Does a Menstrual State and Hormonal Contraception Use Determine Exercise Participation? A Study of 8060 Exercising Women.
Level 4 - case-series / case-control
Cross-sectional survey study
PubMed 42034342 · doi:10.1123/jpah.2025-0746
What was done
An online cross-sectional survey was completed by 8,060 premenopausal women (aged 18 years or older) recruited across six territories via the STRAVA exercise application. The survey assessed self-reported menstrual states, hormonal contraception (HC) use, exercise volume, and perceived impacts of menstrual status on training and competition.
What was found
HC use was reported by 39.7% of participants, oligomenorrhea by 14.5%, nonhormonal IUD use by 6.0%, polymenorrhea by 1.1%, and amenorrhea was listed at 42.1% and 4.4% in the abstract. Reported menstrual dysfunctions included ovarian cysts (11.3%) and polycystic ovarian syndrome (7.9%). HC users were significantly less likely to miss or modify training compared to participants reporting amenorrhea (P < .001) or polymenorrhea (P = .035), and were less likely to miss a race, event, or competition than those with eumenorrheic cycles (P < .001) or amenorrhea (P = .021). Those with polymenorrhea were significantly more likely to miss competitions than those with eumenorrhea (P = .032), oligomenorrhea (P < .001), HC use (P < .001), or nonhormonal IUD use (P = .017).
Why it matters
It characterizes self-reported menstrual patterns in a large active cohort, showing that irregular cycles are associated with greater athletic disruption whereas hormonal contraceptive users report fewer missed sessions.
Limits
The cross-sectional design cannot establish causality. Recruitment via a specific fitness app introduces self-selection bias. All clinical conditions, cycle states, and training disruptions were self-reported without objective clinical confirmation, and the abstract presents contradictory prevalence rates for amenorrhea.
Cited by
- contradicts Survey data shows that women typically do not report overhauling or changing their training in response to menstrual symptoms.