Monitoring Menstrual Health in Footballers: Considerations for Tracking Menstrual and Hormonal Contraceptive Cycles in the Field to Support Performance.

Monitoring menstrual health has gained popularity in sports like football as an opportunity to identify recurring symptoms or adverse symptoms related to the menstrual or hormonal contraceptive cycle; to recognize challenges related to low energy availability (LEA), low carbohydrate availability, overreaching/overtraining, and/or overall lifestyle stress due to their association with menstrual disturbance/dysfunction; to be informative in contextualizing athlete training status, e.g., training load and performance progression; and to promote and empower body/health literacy and overall health in female athletes. Monitoring menstrual health may also offer valuable insights to inform decisions regarding training and recovery. In team sports like football, where training loads and match schedules are relatively uniform across the squad, individualized strategies to effectively manage recurring adverse symptoms or menstrual disturbance/dysfunction may be necessary to ensure that all athletes can perform and recover optimally. The purpose of this article is to describe the rationale and suggested approaches for tracking menstrual and hormonal contraceptive cycles (including menstrual disturbance/dysfunction) in field settings to facilitate monitoring of menstrual health to potentially contextualize the other health and performance data. Herein, we assess the feasibility and potential limitations of different tracking methods from traditional paper and pencil records to more sophisticated digital applications and biochemical measures for use in real-world settings.