Despite the increasing participation of women in Olympic sports, substantial gaps still remain in science-based knowledge concerning female athletes. For example, few studies have evaluated the prevalence and severity of menstrual disorders, such as premenstrual syndrome (PMS). Therefore the aim of the study was to assess the occurrence of PMS symptoms and their severity in naturally menstruating female athletes. A cross-sectional survey was conducted among professional female athletes. The occurrence and severity of PMS were assessed using the validated, retrospective Premenstrual Symptoms Screening Tool (PSST). Various aspects related to menstruation were assessed using the LEAF-Q questionnaire and additional questions. In this study, "naturally menstruating" refers to cis-gender women who experience menstrual bleeding with cycle lengths between 21 and 35 days (Elliott-Sale et al., 2021). Of the 120 questionnaires distributed, 106 were returned. Of these, 32 women were excluded (28 because of irregular menstruation and 5 due to hormonal contraception). Finally the data from 73 women (mean age 20.7 ± 4.8) were taken for analysis. According to PSST criteria, 36% of the female athletes met the criteria for PMS, with half of them (18%) meeting the criteria for the more severe form, premenstrual dysphoric disorder (PMDD). The most common symptoms were overeating/food cravings (86%), physical symptoms (85%) and anger/irritability (80%). No statistically significant differences were found in the incidence of PMS among women training water sports, combat sports, cycling and other. However, more cases of PMS were observed among female athletes training for team sports than in individual sports (50% vs. 27%, p=0.049). Female athletes with and without PMS did not differ in the number of hours training per week (18±9 vs. 17±9 respectively, p=0.597). About 62% of respondents declared that premenstrual symptoms affected their training and competition performance, with 33% describing this effect as moderate to severe. It seems that PMS, and especially its severe form, PMDD, is more prevalent among professional female athletes, particularly those in team sports, than among women of reproductive age in the general population.
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