefore, the primary aim of this study is to investigate what is known about the MC impact on the performance of Saudi female athletes at the moment of research. The secondary aim is to explore and expand the existing knowledge of the MC and its impact on sports performance among athletes and coaches in Saudi Arabia.

Methodology

To achieve research goals, a mixed-method approach will be developed. First, survey methodology, including a questionnaire with closed- and open-ended questions, will allow gathering and describing personal characteristics of participants from a large sample. This method aims to gather statistical data about female attitudes and actions in sport. The rationales for this choice are timesaving, distant connection, cost-effectiveness, and the possibility to obtain diverse information from many people within a short period. Second, semi-structured interviews with coaches and female athletes will be conducted with the purpose at collecting qualitative information for analysis. The benefits of this method include the possibility to prepare questions beforehand, develop creative conversation, and compare replies. SPSS will be used to analyze statistical data from questionnaires. Interview results will be taped and transcribed to be prepared for thematic content analysis.

References

Abbas, K., Usman, G., Ahmed, M., Qazi, R., Asghar, A., Shah, A. M., Rizvi, A., Abid, K., Haq, K. U., Tahir, A., & Usama, S. M. (2020). Physical and psychological symptoms associated with premenstrual syndrome and their impact on the daily routine of women in a low socioeconomic status locality. Cureus, 12(10).

Al Ruwaili, M. D. (2020). Females and sport in Saudi Arabia: An analysis of the relationship between sport, region, education, gender, and religion [PhD thesis, University of Stirling]. Web.

Al-Hazzaa, H. M., & AlMarzooqi, M. A. (2018). Descriptive analysis of physical activity initiatives for health promotion in Saudi Arabia.Frontiers in Public Health, 6. Web.

Brown, N., Knight, C. J., & Forrest Née Whyte, L. J. (2021). Elite female athletes’ experiences and perceptions of the menstrual cycle on training and sports performance. Scandinavian Journal of Medicine & Science in Sports, 31(1), 52–69. Web.

Chidi-Ogbolu, N., & Baar, K. (2019). Effect of estrogen on musculoskeletal performance and injury risk. Frontiers in Physiology, 9.

Elliott-Sale, K., Ross, E., Burden, R., & Hicks, K. (2020). The bases expert statement on conducting and implementing female athlete-based research.The Sport and Exercise Scientist, (65), 6-7. Web.

Findlay, R. J., Macrae, E., Whyte, I. Y., Easton, C., & Forrest Née Whyte, L. J. (2020). How the menstrual cycle and menstruation affect sporting performance: Experiences and perceptions of elite female rugby players.British Journal of Sports Medicine, 54(18), 1108–1113. Web.

Janse de Jonge, X., Thompson, B., & Han, A. (2019). Methodological recommendations for menstrual cycle research in sports and exercise. Medicine and Science in Sports and Exercise, 51(12), 2610–2617.

Julian, R., Hecksteden, A., Fullagar, H. H., & Meyer, T. (2017). The effects of the menstrual cycle phase on physical performance in female soccer players. Plos One, 12(3).

Matsuda, T., Furuhata, T., Ogata, H., Kamemoto, K., Yamada, M., & Sakamaki-Sunaga, M. (2020). Effects of the menstrual cycle on serum carnitine and endurance performance of women.International Journal of Sports Medicine, 41(7), 443–449. Web.

McNulty, K. L., Elliott-Sale, K. J., Dolan, E., Swinton, P. A., Ansdell, P., Goodall, S., Thomas, K., & Hicks, K. M. (2020). The effects of menstrual cycle phase on exercise performance in eumenorrheic women: A systematic review and meta analysis.Sports Medicine, 50(10), 1813–1827. Web.

Romero-Moraleda, B., Coso, J. D., Gutiérrez-Hellín, J., Ruiz-Moreno, C., Grgic, J., & Lara, B. (2019). The influence of the menstrual cycle on muscle strength and power performance. Journal of Human Kinetics, 68, 123–133.

Stevenson, P. (2018). Empowerment discourses in transnational sporting contexts: The case of Sarah Attar, the first female Saudi Olympian. Sociology of Sport Journal,35(3), 238-246.

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