From collapsed on bathroom floors to Olympic podiums: How elite athletes navigated women's health conditions

On February 6, 2026, the Milano Cortina Winter Olympics will kick off, and with it, the spectacle of superhuman feats begins. But beyond the visible glory is an invisible pain that rarely makes the highlight reel. 

It is Olympic long jumper, Jazmin Sawyer, screaming in agony on a doctor’s table, needing a cocktail of painkillers just to stand. It’s long-distance runner, Eilish McColgan, forced to pull out of competitions because the “searing pain” in her stomach made her legs feel like they were “filled with concrete.” 

While more female athletes are speaking out about menstrual challenges, we know that the conversation — especially in the athletic world — remains taboo. However, top Olympians are now echoing the same urgent message: women’s health issues aren't talked about enough in sport.

So let’s finally talk about it.

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The PCOS paradox 

Did you know that around 30% of female Olympic athletes have PCOS? That’s about four times the rate of the general population. And at first glance, polycystic ovarian syndrome (PCOS) might look like a biological advantage for female athletes. The elevated testosterone and androgen levels associated with this hormonal condition allow for a kind of explosive power, muscle synthesis, and competitive behavior often seen in male athletes. And while female athletes are at a higher risk of stress fractures, research indicates that those with PCOS also have increased bone mass, potentially providing a buffer against the rigors of high-impact training.

But the trade-off is often years of diagnostic masking, where irregular or missed periods — a common trait of PCOS — are often brushed off as functional hypothalamic amenorrhea, which is just a fancy way of saying overtraining. Seven-time US national modern pentathlon champion, Samantha Schultz, went seven years without a cycle, which doctors told her was “normal” for her caliber. She only discovered the truth after working with a fertility specialist after the Tokyo Olympics. 

And for 2008 Olympic weightlifter Carissa Gump and 2004 Olympic all-around gymnast champion Carly Patterson, the truth only surfaced after struggling with infertility. Because birth control is a standard treatment for PCOS, symptoms are often quelled until an athlete stops the pill to conceive. Gump, who once suffered a cyst rupture mid-competition, spent years navigating a gauntlet of unexplained symptoms. When a specialist finally identified PCOS, the relief was so profound that she said she felt like "doing cartwheels out of the office.” And while both athletes have been candid about their fertility struggles, with the proper treatment plans in place, they have both gone on to achieve a new dream: motherhood. 

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Fighting through the flare-ups 

“I thought I was losing my mind,” says Australian Olympic swimmer Emily Seebohm. In her training leading up to what should have been one of the most exciting moments of her life (aka the 2016 Rio Olympics), Seebohm was getting her period every 2-3 weeks, battling constant fatigue, and back pain so severe she thought her “spine was going to snap.” When she wasn’t training, she was in bed. She told reporters that despite putting on a brave face and pretending everything was fine, most of the time she felt like she was “dying on the inside.” Her diagnosis? Endometriosis. 

Endometriosis is a chronic condition where lining similar to the lining of the uterus grows outside the uterus, leading to pelvic scar tissue that can swell and bleed during menstruation, cysts, and “knife-like” cramps. Brittany Brown, who won the 200m bronze in the 2024 Paris Olympics, said that even though she hadn’t been diagnosed until 2023, she knew something was wrong in college when, after an intense workout while on her period, she found herself on the bathroom floor shaking and throwing up. 

Olympian track cyclist Elinor Barker said she was in so much pain she almost quit cycling because she struggled to even stand up (but went on to win medals at the 2020 and 2024 Olympics following successful surgery in 2018), and Kiwi Olympian skier Anja Barugh said she’d experienced crippling abdominal and back pain so bad it caused her to vomit at the start of a halfpipe (she’s now a fierce endo advocate who ran a marathon in 2023 to show that endometriosis doesn’t have to stop you from doing what you love).  

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The medical fap in the training room 

The common theme that seems to weave itself into the fabric of all of these stories is how long it took to get a diagnosis. Even for non-athletes, it takes an average of around 6.6 years (but can exceed 11 years) for an endometriosis diagnosis, and an average of 2 years (but can be longer) for a PCOS diagnosis. In elite sports, that delay is often compounded by a culture built on a “tough it out” ethos that sidelines female-specific biology. The logic is: if a bobsledder has the grit to hurtle down a mountain at 90mph, then she can handle a “bad period.” It’s easy to shrug this off as simply a byproduct of the sports industry, but it actually reveals a deeper scientific blind spot.

Historically, sports science — and science in general — has treated women as “small men,” and a 2024 audit found that only 6% to 9% of sports science studies exclusively focus on female athletes. Up until 1993, researchers often avoided including women in clinical trials because menstrual-related hormonal fluctuations were seen as confounding variables. This highlights two things: first, that the medical norm has long been male-centric, and secondly, this male-default framework underlies much of the advice women receive today, whether it’s recovery timelines, nutritional protocols, stress research, or even sleep recommendations, despite clear biological differences. 

And when female athletes struggle with fatigue, brain fog, or persistent abdominal pain, it is often chalked up to the "grind" of intense training, grueling travel schedules, or simply the price of ambition. It seems that you can have a world-class VO2 max and still have a hormonal profile that’s a total blank page. For many, a diagnosis only arrives when they step away from the sport or when the symptoms become so extreme that they can no longer be ignored. 

