PURPOSE:

This study synthesised the experiences and perceptions of menstrual cycle symptomatology (MCS) in sportswomen regarding training, competition participation, management, and coping strategies.

METHODS: 

Guided by the Preferred Reporting of Systematic and Meta-Analyses (PRISMA) protocol, electronic databases MEDLINE, SPORTDiscus, Scopus, and Web of Science were searched between January 2000 and May 2023. Studies which followed a qualitative or mixed methods design, focused on healthy, menstruating, physically active/athletic women of reproductive age (13 to 45 years), and reported on one or more aspects of sportswomen's experiences and perceptions related to MCS, met inclusion criteria. In a sequential manner, titles and abstracts were screened followed by appraisal of full text articles using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Qualitative data were extracted from papers using the standardised data extraction tool from the Joanna Briggs Institute System for the Unified Management of the Assessment and Review of Information (JBI SUMARI). Qualitative research findings were pooled using JBI SUMARI.

RESULTS: 

Nine original qualitative studies were included, eliciting a total of 411 participants. The meta-synthesis yielded four analytical themes (1) experiences; (2) impact on training and competition; (3) management and coping strategies; and (4) knowledge, support and awareness. All included studies investigated team sport athletes and/or active women. Although symptomology varied in type and severity there was a common negative perception of the menstrual cycle on women’s physical and psychological wellbeing. Frequent self-reported MCS were cramps, low energy levels, flooding, lack of motivation and anxiety, which had a greater perceived impact on training compared to competition. Symptoms affected sportswomen on the days prior to and during menstruation. Overall, there was a perceived lack of proactive approaches and limited knowledge about effective strategies to manage MCS. This perception was accompanied by apparent poor communication with and support from both sports staff and health professionals. The existence of menstruation stigma in sport was also voiced.  

CONCLUSION: 

Across the literature, sportswomen report similar experiences and perceptions of their menstrual cycle related to adverse symptomology. Menstrual cycle symptoms affect sportswomen’s physiological and psychological health, leading to reduced or modified training participation and performance, more than competition.