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We are Courageous: Speaking Out Boldly and Acting for Change: Women in Sport and Exercise Academic Network Conference, 20–22 June, 2023

Milly Blundell, Tori Sprung, and Zoe Knowles

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Menstrual Cycle and Hormonal Contraceptive Symptom Severity and Frequency in Athletic Females

Laura R. Kiemle-Gabbay, Stephanie Valentin, Daniel Martin, and Laura J. Forrest (née Whyte)

The purpose of this study was to determine symptom severity and frequency in female exercisers and athletes from a diverse range of sports who have a menstrual cycle (MC) or use hormonal contraceptives (HCs). An additional aim was to explore the perceived impact of MC/HC use upon exercise and sport performance. In total, 604 self-identifying female athletes and exercisers (M = 29.4 years, SD = 9.0) from 85 sports/activities completed a survey which included: sport/exercise participation, bleeding characteristics, HC use, symptom severity/frequency, symptom management strategies, menstrual product use, and perceived impact of MC/HC use on exercise performance. The data were subject to mixed-methods analysis. Over one third (n = 225; 37.25%) of participants reported current HC use. Ninety-five percent (95.36%) of participants experienced symptoms related to MC or HC use. Physiological, psychological, and affective symptoms were all among the most prevalent. The most frequently noted severe and very severe symptoms for all participants, MC and HC users, were abdominal cramps (36.92%, 39.32%, and 32.89%, respectively), mood changes (26.16%, 25.07%, and 28.00%, respectively), and tiredness (25.33%, 25.59%, and 24.89%, respectively). Symptom impact was self-managed through medical and/or other (cognitive/behavioral) strategies. Qualitative content analysis of the data produced four overarching themes: (a) the impact of symptoms, (b) menstrual stigma and taboos, (c) protective factors, and (d) coping strategies. In conclusion, menstruation is a multifaceted, unique experience that impacts upon sport/exercise performance. Practitioners should consider athletes’ distinct needs, including the frequency of occurrence and severity of their symptomatic experiences, when facilitating menstruation-supportive training, avoiding a “one-size fits-all” approach.

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Men and Women Competing on Equal Terms? A Cross-Sectional Study of Young Women About the Impact of Menstrual Concerns on Equestrian Sport Participation

Kirrilly Thompson, Dani Jennifer Barrington, and Julia Coffey

In equestrian sport, women are popularly thought to compete on equal terms with men. This ideal has been critiqued by studies documenting how women’s participation is impacted by gendered equestrian cultures and society more broadly. However, one physiological process has been overlooked—menstruation. This is the first study to focus specifically on the impacts of menstruation and menstrual concerns on women’s participation in horse sport and to locate those concerns within broader equestrian traditions of attire and discourses of control. The authors conducted a cross-sectional survey of 328 female riding members of Pony Club Australia aged 10–17 years. Findings challenge the idea of equestrian as a sport where men and women compete “on equal terms.” In particular, they illustrate how traditional dress codes of white-/light-colored riding pants exacerbate menstrual concerns, limit/prevent participation, and pose safety concerns due to distraction. The majority (80%) of participants supported changing the formal uniform to allow darker-colored riding pants. However, longstanding equestrian associations between white pants, prestige, and respect are a barrier to the adoption and therefore normalization of period-friendly attire. While discriminatory rules or standards need to be revised, they are insufficient to challenge entrenched gendered, socio-historical, and esthetic constructions of some organized sports. The authors therefore recommend that rule changes be supported by other practical and educational initiatives necessary to create period-friendly cultures for equestrian sport.

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Assessing the Effect of COVID-19 Lockdown on Perceived Barriers and Facilitators to Physical Activity Among Women in Southeast England

Katherine Paice, Hannah Hersant, Shannah Anico, and Elizabeth Smith

Background: The COVID-19 pandemic resulted in restricting daily physical activity (PA). Women’s PA levels have been disproportionately negatively affected by the pandemic, compared with men. It is important to determine how women’s PA has changed over the pandemic, and if new barriers to PA participation exist since the release of restrictions. Aims: To assess how women in southeast England changed their activity during the pandemic and postpandemic, including how barriers and facilitators to activity have changed. Methods: Three hundred and thirty females completed the first online questionnaire (during lockdown), and 139 completed the postlockdown questionnaire. Questionnaires were designed from the General Practice Physical Activity Questionnaire and International Physical Activity Questionnaire. Participants self-reported PA, and barriers and facilitators to exercise. Eighteen females then participated in online semistructured focus groups. Descriptive and inferential statistical analyses were used for questionnaire data, and focus group transcriptions were thematically analyzed. Results: Most females maintained PA levels throughout the pandemic. Significant barriers to activity were lack of access to equipment/space, limited time to exercise, limited access to social groups, and finances as well as legal restrictions, safety concerns, gender, and lack of childcare. Similarly, significant facilitators were identified during lockdown and postlockdown for access to equipment, finances, having more time to exercise, and exercising with a social group. Participants both expressed desires to return to prelockdown PA habits, but also maintain new ones that were created. Conclusion: It is evident that the pandemic affected and changed the barriers and facilitators to female PA participation. Governments and industries in the sector should focus on providing services that address these changing habits to improve activity levels in women.

