Menstrual cycle-related symptoms vary in type and severity, and can influence daily functioning, including dietary behaviours (1) . For female athletes, nutrition is crucial for performance and recovery (2) , and fluctuations can have significant implications. While previous research has explored how the menstrual cycle impacts general health and behaviour (3) , less is known about its influence on dietary patterns. This study aimed to explore how athletes across different calibres of competition perceive the impact of menstrual cycle-related symptoms on their dietary behaviours and the support available to manage these effects within their sport. A qualitative interview study was conducted using a pragmatic and interpretivist approach. One-to-one online semi-structured interviews were conducted with female athletes, aged 16-49 years (WHO reproductive age range), residing in the United Kingdom (UK) or Republic of Ireland and actively training/competing in sport. Convenience and snowball sampling was employed. Interviews were audio-recorded and transcribed verbatim. Reflexive Thematic Analysis was conducted; preliminary findings are presented. Ethical approval was granted by King’s College London Research Ethics Board (LRS-24/25-48790). Sixteen female athletes (mean age 26.3 ± 4.67 years) participated in the interviews to date. Participants were UK based, the majority were white (75%), and from endurance sports (43.8%), highly trained/national level (43.8%), and had regular periods (62.5%). Three preliminary themes were generated; 1) “Copy and pasted from the men’s team” – Gaps in menstrual and nutritional education; 2) The inconsistent influence of symptoms on eating behaviours; 3) “You just get on with it” – Cultural pressures and the silence around menstrual health. They highlighted across all calibres of competition there is a lack of structured, female specific education on menstruation and nutrition within a sporting context. Their training and nutrition advice was based on the male body. This led to stigma, confusion and sometimes unhealthy eating behaviours such as under-fuelling. Participants suggested symptoms influenced appetite and eating behaviour; however, effects varied, some athletes reported increased appetite or cravings, while others experienced reduced intake. Cultural barriers in sport were perceived as obstacles to optimising nutrition around the cycle. Many athletes described experiences where menstrual symptoms were overlooked, dismissed, or even ridiculed, with training expected to continue as normal, regardless of how they felt, there were no adjustments, they just had to “push through, push harder.” This study highlights the pervasive lack of support for female athletes, that their training and nutrition is still based on a male body. The athletes believe their symptoms affect their dietary intake and their training and are not supported to manage this. A lack of education may be contributing to under fuelling additionally in this population. These findings highlight the need for more open conversations and structured education around menstrual health and nutrition across all levels in sport; organisations, coaches, and athletes.
Priestley et al. (Fri,) studied this question.