Preparticipation examinations for varsity female athletes: The Canadian healthcare practitioners' perspectives

Background Preparticipation examinations (PPEs) are widely used in sport to gather baseline health data before a competitive season. However, content is not standardized across institutions and is often not tailored to health needs of female athletes. Objectives 1) identify which female athlete-specific health concerns healthcare practitioners (HCPs) consider clinically relevant and important to include in PPEs, and 2) explore HCPs' comfort levels in addressing these concerns. Methods A cross-sectional survey was distributed to HCPs who had worked with Canadian university varsity female athletes within the past five years. The survey included multiple-choice and open-ended questions across five domains: gynecological/pelvic, menstrual, Relative Energy Deficiency in Sport (REDs), training/musculoskeletal (MSK), and mental health. Quantitative responses were analyzed using descriptive statistics, and qualitative data via conventional content analysis. Results HCPs (n=55) reported that PPEs most commonly addressed mental (87%), followed by menstrual (74%), MSK (69%), REDs (63%), and pelvic health (33%). Eighty-one percent (n=45) believed all domains were very important to include on PPEs, with questions surrounding eating behaviour/eating disorders, menstrual regularity (96%), eating behaviour/eating disorders, mental health (98%), surgery history (94%) and (100%) pelvic dysfunction (88%) rated most important within each domain. Qualitative responses indicated variability in comfort discussing these topics; those more comfortable viewed these issues as integral to sport and well-being, while discomfort was linked to lack of training or resources. Some male HCPs perceived sex/gender-based communication barriers. Conclusion Inclusion and prioritization of female athlete-specific health topics vary among HCPs in Canadian University Sport. A comprehensive PPE may enhance trust and communication with athletes.