Discussing the menstrual cycle in the sports medicine clinic: perspectives of orthopaedic surgeons, physiotherapists, athletes and patients

ABSTRACT

Recently, there has been a global increase in female-based sports medicine research related to physiological aspects of the menstrual cycle. However, it is unclear whether health professionals and athletes routinely and openly discuss this sometimes-sensitive topic. This study explored different members of the sports medicine community’s knowledge, perceptions of, and comfort in discussing the endogenous menstrual cycle. Five semi-structured focus group sessions were conducted with 18 participants (2 orthopaedic surgeons, 9 sports physiotherapists, 3 patients, and 4 athletes) in New Zealand. Reflexive thematic analysis revealed an overarching theme which described the menstrual cycle as ‘a pertinent and evolving topic in the sports medicine clinic’. The first theme, ‘A dearth of education and discussion has given rise to a perceived lack of menstrual cycle knowledge’, reflects the participants’ consensus regarding a lack of knowledge of the menstrual cycle. In contrast, ‘Different (mismatched) concerns of health professionals and non-health professionals’ describes the different groups’ differing menstrual cycle-related concerns. The third theme, ‘Health professionals have specific strategies to enable comfortable menstrual cycle conversations’, describes that the broader sports medicine community does not routinely discuss the menstrual cycle in the clinic. In addition, it describes common barriers to in-clinic menstrual cycle discussions, including athlete and health professional age, gender and culture. Finally, the study describes pragmatic approaches health professionals frequently take to tackle these barriers. This study highlights the importance of developing trust, giving context and being aware of athletes’ concerns and sociocultural status when discussing the menstrual cycle in the sports medicine clinic.

KEYWORDS:

• Qualitative
• thematic analysis
• focus group
• menstrual cycle
• physiotherapy
• athlete
• female athlete
• sports medicine
• gender performance

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, EOL, upon reasonable request.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/2159676X.2022.2111459

Additional information

Funding

This work was supported by the New Zealand Manipulative Physiotherapy Association. EOL is also an employee of The Accident Compensation Corporation (ACC). The Accident Compensation Corporation (ACC) has provided funding towards her PhD tuition fees as part of her continuing professional development plan.

Notes on contributors

Emma O’Loughlin

EmmaO’Loughlin is a physiotherapist and current PhD candidate at The Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology where she is investigating the effects of a female-specific rehabilitation programme for anterior cruciate ligament injuries. She is also a Musculoskeletal Medicine Lecturer at the University of Otago.

Duncan Reid

DuncanReid is a Professor of Physiotherapy in Auckland University of Technology. Professor Reid is a Fellow of the New Zealand College of Physiotherapy and a Life Member of the New Zealand Manipulative Physiotherapists Association (NZMPA), the International Federation of Orthopaedic Manipulative Physiotherapists Association (IFOMPT) and Physiotherapy NZ (PNZ). He is also the former Vice President of IFOMPT and is an editorial board member for the journals Musculoskeletal Science and Practice, Journal of Orthopaedic Sports Physical Therapy, and the Deputy Editor of the Journal of Manual and Manipulative Therapy.

Stacy Sims

StacySims, PhD, is a forward-thinking international exercise physiologist and nutrition scientist who aims to revolutionise exercise, nutrition, and performance for women. She has directed research programmes at Stanford and the University of Waikato, focusing on female athlete health and performance and pushing the dogma to improve research on all women. Dr Sims has published over 80 peer-reviewed papers, several books and is a regular featured speaker at international academic and professional conferences.