Article Text

‘That time of the month’ … for the biggest event of your career! Perception of menstrual cycle on performance of Australian athletes training for the 2020 Olympic and Paralympic Games
  1. Alice McNamara1,2,
  2. Rachel Harris1,3,4,
  3. Clare Minahan3,5
  1. 1Australasian College of Sport and Exercise Physicians, Melbourne, Victoria, Australia
  2. 2Victorian Institute of Sport, Melbourne, Victoria, Australia
  3. 3Australian Institute of Sport, Belconnen, Australian Capital Territory, Australia
  4. 4Perth Orthopaedics and Sports Medicine Research Institute, Perth, Western Australia, Australia
  5. 5Griffith Sports Science, Griffith University, Gold Coast, Queensland, Australia
  1. Correspondence to Dr Alice McNamara; dralicemcnamara{at}


Objective This study explored the perceived effect of the menstrual cycle (MC) on the performance of Australian female athletes, preparing for the Tokyo Olympic and/or Paralympic Games.

Methods 195 female athletes, nominated by 24 National Sporting Organisations as preparing for the Tokyo Olympic and/or Paralympic Games, completed an online questionnaire (‘MCq perceptions’). The MCq perceptions investigated menstrual symptoms, hormonal contraceptive (HC) use and a preferred competition window within the MC.

Results Two-thirds (65.6%) athletes reported that their MC affected their performance; in training (65.6%) compared with competition (58.0%).

Aesthetic-sport athletes were most likely to perceive their performance to be affected by their MC (RR=1.40) compared with endurance (RR=0.88) and strength-sport (RR=1.04) athletes. Athletes experiencing three or more symptoms were twice as likely to identify as affected. Athletes who reported pain (RR=1.89) or the use of analgesia (RR=1.45) were more likely to identify as affected by their MC.

A preferred competition window was identified by athletes as ‘just after your period’ (41.5%). For athletes not using HC, this window was identified by 53.7%.

Conclusion In Australia, elite-female athletes perceive their MC to affect their performance, and many have a preferred performance window. Performance-focused strategies should be created for ‘affected’ athletes, aiming to provide these athletes with education, and where appropriate, control over predictability, timing and symptoms of their MC.

  • female
  • athlete
  • performance
  • endocrine
  • olympics

Data availability statement

Data are available on reasonable request. The data that support the findings of this study are available on request (

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Data availability statement

Data are available on reasonable request. The data that support the findings of this study are available on request (

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  • Contributors This study was designed by AM/RH/CM, Communication to Sports was via RH, data were collected and analysed by AM; data interpretation and manuscript preparation were undertaken by AM/RH/CM. All authors approved the final version of the paper. AM acts as guarantor.

  • Competing interests RH as CMO of Paralympics Australia, sought approval from PA to collect data in parasport. AM as Pathways Medical Lead of Rowing Australia sought approval from PMO of Rowing Australia and Head Coach of Women’s Rowing NTC to collect data in rowing.

  • Patient and public involvement statement In 2019 the Australian Institute of Sport conducted its first Female Performance and Health Initiative focus group gathering together current high performance coaches, sports scientists and sports medicine practitioners, academics, and past athletes to discuss the priorities for the Female Performance and Health Initiative. The meeting outcomes shaped the aims and objectives of the MCq-perceptions, and the question design. At the end of the collection period, both group mean and sport-specific mean data was distributed back to the Sports. Those sports who had less than five respondents received group-mean data to preserve anonymity for their athletes. Some sports have used their data in education sessions. The broader preliminary data was used to help inform priorities of the Female Performance and Health Initiative in 2021-22.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.