The Menstrual Cycle; A Priority Research Area For Team Usa Female Athletes

PURPOSE: This study utilized elite female athlete’s input to develop a sports science and medicine research agenda and to inform translational practices. METHODS: Team USA Olympic and Paralympic female athletes were recruited to gain consensus on sports science and medicine topics using a 3-round Delphi survey. Athletes ranked, using a Likert scale (1-5), topics they believe having more knowledge and research on is of high importance to their athletic performance, health, and well-being. Statistical analysis (mean, topic ranking, mean comparisons of binary groups), athlete insight analysis, and expert feedback informed topic changes for the next survey. RESULTS: Forty female athletes (mean age, 29 yrs; sport types, n = 22; Olympians, n = 34; Paralympians, n = 6) completed two rounds of Delphi surveys. Round 1 included a menstrual cycle topic, which rated 2/17 topics with a mean score of 4.4/5. Despite the high ranking and mean in Round 1, new topic suggestions about the menstrual cycle were mentioned approximately 30 times. Specifically, 28% (12/43) of athletes suggested a topic about fueling throughout the menstrual cycle, and over 16% of athletes suggested a topic about symptoms during the menstrual cycle phases. These suggestions resulted in two new menstrual cycle topics for Round 2, with ‘fueling and menstruation’ ranking 1/19 (mean: 4.7) and ‘symptoms during menstrual cycle phases’ ranking 3/19 (mean: 4.5). CONCLUSION: Team USA female Olympic and Paralympic athletes ranked the menstrual cycle among the top three topics during the Delphi process, illustrating the need for further study, information dissemination, and education. Athlete feedback drove the development of multiple menstrual cycle-related topics, showing the value in co-constructing a research agenda driven by and for elite female athletes. The results from this study highlight that female athletes are looking for more information about how the menstrual cycle interacts with their health, performance, and well-being. These findings can drive future research strategy and translational practices for female athletes at all levels of competition. The authors thank Voice in Sport Foundation for funding this study, United States Olympic & Paralympic Committee for help in recruitment, and the Wu Tsai Human Performance Alliance for program support.