Practice does not make perfect: A brief view of athletes’ knowledge on the menstrual cycle and oral contraceptives

Larsen, Brianna; Morris, Kirstin S.; Quinn, Karlee; Osborne, Mark; Minahan, Clare

doi:10.1016/j.jsams.2020.02.003

Cited by 44 publications

(44 citation statements)

References 23 publications

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“…Understanding the prevalence of hormonal contraceptive (HC) use and their reasons for use/disuse are important for practitioners to develop appropriate monitoring and management practices for female athletes. Approximately 50% of elite British athletes use HC (Martin et al, 2018), while similar values are reported in elite Australian athletes (47%, Larsen et al, 2020). In recreational to elite level Australian athletes, the use of HC use is slightly lower at ∼40% (Armour et al, 2020), likely due to the inclusion of recreational level participants.…”

Section: Introductionmentioning

confidence: 52%

“…Many of the athletes surveyed were unable to specify the type or brand of OC they used, suggesting either a lack of interest in, or awareness of, the different types and/or benefits and risks of OC use. Research in Australian athletes has suggested a poor knowledge in relation to the menstrual cycle and use of HC (Larsen et al, 2020). Greater education may be needed for athletes to make informed choices about their HC use, in conjunction with their medical doctor, to ensure optimal health, well-being, and performance.…”

Section: Discussionmentioning

confidence: 99%

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Hormonal Contraceptive Use in Football Codes in Australia

Clarke

Bruinvels

Julian

et al. 2021

Front. Sports Act. Living

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The recent launch of the new National elite women's football competitions in Australia has seen a 20–50% increase in grassroots female participation. With the growing participation across grassroots to elite competitions, understanding the health of female athletes should be prioritized. In elite level athletes, hormonal contraceptive (HC) use is common (~50%), however, little is known about the prevalence and reasons for use and disuse of HC in elite female football athletes. As such, the impact of HC use is often not considered when monitoring the health of female footballers. This study involved a subset of data collected as part of a larger questionnaire investigating menstrual cycle function, hormonal contraception use, and the interaction with training load volume and perceived performance in elite female football code athletes. A total of 177 participants completed the questionnaire across three football codes within Australia (rugby league, rugby union/sevens, Australian football). One third (n = 58) of athletes were currently using HC, predominately in the form of an oral contraceptive pill (OC, n = 47). Reasons for use included: to avoid pregnancy (71%); to control/regulate cycle (38%); and to reduce menstrual pain (36%). However, most athletes using an OC (89%) could not identify the type of pill used (e.g., mono-, bi-, or triphasic). The main reason for disuse was due to the negative side effects (n = 23), such as mood swings, weight gain, and depression/anxiety. Comparing HC users and non-users, there were no statistical differences in the number of reported menstrual symptoms, use of medication to relieve menstrual pain, or frequency for needing to adapt training due to their menstrual cycle (p > 0.05). Since most athletes were unaware of the type of OC they used, female football athletes require further education about the different types of HC, and specifically OC, available to them. Similarities in the symptoms experienced, pain management, and training adaptation requirements between groups suggests that HC use may not have the intended outcome for certain athletes. As such, greater awareness of athlete's personal experiences with the menstrual cycle, how HC may influence their experience, and acknowledgment of non-pharmacological methods to help manage menstrual cycle related symptoms are warranted.

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Section: Introductionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Hormonal Contraceptive Use in Football Codes in Australia

Clarke

Bruinvels

Julian

et al. 2021

Front. Sports Act. Living

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“…Articles must also have compared physical performance in at least two phases of the MC. To standardise the results from the included articles, where possible, the phases were defined using the MC model established by McNulty et al [5] consisting of the early follicular (days 1-5), late follicular (days 6-12), ovulatory (days 13-15), early luteal (days [16][17][18][19], mid luteal (days 20-23) and late luteal (days 24-28) phases.…”

Section: Discussionmentioning

confidence: 99%

“…The MC typically begins around 13 years of age [12] and will continue regularly until perimenopause around the age of 45 years [13] unless interrupted by pregnancy, hormonal contraceptive (HC) use or menstrual or ovulatory dysfunction. Approximately 67%-91% of elite female athletes are eumenorrheic [14,15] and about half of eumenorrheic athletes do not use HC [16,17]. This suggests that a considerable proportion of female athletes may experience cyclic hormonal fluctuations.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Menstrual Cycle Phase on Athletes’ Performance: A Narrative Review

Carmichael

Thomson

Moran

et al. 2021

IJERPH

128

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The effect of the menstrual cycle on physical performance is being increasingly recognised as a key consideration for women’s sport and a critical field for further research. This narrative review explores the findings of studies investigating the effects of menstrual cycle phase on perceived and objectively measured performance in an athletic population. Studies examining perceived performance consistently report that female athletes identify their performance to be relatively worse during the early follicular and late luteal phases. Studies examining objective performance (using anaerobic, aerobic or strength-related tests) do not report clear, consistent effects of the impact of menstrual cycle phase on physical performance. Overall sport performance can be influenced by both perceived and physical factors. Hence, to optimise performance and management of eumenorrheic female athletes, there is a need for further research to quantify the impact of menstrual cycle phase on perceived and physical performance outcomes and to identify factors affecting variability in objective performance outcomes between studies.

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“…This data highlights the great impact that such stress can have on female physiology, not solely on mental health and well-being. Current education around such possible influencers on the menstrual cycle is quite limited amongst the female population (Ayoola, Zandee and Adams, 2016; Larsen et al ., 2020).…”

Section: Discussionmentioning

confidence: 99%

How lifestyle changes within the COVID-19 global pandemic have affected the pattern and symptoms of the menstrual cycle

Bruinvels

Goldsmith

et al. 2021

Preprint

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Background: The coronavirus 2019 (COVID-19) pandemic has caused significant changes to homes, working life and stress. The purpose of this research was to investigate the implications that the COVID-19 pandemic has had on the menstrual cycle and any contributing factors to these changes. Methods: A questionnaire was completed by 749 participants, whom ranged from physically active to elite, in their training status. The questionnaire captured detail on menstrual cycle symptoms and characteristics prior to and during the COVID-19 pandemic lockdown period, as well as lifestyle, stress, exercise and nutrition. Descriptive statistics and frequency distribution were reported and decision tree analysis performed. Statistical significance was assumed at p<0.05. Results: Fifty-two point six percent of females experienced a change in their menstrual cycle during the lockdown period. Psychosocial symptoms had changed in over half of all participants. Participants who reported increased stress/worry in family and personal health were significantly associated with changes in menstrual symptoms. Similarly, job security stress was associated with increases in bleeding time (p<0.05). Conclusions: It is important that females and practitioners become aware of the implications of stressful environments and the possible long-term implications on fertility, particularly given the uncertainty around a second wave of the global pandemic.

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Practice does not make perfect: A brief view of athletes’ knowledge on the menstrual cycle and oral contraceptives

Cited by 44 publications

References 23 publications

Hormonal Contraceptive Use in Football Codes in Australia

Hormonal Contraceptive Use in Football Codes in Australia

The Impact of Menstrual Cycle Phase on Athletes’ Performance: A Narrative Review

How lifestyle changes within the COVID-19 global pandemic have affected the pattern and symptoms of the menstrual cycle

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