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244 Prevalence and burden of menstrual disorders in athletes: a questionnaire study

Background Menstrual disorders including amenorrhea and oligomenorrhea are well-documented issues for female athletes. There are many menstrual disorders that may affect the female athlete. These include conditions such as premenstrual syndrome, dysmenorrhea and menorrhagia. Evidence of the prevalence and burden of these conditions is less common in the published literature. Objective To assess prevalence and burden of menstrual disorders in athletes. Design Cross-sectional study conducted via a web-based questionnaire. Setting Web-based questionnaire circulated directly to sports clubs and via various social media platforms. Patients (or Participants) Females, 18 years and older, engaged in competitive sport or regular physical activity. Interventions (or assessment of risk factors) Participants completed an online questionnaire incorporating demographic details, validated questionnaire assessment of menstrual function and performance related sections. Main outcome measurements Identification of the prevalence and symptomatology of menstrual disorders within this cohort of athletes and the impact of these disorders on athletic performance. Results 533 physically active females completed the online questionnaire. 28.5% competed at national or international level with 66.8% competing regularly in their chosen sport. 35.1% reported concern about their menstrual cycle, with 27.2% overall reporting that these concerns were significant. 35.27% reported current or previous amenorrhea, 48.2% reported symptoms of premenstrual syndrome with 65.7% reporting analgesic use for dysmenorrhea. 82.3% of those studied have sought medical advice and were prescribed medication. Other sources of advice included; friends (68.9%), family (63.2%) and coach/trainer (15.8%). 78.85% have used the oral contraceptive pill, most commonly for contraception (49.64%), dysmenorrhea (18.71%) and menorrhagia (7.91%). Common symptoms associated with exercise included prolonged duration of menses (16.6%) and increased bleeding (2.9%). Conclusions Disorders of menstruation are common in athletes and include premenstrual syndrome, dysmenorrhea and menorrhagia. Although less well studied in athletes, these menstrual disorders can affect quality of life, training and athletic performance in the female athlete. Ideally, these conditions should be identified at pre-participation screening and pro-actively managed in the competitive athlete.