Menstruation, Birth Control, Mental Health Top Team USA Female Athletes’ Research Agenda

In a significant stride toward elevating the voices of female athletes, Emily Kraus, MD, a physical medicine and rehabilitation (PM&R) sports medicine specialist at Stanford Medicine Children’s Health, co-authored a pivotal study aimed at shaping the future of sports science research. The study published in the British Journal of Sports Medicine, marks a transformative moment in understanding and addressing the unique needs of elite female athletes.

Championing the Female Athlete’s Voice

As director of Stanford’s Female Athlete and Translational Research (FASTR) program, part of the Wu Tsai Human Performance Alliance, Dr. Kraus collaborated with study lead author, Dr. Julie McCleery of University of Washington, Boston Children’s Hospital, the U.S. Olympic and Paralympic Committee (USOPC), along with Team USA’s elite female athletes, to identify and prioritize key research topics that directly impact their performance and well-being.

Through a modified Delphi survey, 40 athletes across diverse sports disciplines participated by ranking topics and providing qualitative feedback. The result was a comprehensive list of 14 research topics, with the top five being menstrual cycle symptoms, recovery, birth control, mental health, and the interplay between fueling and the menstrual cycle.

This study represents the first of its kind to actively engage elite female athletes in constructing a research agenda tailored to their specific needs. By centering their voices, Dr. Kraus and her team have laid a solid foundation for future research that can drive meaningful change and support the health and performance of female athletes.

The Power of Collaborative Research

The collaborative nature of this research exemplifies the growing recognition of the importance of including female athletes as partners in the scientific process.

“By involving female athletes directly in the shaping of research and translation agendas, we ensure that the topics we focus on are not only scientifically relevant but also practically meaningful to those who experience these challenges firsthand,” says Dr. Kraus.

The study’s findings highlight the critical need for more comprehensive research into areas that have long been underexplored. Menstrual cycle symptoms and their impact on performance, for example, emerged as a top concern for athletes, yet historically, this area has received limited attention in sports science research.

“This is another thing I know almost nothing about despite being a female athlete for my entire life and having a period for 12 of those years,” said one Team USA athlete who participated in the study. “I also have met countless female athletes who don’t know what is normal/not normal with their period in general and how to handle changes in hormone levels.”

Similarly, topics such as recovery, mental health, and the effects of birth control on athletic performance are crucial areas that require deeper investigation to provide athletes with evidence-based strategies for success.

“I am someone who was on birth control for six years and got off it because I did not feel comfortable continuing to take something that impacted me mentally/hormonally so strongly, and again, I don’t think this is studied enough because it only affects women,” said a second Team USA study participant.

Advocacy and Innovation: Supporting Female Athletes Beyond Research

As a member of the Women’s Health Taskforce launched by the USPOC, Dr. Kraus plays a crucial role in developing guidelines and resources to support women in sports, particularly those returning to competition postpartum. This 16-person panel has been instrumental in generating guidelines for postpartum return to sport, ensuring that female athletes receive the support they need during this critical period.

Shaping the Future of Sports Science

As the world of sports continues to evolve, the work led by Dr. Kraus and her colleagues highlights the importance of amplifying the voices of female athletes, demonstrating the potential for research to drive positive change. Through these efforts, female athletes are not just participants in research but active contributors to shaping the future of sports science.

This study was funded by the Voice in Sport Foundation.