A recent study has found that while there is growing openness to discussing menstrual health among elite women’s football players and staff in Europe, significant gaps in knowledge remain. The research, published in Science and Medicine in Football, surveyed 320 players and 46 staff members from 15 top-tier European clubs.
Participants were asked about their understanding of the menstrual cycle, hormonal contraceptives, and personal experiences. The study revealed that staff scored higher than players on knowledge assessments—47 percent versus 39 percent. Female staff members outperformed male counterparts on these topics.
The survey showed that those who had received prior education about the female reproductive system or hormonal contraception achieved better scores. However, many participants struggled to distinguish between menstruation (bleeding) and the broader menstrual cycle, as well as between different types of contraceptives. Knowledge about amenorrhea—a potential indicator of underlying health or training issues—was inconsistent.
Despite most athletes (72 percent) and staff (94 percent) believing that menstruation affects performance, scientific evidence does not consistently support a universal link between menstrual cycles or contraceptive use and athletic performance or injury risk.
The study also found that few participants identified menstrual health as a primary challenge within women’s football. Instead, they highlighted concerns such as financial instability, crowded competition schedules, injuries, limited infrastructure, and lack of research into female-specific issues.
Some teams have begun experimenting with phase-based training or nutrition programs based on the menstrual cycle. Eighteen percent of players and 22 percent of staff reported using these strategies despite a lack of strong scientific consensus supporting their effectiveness for all athletes.
Self-reported data indicated physiological diversity within squads: 60 percent of players were naturally menstruating; 26 percent used hormonal contraceptives; and 14 percent reported suspected menstrual dysfunctions like amenorrhea or irregular cycles.
Interest in further education was high among both groups—76 percent of players and 92 percent of staff expressed a desire for more information through workshops or digital resources.
The researchers concluded: "Elite European women’s football demonstrates openness to discussing menstrual health, yet significant knowledge gaps remain. While most players and staff believe the menstrual cycle and hormonal contraceptives influence performance, understanding of biological mechanisms and health implications is limited."
They added: "Evidence-based, structured educational programs could support informed health decision-making, reduce misconceptions regarding injury risk, and promote supportive team environments. As women’s football continues to expand globally, integrating menstrual health education into elite sport systems may contribute to sustainable athlete well-being and performance."
