IntroductionMenstrual dysfunction, musculoskeletal injury, and poor nutrition combine to form the female athlete triad (FAT), which results in serious health consequences for affected athletes. To this point, the risk factors of this phenomenon have not been fully explored in Japanese female college athletes. Additionally, the effect of competitive level on FAT risk factors has also not been reported. Therefore, we aimed to examine FAT risk factors in Japanese female athletes of various sports as well as examine the impact of competitive level on FAT.MethodsA Japanese-language survey was completed by 531 athletes and 20 nonathletes at two Japanese universities and answers with regard to menstrual status, musculoskeletal injury, nutrition, and other variables were analyzed based on classification of the sports into nine distinct groups based on activity type. Sport intensity, training volume, and competitive levels were used to further classify each sport. One-way ANOVA and the Bonferroni post hoc test using SPSS were carried out to analyze significance for relationships between sport intensity and FAT risk factors. Additionally, the relationship between competitive level and FAT risk factors was analyzed by ANOVA and Bonferroni post hoc tests.ResultsSport intensity was positively correlated with a delay in menarche as well as dysmenorrhea and poor nutrition while musculoskeletal injury was correlated with repetitive, high-training volume sports. Lower competitive levels increased dysmenorrhea but did not impact injury status or nutrition.ConclusionSport intensity and training volume, but not competitive level, are the critical factors affecting FAT risk in Japanese female college athletes.

This study aimed to identify factors associated with the prevalence and severity of menstrual-related symptoms. The protocol was registered in PROSPERO (CRD42021208432). We conducted literature searches of PubMed and Ichushi-Web and used the Jonna Briggs Institute critical appraisal checklist to assess the quality. Of the 77 studies included in the meta-analysis, significant odds ratios (ORs) were obtained for eight factors associated with primary dysmenorrhea (PD): age ≤ 20 years (OR: 1.18; 95% confidence interval [CI]: 1.04–1.34), body mass index (BMI) < 18.5 kg/m2 (OR: 1.51; 95% CI: 1.01–2.26), longer menstrual periods (OR: 0.16; 95% CI: 0.04–0.28), irregular menstrual cycle (OR: 1.28; 95% CI: 1.13–1.45), family history of PD (OR: 3.80; 95% CI: 2.18–6.61), stress (OR: 1.88; 95% CI: 1.30–2.72), sleeping hours < 7 h (OR: 1.19; 95% CI: 1.04–1.35), and bedtime after 23:01 (OR: 1.30; 95% CI: 1.16–1.45). Two factors were associated with severity of PD (moderate vs. severe): BMI < 18.5 kg/m2 (OR: 1.89; 95% CI: 1.01–3.54) and smoking (OR: 1.94; 95% CI: 1.08–3.47). PD severity (mild vs. severe) and prevalence of premenstrual syndrome were associated with BMI < 18.5 kg/m2 (OR: 1.91; 95% CI: 1.04–3.50) and smoking (OR: 1.86; 95% CI: 1.31–2.66), respectively. The identified risk factors could be utilized to construct an appropriate strategy to improve menstrual symptoms and support women’s health.

Chronic menstrual dysfunction and low female sex hormones adversely affect muscular performance in women but studies in college athletes are scarce. A cohort of 18 Japanese, female college athletes at the University of Tsukuba, Japan, were recruited and studied over 3 weeks under 2 conditions. One group had normal menstrual cycling (CYC, 9 athletes) while the other had irregular cycles (DYS, 9 athletes). Hormones and creatine kinase (CK) were measured from blood under both rest (RE) and exercise (EX) conditions. Biceps femoris tendon stiffness was measured by myometry. No differences in age, height, weight, menarche age, or one-repetition maximum weight existed between the groups. The DYS group had persistently low levels of estrogen and progesterone. In the CYC group, the CK level significantly increased at each point immediately post-exercise and 24 h post-exercise compared to pre-exercise in Weeks 1 and 2, and significantly increased at 24 h post-exercise compared to pre-exercise status in Week 3. The DYS group was significantly different only between pre-exercise and 24 h post-exercise over all 3 weeks. The DYS group also suffered from higher biceps femoris tendon stiffness at 24 h post-exercise. Chronic menstrual irregularities in Japanese college athletes increase muscle damage markers in the bloodstream and muscle stiffness after acute strength training.

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