Menstrual cycle knowledge, first- and second-hand experiences, personal opinions, and practices of players and staff from elite European women’s football clubs

The aim of this study was to assess the knowledge, experiences, opinions, and practices of players and staff from elite European women's football clubs on topics related to the menstrual cycle. Players (women only, <i>n</i> = 320) and staff (men <i>n</i> = 27, women <i>n</i> = 19) completed a bespoke questionnaire and 16 players (women only) and 15 staff (men <i>n</i> = 9, women <i>n</i> = 6) participated in semi-structured interviews. Players (women only, <i>n</i> = 305) provided their self-reported ovarian hormone status. Mean knowledge scores were 39% ± 19% and 47% ± 25% for players and staff, respectively. Among players and staff, 72% and 94%, respectively, stated that the menstrual cycle affected their own/players' performance. Hormonal contraceptives were reported to affect their own/players' performance by 39% of players and 57% of staff. The belief that the menstrual cycle affects sports performance in general was held by 91% of players and 97% of staff, while 70% of players and 80% of staff said the same for hormonal contraceptives. In terms of self-reported ovarian hormone status, 60% of players were naturally menstruating, 26% used hormonal contraceptives, and 14% disclosed menstrual irregularities. Our findings show that knowledge on topics related to the menstrual cycle and hormonal contraceptives was low in both players and staff at elite European women's football clubs. These data highlight that further credible education is warranted to empower players to make evidence-informed decisions about their health and performance and to equip staff to provide appropriate support.