472 BO42 – Are we asking the right questions? Exploring female athlete perceptions on important menstrual cycle topics

Background Menstrual cycle (MC) research in sport is rapidly increasing. Considering end-user perspectives is critical when addressing this fundamental health process to ensure practical outcomes related to athletes' training and performance. Objective To understand what athletes perceive is important to consider regarding their menstrual cycles in sport. Design Qualitative research study; one-on-one semi-structured interviews. Setting Online; Zoom audio and video. Participants Twenty high-level team and individual sport female athletes competing nationally (65%) or internationally (35%). Assessment of Risk Factors Participants discussed their MC experiences as athletes in response to 12 interview prompts. Main Outcomes MC-related topics for consideration by researchers and healthcare practitioners were determined through inductive, grounded-theory analyses using line-by-line coding, focused coding, and theory building. Results MC topics were highlighted within four overarching theories: 1) Training and performance, 2) Culture, 3) Health, and 4) Knowledge. Athletes' feelings related to support in their athletic environment were explained by suggesting strategies they desire from their coaching and support staff. Participants wanted access to modifications and symptom management strategies as they strived to understand how to train around their cycle to optimize performance. The athletes recognized the MC should be individualized, however they desired normalizing the cycle as a health process within sport. This included recognizing relationships with overtraining, body image, and misdiagnoses. Hormonal contraceptives were discussed, and athletes had a strong desire to be better informed. Misinformation was evident despite knowledge accrual through family members, peers, and technology. Participants recognized that access to education would be key to increased MC knowledge and awareness. Conclusions These data provide practical recommendations for coaches and practitioners to support female athlete health and wellness. Researchers should continue to pursue high-quality MC research on training strategies, performance impacts, injury risk, and hormonal contraceptives. Sport organizations should prioritize MC education for athletes and coaches.