Original scientific paper
https://doi.org/10.69589/hsv.40.2.5
THE IMPACT OF COMPETITIVE SPORT ON THE AGE OF MENARCHE, OCCURRENCE OF AMENORRHEA, AND CHARACTERISTICS OF THE MENSTRUAL CYCLE: A RETROSPECTIVE CROSS-SECTIONAL STUDY
Ellen Zaradić
; Prirodoslovna škola Vladimira Preloga, Zagreb
*
* Corresponding author.
Abstract
In recent decades, female participation in competitive sports has increased significantly. While physical activity offers numerous health benefits, intensive training can adversely affect the menstrual cycle. The aim of this study was to analyze the impact of competitive sports on menstrual disorders and cycle characteristics among female athletes from different countries and sports disciplines. This retrospective, cross-sectional study included 369 women, of whom 298 were athletes (experimental group) and 71 were non-athletes (control group). Participants completed an online questionnaire collecting data on age at menarche, incidence of primary and secondary amenorrhea, menstrual bleeding regularity, duration and intensity, and the intensity of menstrual pain. Athletes were further categorized by sport (swimming, athletics, gymnastics, basketball, water polo) and country of training (USA, Croatia, Spain, Singapore). Statistical analyses included t-tests, chi-square tests, ANCOVA, and post-hoc tests. Athletes experienced significantly later menarche compared to non-athletes (12.9 vs. 11.5 years; p < 0.001), with the highest age at menarche observed in gymnasts (13.79). Primary amenorrhea was reported in 4.7% of athletes, varying significantly by sport (p = 0.009), while no cases were recorded among non-athletes. Secondary amenorrhea was more prevalent among athletes (37.6%) than non-athletes (18.3%; p = 0.002), although there was no significant difference in its duration between groups. Athletes reported shorter menstrual bleeding (5.2 vs. 5.8 days; p < 0.001), with the shortest duration observed among Spanish athletes (4.8 ± 1.3), and lighter menstrual flow (3.5 vs 3.4, p = 0.044), which did not significantly vary by sport or country of training. No significant difference was found in the intensity of menstrual pain between athletes and non-athletes, although differences were noted among countries, with participants from Singapore reporting the least intense pain (2.9/6). Competitive sports are associated with alterations in menstrual function, including delayed menarche, higher prevalence of secondary amenorrhea, and shorter, lighter menstrual bleeding. These findings highlight the importance of education and monitoring of female athletes’ reproductive health, with timely recognition and treatment of menstrual disorders essential to preserving long-term health and athletic performance.
Keywords
female athlete, RED-S, menstrual disorders, menstrual characteristics, competitive sports
Hrčak ID:
340604
URI
Publication date:
9.12.2025.
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