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BLinG-Health: A Peer-Led Physical Activity Program for Black Adolescent Girls—A Pilot Study

Tara B. Blackshear and Taylor Baucum

Background: Culturally relevant approaches that address low physical activity rates among Black girls are increasing, yet opportunities to engage in physical activity (PA) remain minimal. Coupled with deficit approaches to school-based PA programming, positioning Black adolescent girls as PA leaders is missing from practice. BLinG-Health aims to develop peer leaders to participate in and deliver group fitness sessions in an after-school PA program. Methods: Black adolescent girls engaged in a culturally relevant, 8-week pretest and posttest quasi-experimental pilot study examining the impact of a peer-led school-based PA intervention program in a Baltimore, Maryland, public school. After peer leaders engaged in a 12-hr fitness education, training, and certification program using the Interactive Fitness Trainers of America’s Tabata group fitness instruction and certification series, peer leaders led classmates in group fitness 2–3 days a week for 8 weeks. Peer leaders and participants completed two assessment rounds at baseline and Week 9, including height and weight, to compute body mass index, waist circumference, hip circumference, hip-to-waist ratio, a 12-min run/walk, and push-up test. Results: Participants (n = 7; M age = 16.43 years) significantly improved in cardiovascular endurance (p = .025) and muscular endurance (p = .013) with modest, nonsignificant changes in anthropometric measures. Discussion: Challenging deficit narratives on Black girls’ PA engagement, participants consistently attended weekly group fitness sessions and improved cardiovascular and muscular fitness. Empowering Black adolescent girls to lead group fitness sessions among peers may enhance PA engagement. Schools should consider culturally relevant programming to increase Black girls’ opportunities to engage in PA.

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Evaluating Change in Body Composition and Impact of Menarche Across a Competitive Season in Elite Collegiate Gymnasts

Sam R. Moore, Hannah E. Cabre, Amanda N. Gordon, and Abbie E. Smith-Ryan

The purpose of this study was to evaluate change in bone mineral density (BMD), BMD percentile (BMDp), lean mass (LM), fat-free mass index, body fat percentage (BF%), and muscle size (mCSA) and quality (EI) in collegiate female gymnasts over a competitive season and characterize the impact of menarche on changes. Twenty gymnasts completed a validated survey to assess age of menarche. Body composition was assessed via whole-body dual-energy X-ray absorptiometry scans at pre- and postseason. mCSA and EI were determined from a panoramic ultrasound scan of the vastus lateralis. Pre- to postseason changes were evaluated using paired sample t tests, and strength of relationships between were analyzed via bivariate correlations and linear regression. Significant losses in body fat percentage (Δ -1.1 ± 1.9%; p = .022) and EI (Δ -5.0 ± 5.8 a.u.; p = .002) were observed. No significant changes were observed in BMDp, mCSA, BMD, LM, or fat-free mass index (p = .310–.869). Age of menarche (15.4 ± 1.5 years) was negatively correlated with Δ BMDp (r = −.454; p = .044) and Δ mCSA (r = −.658; p = .002), explaining 21% and 43% of variation in Δ BMDp and Δ mCSA, respectively. Positive outcomes of gymnastics training, such as gains in LM and mCSA, may be attenuated by delayed menarche, suggested by increased EI and decreased body fat percentage, despite no changes in mCSA or overall LM. These findings may indicate a higher priority of fat utilization within the muscle over muscle and bone growth. Considering menarche as a significant predictor for Δ mCSA, this lack of increase (despite improved EI), may signify increased injury risk resulting from team-specific training style or insufficient energy intake to support appropriate muscle growth.

