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How the menstrual cycle and menstruation affect sporting performance: experiences and perceptions of elite female rugby players
  1. Rebekka J Findlay1,
  2. Eilidh H R Macrae1,
  3. Ian Y Whyte2,
  4. Chris Easton1,
  5. Laura J Forrest (née Whyte)1
  1. 1 School of Health and Life Sciences, University of West of Scotland, Lanarkshire, UK
  2. 2 Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, Tyne and Wear, UK
  1. Correspondence to Dr Laura J Forrest (née Whyte), School of Health and Life Sciences, University of West of Scotland, Lanarkshire G72 0LH, UK; laura.forrest{at}


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.

  • female
  • rugby
  • performance
  • health

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  • Contributors LJF and RJF have contributed to all elements of planning, conduct and reporting of the work described in the article. IYW, EHRM and CE have contributed to the conduct and reporting of the work.

  • Funding This study has been funded by the University of the West of Scotland.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. The data that support the findings of this study are available on request from the corresponding author, Laura Forrest, via email: The data are not publicly available due to the qualitative nature and despite all transcribed data being kept in a deidentified form (ie, participant coding), the data still contain information that could compromise the privacy of research participants and/or the support staff.