But the good news is that the tide is starting to turn. Research highlights that female athlete participation in studies increased from 39% to 43.95% over the past decade. The push for female-only trials is growing (even if it might be a bit slow to start). The hope is that this will move us toward a future where "mental toughness" is no longer used as a cover for a missing diagnosis.

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Advice from the arena 

In becoming their own advocates, many of these athletes have field-tested strategies for managing their conditions, uncovering wisdom that can serve as a roadmap for anyone, whether you're training for the Olympics or just trying to survive a Tuesday afternoon. 

Optimize your nutrition: Insulin resistance is common in PCOS and can drive blood sugar spikes and crashes. Gump found that a high-protein, lower-carb approach — paired with eating every hour and a half — helped stabilize her energy and prevent crashes. For Schultz, wearing a continuous glucose monitor (CGM) helped her identify trigger foods. Now, simple additions like adding nuts to oatmeal or avocado on toast provide enough fat to blunt spikes and steady her blood sugar.

In endometriosis, where inflammation plays a central role, athletes like Seebohm limit refined sugars and simple carbs while prioritizing nutrient-dense foods like fruits and vegetables. Emerging research suggests higher fiber intake may reduce circulating estrogen, while plant-based dietary patterns and vitamins D, C, and E have been associated with significantly reduced endometrial pain and other symptoms.

Incorporate regular exercise: And no, you don’t need to train like an Olympic athlete. In fact, many “retired” Olympians like Gump now prioritize simple, sustainable movement like walking several times a week for 20-30 minutes or doing bodyweight or dumbbell workouts. Research shows that both aerobic and resistance exercise improve body composition, metabolic health, and hormonal balance in women with PCOS. 

Seebohm says she enjoys yoga, which has been shown to significantly reduce inflammation, pelvic pain, and dysmenorrhea (painful period cramps) in women with endometriosis. Another study found that just eight weeks of yoga improved quality of life across pain, control, powerlessness, emotional well-being, self-image, and social support in women with endometriosis. 

Consider alternative therapies: Both Brown and Seebohm highlight the benefits of pelvic physiotherapy for endometriosis, which uses exercises, manual therapy, biofeedback, and education to address pelvic floor dysfunction by strengthening weak muscles and relaxing tight ones. Studies show physiotherapy techniques can significantly reduce pain intensity and improve quality of life in women with endometriosis. 

Physiotherapy may also support PCOS, although the research is more limited. One study found it could improve infertility treatment outcomes, quality of life, and overall health in women with PCOS, but more research is needed.  

Lean on your support network: Humphries credits elite sport with instilling grit and focus, but acknowledges that motivation can waver. When it does, she says turning to her great support network is key, and research backs this.

A 2025 study found that in women with PCOS, social support, self-compassion, and resilience were significantly associated with better health-related quality of life. Social support may also buffer the effects of stigma and pain on quality of life and self-esteem in women with endometriosis.

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When to speak to a specialist 

Many of these athletes say they sensed something was wrong long before they had a diagnosis. “I knew something wasn’t right from the first few times I had my period,” says Barugh, describing severe period pain beginning at just 11 years old. Brown has said, “For a long time, my body was talking to me, but I wasn’t listening,” reflecting on years of symptoms before she got answers. Persistent period pain, irregular cycles, unexplained fatigue, and fertility concerns shouldn’t be ignored. 

While a primary care provider may offer initial testing or referrals, many women benefit from seeing a hormonal health specialist, like the team at Allara, for a more comprehensive evaluation. Allara’s clinicians regularly assess hormone and metabolic markers, create personalized treatment plans, and provide ongoing support from a multidisciplinary care team. With the right guidance, many patients are able to better understand their symptoms and feel more supported in their health.

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The bottom line 

• Around 30% of elite female athletes may have PCOS, which is around four times higher than in the general population. 
• Symptoms like severe period pain, irregular cycles, fatigue, and fertility challenges are often normalized or dismissed, even in athletes with a world-class medical team. 
• Women have historically been underrepresented in clinical research, leading to gaps in diagnosis, treatment, and training guidance.
  Nutrition, movement, stress management, social support, and pelvic health therapies can help manage symptoms and improve quality of life.
  
  

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Frequently Asked Questions (FAQS)

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Why is PCOS more common in female athletes? 

Studies suggest PCOS may be more common in elite female athletes, but researchers don’t yet know why. It may be that traits linked to PCOS, like higher testosterone, help some athletes excel or that PCOS is simply underdiagnosed in the general population. But training itself has not been shown to cause PCOS. 

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Why do many gynecological conditions take so long to diagnose?

Both conditions have symptoms that are often normalized or misattributed. PCOS has no single diagnostic test, and endometriosis often requires laparoscopic surgery for confirmation, which can delay diagnosis. In athletes, symptoms are frequently attributed to training stress, overtraining, or Relative Energy Deficiency in Sport (RED-S), which can overlap with hormonal symptoms and further mask underlying conditions. Furthermore, research shows that women’s pain is more likely to be attributed to stress or psychological causes compared to men’s, which can also delay diagnosis. 

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Can lifestyle changes actually help PCOS or endometriosis symptoms?

Evidence suggests that nutrition, regular movement, stress management, sleep, and pelvic health therapies can improve symptoms and quality of life. However, many women benefit most from a personalized treatment plan that may also include medication or hormonal therapy.

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