Menstrual cycles and the impact upon performance in elite British track and field athletes: a longitudinal study.

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.