Female athlete triad cross-sectional study of soccer players by level of competition.
Chiaki Matsumoto, Masahiro Ishizaka, Akira Kubo and 1 others
PMID 36866004WHAT IT FOUND
Most female soccer players reported menstruation as bothersome or affecting performance, yet only a few used low-dose pills.
Players with a history of amenorrhea had later menarche. Lower-level players expressed a stronger desire to lose weight than top-league athletes.
Key findings
0192% of players found menstruation bothersome and 86% reported performance changes, but only 5% used low-dose pills.
02Athletes with a history of amenorrhea had a significantly later age at menarche compared to those without.
03The desire to lose weight was significantly higher in lower-level leagues (up to 84% in prefectural leagues) compared to the top league (39%).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Data was self-reported via an anonymous online survey, meaning medical diagnoses for amenorrhea, fatigue fractures, and menarche age were not clinically verified. Height, weight, and BMI were measured at the time of the survey, not at the time of amenorrhea onset, preventing analysis of the causal relationship between body composition and menstrual dysfunction. The study groups had significant age differences, with top-league players being older than those in lower leagues, which may confound comparisons between competition levels. The cross-sectional design cannot determine cause and effect, only associations.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not assume that players who eat three meals a day have adequate energy availability. The study found that while 90% ate three meals, only 23% knew their calorie requirements, and a high percentage desired weight loss, indicating potential gaps in nutritional literacy and energy balance that self-reported meal frequency does not capture.