Abstract

Objectives To explore athletes’ past and current
experiences and perceptions of the menstrual cycle in
relation to its impact on sporting performance.
Methods 15 international female rugby players
participated in individual semi-structured
interviews
(age: 24.5±6.2 years). All interviews were recorded and
transcribed verbatim, resulting in 37 376 words of text
for descriptive and thematic analysis. Inter-rater
reliability
checks resulted in a concordance of agreement of 83%.
Results Almost all athletes (93%) reported menstrual
cycle-related
symptoms. Thirty-three
per cent perceived
heavy menstrual bleeding and 67% considered these
symptoms impaired their performances. Two-thirds
of
athletes self-medicated
to alleviate symptoms. Thematic
analysis generated 262 meaning units, 38 themes, 10
categories and 4 general dimensions. The four general
dimensions were: (1) symptoms: physiological and
psychological menstrual cycle-related
symptoms such as
dysmenorrhoea, flooding, reduced energy levels, worry,
distraction, fluctuating emotions and reduced motivation;
(2) impact: perceived impact of menstruation on different
aspects of daily lives and performance including negative
and neutral responses; (3) resolution: the methods/
approaches in dealing with menstruation-related
concerns including accepting, or adapting and managing
symptoms with self-medication
or expert treatment;
(4) support: available support and comfortability in
discussing menstrual cycle-related
issues.
Conclusions This study provides the first in-depth
insight into athlete’s experiences of the menstrual cycle
and perceived impact on training and competition. It
highlights individual responses to menstrual ’issues’
and emphasises the need for clinicians and support staff
to undertake menstrual cycle profiling, monitoring and
continue to develop awareness, openness, knowledge
and understanding of the menstrual cycle.