Menstrual Health Awareness and Misconception in Collegiate Athletes: A Pilot Study
Julie Burland, Samantha Stuek, Matthew Hall, Allison Schafer · Journal of Women s Sports Medicine · 2026
Background: The
Purpose: of this study was to evaluate athletes’ misconceptions regarding menstrual irregularities and sport and to evaluate prevalence of medical specialties prescribing oral contraceptive pills (OCP) for athletes with irregular menstrual cycles representing oligomenorrhea/amenorrhea. We hypothesized that athletes are often prescribed oral contraceptives prior to receiving comprehensive screening for the female athlete triad and relative energy deficiency in sport (REDs).
Methods: Division I female athletes at a single institution completed a survey during annual pre-participation examinations (PPEs). Athletes were included if they were ≥ 18 years, read an information sheet describing the study and completed the survey.
Results: 86 collegiate female athletes (19.44 ± 1.44 years) completed the survey (34.9% freshman, 18.6% sophomore, 11.6% junior, 22.1% senior, 8.1% graduate students). 7% were characterized as primary amenorrhea having the onset of menses after age 15. 16 (18.6%) athletes screened positive for menstrual irregularity that were taking oral contraceptives for irregular menstrual cycles. 11.6% and 6.9% presented with oligomenorrhea and amenorrhea, respectively. 65% of athletes responded that they were told it was normal to have irregular menses as an athlete. Of those that screened positive for menstrual irregularity, 25% stated OCPs were prescribed by their OB-GYN, 4% by a pediatrician and 68% did not designate a specialty.
Conclusion: There is a subset of female athletes with menstrual irregularities who take OCPs. OCPs can mask the symptoms of menstrual irregularity which is a component of REDs and can increase the risk of undiagnosed bone stress injuries. These athletes also have misconception regarding their menstrual cycles and sport. These data demonstrate a need for improved athlete awareness regarding menstrual health and symptoms of REDs. Physicians who care for athletes should understand common athlete misperceptions surrounding menstrual health and maintain increased awareness of REDs to facilitate earlier screening, accurate diagnosis, and timely referral for treatment.