A Systematic Literature Review on Menstruation Management and Suppression in Female Athletes Including Performance in Remote Environments

BACKGROUND: This review aims to analyze general principles, current evidence and management options of menstrual management and suppression. It is aimed at those who are involved in sports participation with an additional focus on endurance events within remote environments and wish to further educate themselves on menstruation management, regardless of sex and/or gender. METHODS: A systematic search was conducted using the Boolean method through the Scopus database and Google Scholar. A list of inclusion and exclusion criteria was formed along with a parallel search of resources. Results regarding the suppression or manipulation of menstruation were synthesized. RESULTS: This review demonstrates that there is no ‘correct way’ to manipulate menstrual cycles. The information has been collated and presented with considerations given to the challenges female athletes face. CONCLUSION: Several challenges unique to female athletes, especially in remote environments, have been identified in this review. It is the responsibility of everyone involved in performing and managing female athletes to educate themselves and abolish the taboo of menstruation in sports performance. In doing so, we can encourage more females to participate, including adventurous activities in extreme environment.