# Menstrual Cycle Characteristics and Injury History in Adult Amateur Female Football Players: A Cross-Sectional Study Using Selected LEAF-Q Items

## TL;DR

This study explores menstrual cycle patterns and injury history in amateur female football players, finding that many experience changes in their cycles and frequent injuries.

## Contribution

The study provides descriptive insights into menstrual health and injury prevalence among non-elite female football players using the LEAF-Q.

## Key findings

- Most players reported normal menstruation, with menarche occurring between 12 and 14 years.
- 12.71% of players reported clinically meaningful amenorrhea, and 52.54% experienced training-related menstrual changes.
- 71.19% of players reported one or two injuries in the past 12 months, highlighting the sport's physical demands.

## Abstract

Background/Objectives: Increasing training demands in women’s football have heightened interest in female-specific health characteristics, including menstrual health. The aim of this study was to describe menstrual-cycle characteristics and injury history in adult amateur female football players using selected items of the Low Energy Availability in Females Questionnaire (LEAF-Q), with particular focus on prolonged absence of menstrual bleeding and training-associated menstrual changes. Methods: A cross-sectional survey was conducted in 118 adult amateur (non-elite) female football players (mean age 24.41 ± 4.50 years). Participants reported mean weekly training hours of 4.88 ± 2.45, consistent with amateur-level competitive and recreational participation. Selected items of the LEAF-Q were used, rather than the complete questionnaire; therefore, findings should be interpreted as descriptive indicators of menstrual health and injury history rather than a comprehensive LEA screening. Results: Most participants reported normal menstruation (95.76%), and menarche most commonly occurred between 12 and 14 years of age (92.37%). A history of ≥3 consecutive months without menstrual bleeding (clinically meaningful amenorrhea) was reported by 12.71% of players, while 4.24% reported such an episode at the time of the survey. Training-associated changes in menstrual bleeding were reported by 52.54% of participants, most commonly shorter and lighter bleeding; less frequently, cessation of bleeding (8.93%) or heavier and prolonged bleeding (1.79%) was reported. Injuries in the preceding 12 months were common, with 71.19% reporting one or two injuries and 28.81% reporting three or four injuries. Conclusions: Despite a high prevalence of self-reported regular menstrual cycles, a notable proportion of adult amateur female football players reported episodes of prolonged absence of menstrual bleeding and training-associated changes in bleeding characteristics. These findings highlight the variability of menstrual-cycle characteristics in the context of football training and support the inclusion of routine, confidential menstrual-health monitoring as part of broader athlete health management in women’s football. Football-related injuries were common over the preceding 12 months, reflecting the substantial musculoskeletal demands of the sport.