Top athletes must stop ignoring ‘alarm bell’ of missed periods Women’s sport is not a hard sell – I should know
Former runner Bobby Clay wants to banish a dangerous mentality after paying the price with her promising career, writes Fiona Tomas Industry wisdom says only men’s coverage draws an audience, but Orla Chennaoui finds the truth is very different in cyclin
Bobby Clay remembers the tear that slid down her mother’s face in the surgery, trying to process the doctor’s earth-shattering words. She was 20.
“He turned to my mum and said, ‘Your daughter will never have children.’ She didn’t say a word. That’s when I decided to change,” Clay tells Telegraph Women’s Sport.
A successful middle-distance runner, Clay was tipped to be athletics’ next big star. She was fourth in the 1500metres at the 2013 World Youth Championships, crowned European junior champion two years later and made the Great Britain under-20s team when she was just 15. Three years later, she was diagnosed with osteoporosis, a result of years of overtraining and undereating.
That merciless combination meant her body had been deprived of oestrogen, the female sex hormone – crucial for bone density.
Clay first realised something was wrong after fracturing her foot in a swimming pool doing a tumble turn. On another occasion, her shin snapped when she sat down in the gym. Both were clues that she was suffering from Relative Energy Deficiency in Sport (RED-S) Syndrome – formerly known as “the female athlete triad” – which can cause devastating effects due to low energy availability.
In 2019, American middledistance runner Mary Cain became the first high-profile female athlete to speak out about her experience with RED-S.
The condition is not found exclusively in women – Britain’s Olympic champion cyclist Chris Boardman retired in his early 30s due to weak bones and low testosterone.
In women, the condition manifests itself in an early warning sign, the absence of periods, something which Clay says is actually still celebrated in athletics. “I would have been mortified if I had had a period during my
Campaigner: Bobby Clay, running with her dog Rupert, suffers from osteoporosis after early warning signs that her body was breaking down went undiagnosed teenage years,” she says. “I would have instantly thought, ‘I’m out of shape, I’m not race fit.’ I thought it meant that my body fat would be over a certain percentage. That mentality was the norm.”
Clay was put on hormone replacement therapy – usually used for older women to relieve the symptoms of the menopause – to kick-start her body, wake up its reproductive system and artificially induce her first period.
Clay had never struggled with her physique as an athlete, despite being known as the “chunky one” among her peers and “surrounded” by eating disorders in the sport.
She insists she never had a dysfunctional relationship with food as an athlete, so when she learnt that her osteoporosis was linked with RED-S – commonly seen in athletes who are obsessively restrictive about their food intake – it was a shock.
RED-S is not exclusive to elite endurance athletes, although they are generally at a higher risk due to their increased energy expenditure. A study published last year in the British Medical Journal found that of 112 elite female Australian athletes from eight sports, 80 per cent demonstrated at least one symptom of RED-S.
“You can go through every bodily system and find a reason why underfuelling is a bad idea for performance,” explains Dr Amita Biswas, head of physiology at the English Institute of Sport and co-lead of Smarther, an EIS initiative promoting awareness of female athlete health.
“There is good evidence that your decision-making could be affected, that your adaptation to strength training can be reduced and it can impact your mood and concentration.”
Dr Biswas commonly sees RED-S in athletes transitioning from junior to senior programmes who, like Clay, simply underestimate the amount of energy they need.
However, the normalisation around missing periods is also a major contributing factor.
“It’s common for elite athletes to have irregular cycles, even if they’re fuelling adequately and their body composition is good,” says Dr Biswas. “But missed periods or no periods shouldn’t be considered normal. It’s a really concerning myth.”
The oral contraceptive pill can also mask hormonal problems associated with RED-S. This is because the pill artificially induces a monthly bleed – not a period – at an athlete’s convenience.
“An athlete might think that because they’re having a withdrawal bleed, everything is fine,” says Dr Biswas. “But when you’ve got a female athlete on the pill, you’re effectively putting them into the category where men are, where it’s much harder to realise that there’s a problem.”
