Author(s): COTHAM, I., BROWN, H., CARR, A., HAMILTON, L., SNIPE, R. , Institution: DEAKIN UNIVERSITY, Country: AUSTRALIA, Abstract-ID: 716

INTRODUCTION:
Most female athletes and exercisers (active females) experience menstrual cycle-related symptoms (MCS) which can negatively affect sport and exercise participation and performance. However, there is currently no valid or reliable method to assess MCS in active females. This study aimed to develop the first valid and reliable tool to assess MCS and their perceived impact on exercise performance and participation in active females.
METHODS:
A pool of items (MCS) was generated through reviewing the existing literature. Items were evaluated by 7 experts across three Delphi rounds, alongside two focus groups with active females (n=7), to develop a draft MCS monitoring tool (MCS-MT; content validity). Refinements were made following cognitive interviews with active females (n=7; face validity). Item reduction, factor analysis, validity (construct, criterion) and reliability (internal consistency, test-retest) were assessed following daily MCS-MT administration and additional validated questionnaires (Brunel Mood Scale (BRUMS), Premenstrual Symptom Screening Tool, and a dysmenorrhea visual analogue scale), and criterion indicative of MCS (number of health professionals seen and management strategies used for MCS), to active females (n=215) across two menstrual cycles
RESULTS:
Forty MCS achieved consensus for inclusion. Following item reduction and factor analysis, the final MCS-MT included 26 MCS across six factors; energy and functional capacity, fluid retention and affective lability, positive activation, somatic pain, negative affect, and sleep disturbance. Internal reliability was acceptable during early follicular (menstruation; α= 0.85) and the late luteal phases (five days pre- menstruation; α= 0.86). Test-retest reliability of the total MCS-MT was poor to good, with an intra-class coefficient of 0.46 during the early follicular and 0.78 in the late luteal phase. Total MCS-MT scores were higher in individuals with moderate dysmenorrhea than no-mild dysmenorrhea during the early follicular phase (median 65 [IQR 36 –92] vs. 26 [14–54]; p<0.001) and with moderate-severe premenstrual syndrome (PMS) than no-mild PMS during the late luteal phase (median 26 [IQR 5–51] vs. 10 [1–22]; p<0.001). The MCS-MT correlated with BRUMS (r=0.57 early follicular; r=0.43 late luteal; p<0.01) and criteria indicative of MCS (health professionals seen and management strategies) during the early follicular and late luteal phase (p<0.05).
CONCLUSION:
The MCS‑MT is the first validated and reliable tool specifically developed to assess MCS in active females. It demonstrates strong content, face, construct, and criterion validity, with acceptable internal reliability. While test–retest reliability varied, this aligns with natural fluctuations in MCS across cycles. The MCS‑MT offers a robust method for identifying MCS, understanding their impact on exercise, and evaluating strategies aimed at reducing symptom burden in female athletes and exercisers.