Author(s): TAIM, B., CHOO, D., CHAN, T., HUANG, L., SIM, S., ONG, S., SUPPIAH, H., LOW, C., XU, C., Institution: HIGH PERFORMANCE SPORT INSTITUTE, Country: SINGAPORE, Abstract-ID: 1544

INTRODUCTION:
The International Olympic Committee Expert Group on exercise and pregnancy has identified reproductive health in female athletes as a research priority (Bø et al., 2017). However, data from Asian athletic populations remain limited. Therefore, this study aimed to provide context-specific descriptive data that can contribute to applied practice and future research in the wider Southeast Asian region. Specifically, it sought to describe Singaporean female athletes’ help-seeking behaviours, symptom management strategies, and perceived performance impacts of the menstrual cycle (MC).
METHODS:
This study used a subset of responses from a larger survey examining MC characteristics, hormonal contraceptive (HC) use, experiences, and perspectives in Singaporean female athletes. A total of 279 athletes (23 ± 7 years) from 57 sports completed the survey. Athletes were classified using the Participant Classification Framework as Tier 2 (trained; 43%, n=120), Tier 3 (highly trained; 25%, n=71), Tier 4 (elite; 26%, n=71), and Tier 5 (world class; 6%, n=16).
RESULTS:
Of 279 athletes, 95% (n=264) were post-menarcheal and not currently using HC (non-HC users). The remaining athletes were pre-menarcheal (0.4%, n=1; age 29 years) or reported current HC use (5.0%, n = 14). Age of menarche was 12 ± 2 years (range: 8–21). Among non-HC users reporting current or previous secondary amenorrhea (23%, n=60), the self-reported duration of period loss was 8 ± 10 months (range: 3–60). Of these, only 25% (n=15) had consulted a medical doctor; 42% (n=25) perceived it was not severe enough to warrant medical care and 33% (n=20) reported that it did not bother them. MC symptoms were reported by 62% (n=164) of non-HC users; among them, 52% (n=85) reported not using any symptom management strategies. Of athletes reporting non-pharmacological symptom management (37%, n=60), strategies included traditional Chinese remedies, supplementation, dietary manipulation, recovery modalities, and exercise. Among non-HC users, 48% (n=126) and 33% (n=87) perceived that their MC affected their ability to train and compete, respectively; of these, 77% (n=97) and 68% (n=59), respectively, also reported MC symptoms. While 41% (n=108) reported missing training due to MC symptoms, only 4% (n=10) reported being unable to compete
CONCLUSION:
The low prevalence of HC use highlights the relevance of the MC, and thus menstrual health, for a large proportion of Singaporean female athletes. MC symptoms and perceived performance impacts were commonly reported; however, medical help-seeking and symptom management were limited. These emphasise the need to strengthen menstrual health literacy and to examine context-appropriate symptom management strategies to support proactive athlete self-management. Collectively, this study provides, to our knowledge, one of the first reports describing Southeast Asian athletes’ perspectives on the MC and perceived performance impacts, offering a foundation to inform research and practice in similar settings.