After being pressured to change her body composition by a coach, Cain lost so much weight that she lost her periods for three years and broke five bones due to osteoporosis. Clay went public with her battle with the condition after penning a harrowing testimony in Athletics Weekly in 2017, after which she received hundreds of messages from other sufferers. “It makes me
Her shin snapped when she sat down in the gym. It was a clue she was suffering from RED-S
Women’s sport doesn’t sell, isn’t that what we’re always told? When I was asked to guest-edit the first ever women’s issue of the biggest cycle sport magazine in the world, Rouleur,
I had no doubt we would find the stories, writers, illustrators and photographers to make an issue that was both beautiful and interesting, a collector’s item. The real challenge, we thought, was to create something that would sell in enough numbers to justify the investment, something that could change the industry perception that women’s sport is not commercially viable.
So often we are presented with the statistics that there is little or no appetite for women’s sport. What the presentation of the standard data showing online traffic wilfully ignores, is that we are not usually comparing like for like. Page layout and broadcast running orders are framed around men’s sport, the disproportionate prominence leading readers, listeners and viewers to the position that it is more important, and more worthy of their time.
With four to 10 per cent of sports coverage given over to women’s sport we cannot pretend that market forces stand alone, without admitting the confirmation bias of our news and broadcast agendas. What we did at Rouleur was test whether women’s cycling could hold its own when readers were not guided towards an alternative. The answer is in the sales figures.
When the dedicated women’s cycling Rouleur issue went on presale on Feb 4, it became the fastest selling issue of the magazine’s 15-year history. It sold out, not once, but twice, and has been reprinted for a third run.
More copies were sold online in one week than the previous bestseller in six, and the return on investment is not only in the short term. The number of subscribers to
Rouleur has tripled in the past year, but this issue has accelerated that growth – by halfway through February, there had already been 50 per cent more sign-ups than the average month last year.
As with most sports media,
Rouleur’s readership is heavily gender-skewed; around 85-90 per cent are men. With this issue, not only has the proportion of female subscribers more than tripled, but the quantity of male subscribers has also increased. Whichever way you slice the data, the commercial value of a women’s-only cycling issue has been overwhelming.
Cycling is a very traditional sport, still run for the most part by men, for men. Yet even from this corner of our industry, there are other examples which demonstrate the appetite for women’s sport when the options are presented more equally.
Cyclo-cross is a shorter discipline than road racing, lasting around an hour, making it easier to give almost equal TV coverage. The viewing figures reflect the gender split. At the recent World Championships, where Dutch riders won both elite races, 91 per cent of the home audience watched the women’s race as well as the men’s. Two weekends later, Eurosport Netherlands recorded higher viewing figures for a weekend of women’s cyclocross racing than for the men’s.
In road racing, one of the largest one-day races of the calendar recorded a remarkable turnaround in viewing figures last year, thought by organisers to be at least partly because of a change of focus in race scheduling.
Rather than coming first as a sort of warm-up, and moved to another channel once the men’s race got under way, the women’s Tour of Flanders followed immediately after, and saw a 12-times increase in viewing figures. With more women’s races being broadcast than ever before, we can expect viewing figures to continue to rise.
What this trend in broadcast, and the success of the women’s issue of Rouleur, show is that women’s sport does indeed sell. This may be an uncomfortable fact for those who prefer the comfort of the status quo, rather than the disruption and required energy of change.
Delivering women’s sport necessitates a new understanding of the disciplines, the personalities and the narratives that will sell. At Rouleur, market forces have dictated. The next issue of the magazine is a 50-50 gender split. Change must be wider than one magazine, broader than one sport. Will this mark a turning point in the delivery and coverage of women’s sport, or will it be a flash in the pan, a sign of what could have been? If it is the latter, you cannot tell me we have not shown what is possible.
The issue sold out not once, but twice, and has been reprinted for a third run