Objective: To assess the prevalence of menstrual disorders and the perceived
effect of menstrual cycles upon performance in elite athletes.
Methodology: A longitudinal survey in the form of a questionnaire was sent to
female track and field athletes at British Athletics every 6 months, over a
five-year period between 1st October 2014 and 1st October 2019 in the
United Kingdom (UK).
Results: 128 athletes completed an average of 4.2 ± 2.9 questionnaires across
the study period. The mean age of menarche was 14.2 ± 1.4 years, 13.4 ± 1.3
years and 12.8 ± 1.4 years in endurance, power, and thrower athletes
respectively (p < 0.05). Two-thirds (66%; n = 82) reported consistently regular
cycles, 30% (n = 37) irregular at some point during the period of observation
and 4% (n = 5) were amenorrhoeic. 87 athletes (68%) reported dysmenorrhoea
and 40 (31%) menorrhagia. More than three quarters (76.8%; n = 96) described
their cycle negatively affected performance. Amongst those who reported
when the negative impact occurred (n = 91), 40% (n = 36) reported this in
the late luteal phase and 35% (n = 32) during the early follicular phase. 79%
(n = 100) of athletes reported at least one cyclical symptom, of which bloating,
lower back and pelvic pain were most frequently experienced.
Conclusion: This data highlights the complex interrelationship between women’s
health and elite athletic performance. Athletes perceive a negative impact from
their menstrual cycles upon performance with a desire to manage these more
effectively, particularly during competition. Female reproductive health
expertise in the multi-disciplinary management of elite athletes is required.