{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:18:49Z","timestamp":1787768329128,"version":"build-2784847793"},"reference-count":40,"publisher":"Human Kinetics","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:p>\n                    <jats:italic>\n                      <jats:bold>Background<\/jats:bold>\n                      :\n                    <\/jats:italic>\n                    Menstrual states and hormonal contraceptive (HC) use may affect athletic training and performance. The prevalence of different menstrual states, menstrual dysfunctions, and HC use is not well established in the exercising population. This study aims to describe this, as well as identify the impact that menstrual states may have on training and performance.\n                    <jats:italic>\n                      <jats:bold>Methods<\/jats:bold>\n                      :\n                    <\/jats:italic>\n                    8060 premenopausal women, aged 18\u00a0years or over, from 6 territories were recruited through the STRAVA\u2122 exercise app. An online survey was completed to understand current menstrual states, HC use, current exercise volume, and perceived influence of the menstrual cycle on training and competition.\n                    <jats:italic>\n                      <jats:bold>Results<\/jats:bold>\n                      :\n                    <\/jats:italic>\n                    The most prevalent menstrual state was amenorrhea (42.1%), and HC was used in 39.7% of participants. The occurrences of oligomenorrhea (14.5%), nonhormonal IUD (NonH IUD) (6.0%), amenorrhea (4.4%), and polymenorrhea (1.1%) were comparatively lower. HC users were significantly less likely to miss\/change training compared with amenorrhea (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u2009.001) or polymenorrhea (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u2009.035) cycles. HC users were significantly less likely to miss a race\/event\/competition than those with a eumenorrheic cycle (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u2009.001) or amenorrhea (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u2009.021). Those with polymenorrhea were significantly more likely to miss a race\/event\/competition than those with a eumenorrheic cycle (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u2009.032), oligomenorrhea (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u2009.001), HC users (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u2009.001), or NonH IUD users (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u2009.017). Ovarian cysts (11.3%) and polycystic ovarian syndrome (7.9%) were the most reported forms of menstrual dysfunctions.\n                    <jats:italic>\n                      <jats:bold>Conclusions<\/jats:bold>\n                      :\n                    <\/jats:italic>\n                    Most participants were eumenorrheic or using hormonal contraception. Having polymenorrhoea or amenorrhea was associated with an increased likelihood of negative outcomes on exercise participation. Those using HC were less likely to miss\/change training.\n                  <\/jats:p>","DOI":"10.1123\/jpah.2025-0746","type":"journal-article","created":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T18:45:11Z","timestamp":1777142711000},"page":"1288-1295","source":"Crossref","is-referenced-by-count":0,"title":["Does a Menstrual State and Hormonal Contraception Use Determine Exercise Participation? A Study of 8060 Exercising Women"],"prefix":"10.1123","volume":"23","author":[{"given":"Emily","family":"Bowring","sequence":"first","affiliation":[{"name":"Faculty of Sport, Allied Health and Performance Science, St Mary\u2019s University Twickenham, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9720-3469","authenticated-orcid":true,"given":"Jessica","family":"Hill","sequence":"additional","affiliation":[{"name":"Faculty of Sport, Allied Health and Performance Science, St Mary\u2019s University Twickenham, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal","family":"Hassan","sequence":"additional","affiliation":[{"name":"Kang Women\u2019s Institute, Soccer Forward Foundation, U.S. Soccer Federation, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7582-9575","authenticated-orcid":true,"given":"Emily","family":"Cushion","sequence":"additional","affiliation":[{"name":"School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4354-9912","authenticated-orcid":true,"given":"Jamie","family":"Tallent","sequence":"additional","affiliation":[{"name":"School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, United Kingdom"},{"name":"Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3075-9101","authenticated-orcid":true,"given":"Charles R","family":"Pedlar","sequence":"additional","affiliation":[{"name":"Faculty of Sport, Allied Health and Performance Science, St Mary\u2019s University Twickenham, London, United Kingdom"},{"name":"Orreco Ltd, Business Innovation Centre, NUIG, Galway, Ireland"},{"name":"Institute of Sport, Exercise, and Health, University College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9352-7228","authenticated-orcid":true,"given":"Georgie","family":"Bruinvels","sequence":"additional","affiliation":[{"name":"Faculty of Sport, Allied Health and Performance Science, St Mary\u2019s University Twickenham, London, United Kingdom"},{"name":"Orreco Ltd, Business Innovation Centre, NUIG, Galway, Ireland"},{"name":"Institute of Sport, Exercise, and Health, University College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"100","reference":[{"key":"r1","series-title":"Endotest","first-page":"2000","article-title":"The normal menstrual cycle and the control of ovulation","author":"Reed BG","year":"2018","unstructured":"Reed BG, Carr BR.\u00a0The normal menstrual cycle and the control of ovulation. 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