Offered Support and Knowledge about the Menstrual Cycle in the Athletic Community: A Cross-Sectional Study of 1086 Female Athletes

Abstract

Many female athletes perceive that symptoms related to the menstrual cycle such as dysmenorrhea, premenstrual symptoms, amenorrhea or side-effects of hormonal contraceptives negatively impact their training, performance, and general well-being. Knowledge and communication about female athletes' health is therefore important in the sport community. The aims of this study were to explore the level of knowledge and communication about menstrual cycle issues and use of hormonal contraceptives in the athletic community and to describe the kinds of medical support offered to female athletes. A total of 1086 Swedish and Norwegian athletes from 57 different sports responded to a web-based questionnaire. Of these, 58% (n = 627) practiced team sports and 42% (n = 459) individual sports. Twenty-six percent (n = 278) of the athletes perceived their knowledge about female athlete health to be poor/very poor and the knowledge was most often acquired from medical staff. Fifty-three percent (n = 572) of the athletes perceived the knowledge acquired of their coaches as poor/very poor, even though a significantly (p < 0.001) higher proportion of athletes with a female coach (30%, n = 31) rated their coach's knowledge as very good/good, compared to athletes with a male coach (5%, n = 31). Only 11% (n = 116) of the athletes discussed female health issues with their coach. The majority (81%, n = 842) of the athletes partly to strongly agreed that female athlete health is considered a taboo topic in the athletic community. Forty-seven percent (n = 510) of the athletes had access to a physiotherapist, while only three percent (n = 29) had access to a gynecologist. Low perceived knowledge, lack of communication and support demonstrate the need for a multi-professional medical team and enhanced educational efforts focused on female athlete health in the athletic community.

Keywords: amenorrhea; hormonal contraceptives; menstrual cycle; physical performance; sport.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1

How knowledge about female athlete health was acquired (A), person to talk with about female athlete health (B) and opportunities to discuss amenorrhea, lasting > 3 months, in the athletic community (C).

Figure 2

Athletes’ own perceived knowledge about aspects of female athlete health that might influence athletic performance (A), their coach’s knowledge in this area (B) and whether this subject was taboo in the athletic community (C) across athlete level. For “C”, the ordinal scale “Strongly agree/agree”, “Partly agree”, “Disagree/strongly disagree”, “Do not know” was used in descending order.

Figure 3

Athletes’ own perceived knowledge about aspects of female athlete health that might influence athletic performance, their coach’s knowledge in this area and whether this subject was taboo in the athletic community across age of the athletes. Confidence intervals (95%) depicted by error bars. p-values are based on one-way ANOVA for differences across age for each item. For item “Subject is taboo in the athletic community”, the ordinal scale “Strongly agree/agree”, “Partly agree”, “Disagree/strongly disagree” was used in descending order.