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Quantitative Hormone Analysis Reveals Sources of Variability in the Menstrual Cycle

Gavin Francis and Nicola Keay

Although the fluctuations of hormones over the menstrual cycle are well recognized, this study investigated the variability in these patterns for individual women. This study examined a set of daily blood hormone results from an underlying data set of previous research. Hormones included follicle-stimulating hormone (FSH), luteinizing hormone, progesterone, and estradiol taken over one menstrual cycle in 20 women of reproductive age (age 20–36 years), with ultrasound-confirmed ovulation. Although every woman’s profile of hormone changes was consistent with the expected physiological sequence of events, there was notable variability in the timing and peak levels. Variability in the length of the follicular phase was greater than in the length of the luteal phase, with the greater part of the variability in the cycle length being explained by variability in the follicular phase. Lower levels of FSH at the beginning of the cycle were associated with a longer follicular phase. Variability in the timing of events around ovulation was relatively consistent across all women. Variability in the length of the luteal phase was associated with the duration of elevated levels of progesterone. Differences were seen in the extent to which FSH increased at the end of the cycle. This study suggests the variability of the first part of the follicular phase may be due to initial FSH changes. Understanding the variability of menstrual cycle hormones is relevant for all women. Identifying subclinical ovulatory disturbances and variability is important to understand female health, across different populations including menstruating women and female athletes.

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Progress of Female Athlete Representation in Research Influencing International Conference on Concussion in Sport Consensus Statements: An Evidence Review

Sydney Asselstine, Jason Krystofiak, Michelle Gorbonosov, and Diana Toto

We aimed to quantify the representation of female athletes in research informing the fifth (Berlin 2016) and sixth (Amsterdam 2022) International Conference on Concussion in Sport consensus statements and analyze trends in progress between the statements. We identified all original research analyzed in each systematic review influencing the consensus statements and determined the percentage of female subjects for each study. Twenty-two systematic reviews and 1,161 original studies were reviewed (572 studies from Berlin 2016 and 1,089 from Amsterdam 2022). Both statements underrepresented females; however, there were significantly fewer studies with no female subjects in the 2022 statement, and more studies with a near equivalent (40%–60%) representation of females. While female athletes are still underrepresented within original research influencing international consensus statements, improvements are evident. We recommend a continued emphasis on female athlete representation and suggest a female-focused component of upcoming statements along with involvement from female predominant sponsoring associations.

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Effect of Training Model on the Physical Condition of Young Female Football Players

Salvador Pérez-Muñoz, Gema Alonso García, Laura Benito García, and Alberto Rodríguez-Cayetano

The aim of the study was to analyze the impact of two training models—the traditional methodology and an alternative or nonlinear mixed methodology—on coordination, speed, and changes of direction (COD) in U-12 football players. The subjects were divided into two groups: a traditional group of 11 female players and a second group of 14 female players, which followed a mixed methodology. Ten training sessions of 30 min were carried out focusing on motor coordination and COD. The variables analyzed were motor coordination with the SportComp test, COD with the Modified Agility test, and the Suttle Sprint and Dribbling test, with and without the ball, and speed over 30 m, with and without the ball. Overall, improvements were obtained in the mixed training program, leading to significant improvements (p < .05) in the variables of motor coordination, speed, and COD, with a large effect size. Therefore, coaches and physical trainers, taking into account that it causes greater benefits in the physical condition of female football players in training, than the traditional training program, can use the mixed training program.

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Fast and Slow Jump Training Methods Induced Similar Improvements in Measures of Physical Fitness in Young Females

Rohit K. Thapa, Bhargav Sarmah, Utsav Chaware, José Afonso, Jason Moran, Helmi Chaabene, and Rodrigo Ramirez-Campillo

This study aimed to contrast the impacts of an exercise intervention using either bounce drop jump (DJ; fast stretch-shortening cycle exercise) or countermovement jump (CMJ; slow stretch-shortening cycle exercise) on measures of physical fitness in young females. A total of 23 young females (age: 19.7 ± 1.0 years, height: 159.8 ± 4.2 cm, body mass: 54.3 ± 14.3 kg) were randomly assigned to either DJ (n = 12) or CMJ (n = 11) training, which spanned 6 weeks. Pre- and posttraining assessments were conducted for 10 m and 30 m linear sprints, change-of-direction speed, CMJ, DJ (jump height, contact time, and reactive strength index), standing long jump, triple-hop distance, and isometric strength. Apart from the variance in jump technique, both interventions were standardized in terms of total repetitions, intensity, and surface type. No significant Group × Time effect was observed in any dependent variables (all p > .05). A significant time effect was observed in 10 m (p < .001, effect size [ES] = 0.70) and 30 m (p < .001, ES = 0.79) linear sprint, CMJ height (p = .012, ES = 0.34), DJ contact time (p = .012, ES = 0.34), and triple-hop distance (p = .006, ES = 0.38). Both DJ and CMJ training interventions led to comparable improvements in linear sprints, CMJ height, DJ contact time, and triple-hop distance. These findings suggest that the duration of ground contact during intervention exercises (i.e., fast vs. slow stretch-shortening cycle) did not significantly influence initial (6 weeks) physical fitness adaptations in young females. However, extending these results to highly trained groups (e.g., athletes) warrants further investigation.