De-tabooing the menstrual cycle in sports – A qualitative approach

Abstract

Introduction

Embarrassed and afraid to discomfort their – predominantly male – coach when talking about the menstrual cycle (MC), in elite sports populations 73-89% of female athletes avoided doing so, despite noticing an impact on training and performance (Solli et al., 2020; von Rosen et al., 2022). The aim of this study was to identify whether the topic of the MC in the context of sports is a persistent taboo and which measures could contribute to de-stigmatization.

Methods

The World Café method developed by Brown and Isaacs (2005), a qualitative research technique characterized by a creative approach to participatory action research (PAR), was conducted with 28 adult amateur athletes (15 males, 13 females) aged 20 to 35 years. An interactive workshop, consisting of a lecture on the current state of the scientific literature regarding the interaction between sport and the MC, was followed by small group conversations. Through three separate tables consisting of up to 10 randomly assigned people (mixed-gender groups) and three rounds of conversations per table, guiding questions to the following topics were discussed: “Perception of MC as a taboo subject in sports” (table 1); “Importance & learnings of the workshop” (table 2); “Self-experience effects of MC on performance” (table 3). The documents resulting from the World Café method (tablecloths and cardboard papers) were captured in photographs. Table conversations were recorded and transcribed anonymously. A qualitative content analyses according to Mayring and Fenzl (2022), using an inductive category-building approach, was applied. Data was analysed with MAXQDA 24 software.

Results

MC was reported to be a persistent taboo as perceived to be less communicated due to the prevalence of the following conditions: 1) degree of intimacy regarding the relation to the counterpart, 2) sex of the dialog partner, 3) generation and socialisation, 4) consensus, 5) communication and wording and 6) type of sport. The investigated male amateur athletes phrased “readiness to listen” but most of the times shy away from initiating a conversation because of an existing lack of knowledge or feeling uncomfortable crossing the opposite’s personal boundary. Several female participants described “readiness to talk” about MC (when talking to other women) but addressed the gap of neutral wording when it comes to mixed-sex conversation. From the respondents’ point of view, the topic of the MC in the context of elite sport is perceived as less of a taboo subject, as an enhanced number of female athletes are talking about it in public and media coverage is increasing. Application of different communication media and available edited knowledge was reported to be helpful when de-tabooing and de-emotionalising the topic.

Discussion & Conclusion

In line with previous studies (Gopalan et al., 2024), the societal taboo against the MC is evident as communication about it is limited under certain conditions. This study highlights mixed-gender perceptions regarding opportunities to foster consensus and professionalism in athletic communities. De-tabooing strategies should consider adapted content and communication media to appeal to different target groups.

References

Brown, J., & Isaacs, D. (2005). The World Café: Shaping our futures through conversations that matter. Berrett-Koehler Publishers.

Gopalan, S. S., Mann, C., & Rhodes, R. E. (2024). Impact of symptoms, experiences, and perceptions of the menstrual cycle on recreational physical activity of cyclically menstruating individuals: A systematic review. Preventive Medicine, 184, Article 107980. https://doi.org/10.1016/j.ypmed.2024.107980

Mayring, P., & Fenzl, T. (2022). Qualitative Inhaltsanalyse [Qualitative content analysis]. In N. Baur, & J. Blasius (Eds.), Handbuch Methoden der empirischen Sozialforschung (3^rd ed., pp. 691-706). Springer VS. https://doi.org/10.1007/978-3-658-37985-8

Solli, G. S., Sandbakk, S. B., Noordhof, D. A., Ihalainen, J. K., & Sandbakk, Ø. (2020). Changes in self-reported physical fitness, performance, and side effects across the phases of the menstrual cycle among competitive endurance athletes. International Journal of Sports Physiology and Performance, 15(9), 1324–1333. https://doi.org/10.1123/ijspp.2019-0616

von Rosen, P., Ekenros, L., Solli, G. S., Sandbakk, Ø., Holmberg, H. C., Hirschberg, A. L., & Fridén, C. (2022). Offered support and knowledge about the menstrual cycle in the athletic community: A cross-sectional study of 1086 female athletes. International Journal of Environmental Research and Public Health, 19(19), Article 11932. https://doi.org/10.3390/ijerph191911932