PT - JOURNAL ARTICLE AU - Alice McNamara AU - Rachel Harris AU - Clare Minahan TI - ‘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 AID - 10.1136/bmjsem-2021-001300 DP - 2022 Apr 01 TA - BMJ Open Sport & Exercise Medicine PG - e001300 VI - 8 IP - 2 4099 - http://bmjopensem.bmj.com/content/8/2/e001300.short 4100 - http://bmjopensem.bmj.com/content/8/2/e001300.full SO - BMJ OPEN SP EX MED2022 Apr 01; 8 AB - 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.Data are available on reasonable request. The data that support the findings of this study are available on request (dralicemcnamara@gmail.com).