Author: Kirsty Elliott-Sale et al.
Journal: Science and Medicine in Football (2026)

This research paper, published in Science and Medicine in Football, provides a comprehensive look at how the menstrual cycle is managed within 15 elite European women’s football clubs. It highlights a significant gap between the perceived importance of the cycle and the actual knowledge and practices of players and staff.

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1. The Knowledge Gap

Despite working at the highest level of the game, basic menstrual health literacy is low across the board:

• Low Scores: Players scored an average of 39% on a menstrual knowledge test, while staff scored 47%.
• The Gender Divide: Female staff members scored significantly higher (64%) than their male counterparts (36%).
• Contraceptive Confusion: A staggering 95% of players were unaware of the different types of oral contraceptive pills available (e.g., combined vs. mini-pill).
• Basic Errors: Many players struggled to distinguish between the length of the entire cycle (avg. 28 days) and the duration of menses (the bleeding phase).

2. Impact on Performance and Wellbeing

There is a strong consensus that the cycle affects what happens on the pitch:

• Performance Perceptions: 72% of players and 94% of staff believe the menstrual cycle impacts performance.
• Common Symptoms: Players frequently reported menstrual cramps, fatigue, disrupted sleep, and mood changes as the primary issues affecting their game.
• Injury Concerns: Both groups expressed concern that certain phases of the cycle might increase the risk of injuries (such as ACL tears), though specific knowledge on when that risk is highest remains inconsistent.

3. Current Practices: Tracking vs. Action

While tracking is common, using that data to change training is still rare:

• Tracking: 67% of players track their cycles (mostly via apps), and 65% of staff encourage players to do so.
• Training Modification: Only 18% of players and 22% of staff actually modify training programs based on the cycle.
• Nutrition: Very few clubs personalize nutrition based on hormonal phases (only 17% of players and 30% of staff reported doing this).

4. Communication and Priorities

The study found an interesting paradox regarding “taboos”:

• High Comfort: 100% of players and staff said they felt comfortable discussing the menstrual cycle within the club environment. The “taboo” seems to be fading.
• Low Priority: When asked to rank the biggest challenges in women’s football, only 6% of players and 13% of staff ranked the menstrual cycle as a top priority. Financial issues, facilities, and general injuries were seen as more urgent concerns.

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Actionable Takeaways

For Coaches:

• Bridge the Gender Gap: Male staff members should seek specific education to close the knowledge gap between them and their female colleagues.
• Move Beyond Tracking: Tracking is only useful if it leads to action. Start small by adjusting recovery protocols or intensity for players reporting high-distress symptoms.
• Education is Key: Players want to learn. Providing infographics or short workshops is the most requested form of support.

For Athletes:

• Increase Your Literacy: Understanding your own cycle can help you manage symptoms like fatigue and sleep disruption more effectively.
• Talk to Your Staff: Since 100% of staff feel comfortable talking about it, don’t hesitate to report symptoms. It helps them help you stay on the pitch.
• Don’t Ignore Nutrition: Simple changes in nutrition during different phases can help mitigate symptoms and support energy levels.

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Based on the findings of the study you provided — which highlights a major gap in menstrual health literacy — taking a structured course is the most effective next step for both athletes and staff.

The OpenLearn course “Supporting female performance in sport and fitness” is specifically designed to bridge this gap. The research shows that while 100% of staff feel comfortable talking about the menstrual cycle, only 18-22% actually know how to adjust training. This course provides the “how-to” that is currently missing in elite football.

Note: This summary was generated with the assistance of Google Gemini based on the original paper and course, with the aim of translating the research into practical insights for coaches and practitioners.