Author(s): TAYLOR, M., TIFTIKCI, S., HEIKURA, I.A., BROWN, N., STEEL, K., CHRISMAS, B.C., MCGAWLEY, K., Institution: UNIVERSITY OF TROMSØ, Country: NORWAY, Abstract-ID: 1419

INTRODUCTION:
Female athletes report experiencing a variety of menstrual cycle (MC) symptoms, often concentrated around the bleeding phase, which may influence their training and performance. While several studies have described the prevalence and severity of MC symptoms at a group level, few studies have explored the cycle-to-cycle characteristics of symptoms at the individual level. Thus, the aim of this study was to investigate the within-individual variation in symptom type, frequency and severity across four consecutive MCs in naturally menstruating athletes.
METHODS:
Seventeen naturally menstruating athletes (25±4 years) completed an online questionnaire twice daily (morning and evening) on the bleeding days of four consecutive MCs. The questionnaire assessed 50 distinct physical (i.e., bloating, cramps, breast pain, etc.) and perceptual (i.e., sad, energetic, anxious, etc.) symptoms, rated on a 0–4 Likert scale (0=none; 4=extremely strong/severe). To analyze symptom characteristics between MCs at the individual level, the three most frequently reported symptoms were identified and ranked for each individual. Severity scores for each of the individually ranked symptoms were summated within each MC. Linear-mixed-effect models were used to examine the effect of MC number (1-4) on symptom severity of each individuals top three symptoms. Analyses were performed in RStudio.
RESULTS:
68 MCs were recorded during the study period. Mean cycle length was 30.1±5.0 days, with 5.5±1.4 days of bleeding. At the group level, the most frequently reported symptoms were stomach cramps, bloating and disturbed sleep, and the most severe symptoms were period cramps, bloating and diarrhea. At the individual level, no specific symptoms were significantly more likely to appear in a participants’ top three most frequent symptoms compared to another (X²=22, df=26, p=0.69), indicating that symptom profiles differed substantially between participants. When examining the severity of the individuals’ most frequent symptoms across MCs, no significant differences in severity were identified for the 1st and 3rd ranked symptoms between MCs (all p > 0.10). For the 2nd ranked symptoms, there was a non-significant trend toward lower severity in MCs 3 and 4 compared to MC 1 (both p=0.056).
CONCLUSION:
These findings indicate that although certain symptoms may be more prevalent at the group level, the specific symptoms experienced at the individual level vary substantially. Notably, the severity of an individual’s most frequently reported symptoms remained stable across consecutive MCs, suggesting that once an individual’s top symptoms are identified, their occurrence is likely to remain relatively consistent and predictable over time. This study highlights the importance of personalised approaches to monitoring and managing menstrual symptoms in sport, as the symptomatic experience during the bleeding days appears to be highly individualistic.