Objectives This study aimed to investigate the impact of menstruation on sport participation among girls in the early years of their menstrual cycle. Design Mixed methods online survey. Methods Girls aged between 10 and 16yrs. were invited to participate in an online survey promoted through two sports governing bodies in Australia (Swimming Victoria and Little Athletics Victoria). The participants completed a 30-item questionnaire, capturing demographics, behaviours, menstrual symptoms and experiences during training and competition. Results A total of 464 participants responded to the survey. Fatigue (n=236, 88.4%), mood (n=238, 89.1%), and pain (n=231, 87.5%) were the most frequently reported symptoms. Girls perceived their sports experience was affected by their periods, reporting changes in skill (n=280; 90.9%), participation effort (n=238; 77%) and attendance (n=180; 58.3%). Menstruation disrupted training (62.8%) and/or competition (33.3%) attendance, especially among individual sport participants (p<0.038). Participants were unable to change their period protection when needed (training: 61.3%; competition 75.4%) and worried about menstrual blood leaking through uniform clothes (training: 89.8%; competition: 91.5%). Participants (n=48; 18.1%) worried about their period to the point they considered dropping out and these participants were significantly likely to report bowel symptoms (p=0.045), missed training (p=<0.001) and competition (p<0.001), and perceived changes in skill (p=<0.001), participation effort (p=<0.001) and attendance (p=<0.001). Conclusions The menstrual cycle impacted girls' sport participation, with a range of symptoms reported and disruptions to training and competition. This study provides data to inform future strategies to better support girls to manage their early years of menstruation in organised sport.
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