“No, that is not normal”: Psychosocial lived experiences of Elite Athletes living and performing with Menstrual Dysfunctions

Abstract

Background With the increasing representation of women in sports, addressing menstrual health issues, specifically menstrual dysfunctions (MDs), has gained significance. This study aimed to gain a comprehensive understanding of the experiences of athletes living with MDs and how they manifest in their sports performance and psychological well-beingMethods Ten female athletes (mean age = 24.5, SD = 5.20), active and retired, living with MDs, including endometriosis, polycystic ovary syndrome (PCOS), primary dysmenorrhea, and premenstrual dysphoric disorder (PMDD), for a minimum of one year, were engaged in semi-structured interviews. Data analyses utilized Braun and Clarke's (2019) six-phase guide for reflexive thematic analysis, which incorporated a three-step coding process (Moghaddam, 2006) for an in-depth exploration.Results A two-phase thematic analysis highlighted six key themes: medical impact, health impact, psychological impact, socio-cultural impact, social support, and suggestions. These themes illuminate how their physical symptoms led to psychological challenges and underscore the inadequate support received from sporting and medical professionals. In the second phase we identified several barriers and facilitators as illustrated from the lived experience with MDs. These are then synthesised into reccomendations that the athletes suggest themselves which offer insights that can benefit other athletes with MDs and guide coaches and medical practitioners in providing effective support.Conclusions Study findings highlight athletes' daily experiences living with menstrual dysfunctions (MDs) both in and out of sport, including their thoughts on how MDs affect their sports participation, sense of self and personal well-being. Future studies can adopt a more longitudinal approach, delving into various MDs individually for a deeper understanding and conduct focus groups with medical personnel, support staff and athletes for improved support provisions. We recommend an education programme for athletes and coaches in an asynchronous format for access to information and CPD for holistic support for pathway athletes.