‘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

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.