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Barriers to Leisure-Time Physical Activity Among Women of Rural Gipuzkoa: A Mixed-Methods Approach

Olaia Eizagirre-Sagastibeltza, Uxue Fernandez-Lasa, and Oidui Usabiaga

Background: Women, particularly those with young children, engage in less leisure-time physical activity (LTPA) than men. Additionally, mothers living in rural areas have more difficulty participating in LTPA than those in urban areas. The aim of this study was to analyze the challenges faced by mothers of rural areas of Gipuzkoa in LTPA participation, from a feminist perspective. Methods: A total of 129 mothers (age 41.5 ± 5.9; 45.7% inactive) with young children completed the Gipuzkoa Women’s Physical Activity Questionnaire. Concurrently, four focus groups were organized in four different municipalities, in which 19 mothers of young children participated (13 were inactive). Barriers were classified based on the socioecological perspective. Results: The most frequently mentioned intrapersonal barriers were lack of time due to work and caregiving, age-/pregnancy-/motherhood-related health issues, and a feeling of rejection toward LTPA. The most relevant interpersonal barriers were a lack of partners to do LTPA with and a lack of spouse support. The main environmental barriers were related to the shortage of facilities and activities suited to their needs and the rugged terrain. Conclusions: Mothers of young children living in rural areas face barriers twice over: because they are women and mothers and because they live in a rural environment. It therefore seems important to consider their perceived barriers to design, develop, and implement strategies to promote LTPA among this population group.

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Self-Reported Performance and Hormonal-Cycle-Related Symptoms in Competitive Female Athletes

Johanna K. Ihalainen, Sinikka Takalo, Katja Mjøsund, Guro Strøm Solli, Maarit Valtonen, Marja Kokkonen, Anthony C. Hackney, and Ritva S. Mikkonen

Introduction: The present scientific consensus is that the menstrual cycle (MC) and hormonal contraceptive (HC) cycle only influence performance trivially. Nevertheless, athletes perceive changes in performance that they associate with different phases of their hormonal cycle. Methods: A total of 959 female athletes completed a questionnaire, of which 750 were included in the present analysis. The questionnaire included questions about demographics and experiences of the MC and HC (symptoms, perceived impact on performance characteristics). Results: In total, 55% of athletes reported a natural MC while 45% reported HC use. Meanwhile, 56% of all athletes reported a decline in perceived performance during the bleeding or inactive phase, whereas 26% of all athletes reported no changes in performance over their hormonal cycle. All athletes reported an average of 10 ± 7 symptoms during hormonal cycles. The naturally menstruating (NM) group reported more symptoms than the HC group (p < .05). The most frequent symptoms reported were abdominal pain, bloating, and mood swings. Only 7% of all athletes (4.1% in NM and 11.3% in HC) reported an absence of any symptoms. Quantity of total symptoms was associated with a perceived decrease in performance (R 2 = .138, p < .05). Hormonal cycles had the greatest negative effect on mental performance with 37% reporting a large to very large effect. Conclusions: Perceived negative effects on performance were similar in both NM and HC groups while perceived mental performance (e.g., mood and attention) appeared to be most affected by both MC and HC.

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“They Seem to Only Know About Bleeding and Cramps”: Menstruation, Gendered Experiences, and Coach–Athlete Relationships

Anna Goorevich and Sarah Zipp

Menstruation is a barrier to women’s sport participation through stigmas, silence, a lack of coach and athlete education, discomfort in communication, and risk of menstrual disorders, especially at nonelite levels. This study provides a qualitative and quantitative, poststructuralist feminist examination of the barriers and facilitators to positive coach–athlete communication and relationships around menstruation. The aim of the study is to create a gender-responsive model of coaching about menstruation. An online questionnaire was completed by 494 athletes aged 16 years or older. Utilizing poststructuralist feminist theory, qualitative and quantitative analysis highlighted women athletes’ experiences with menstruation, particularly surrounding coach–athlete communication. The results illustrated the heterogeneity of menstruation experiences, with athletes’ previous gendered experiences leading them to resist and/or uphold traditional, masculine-centric gender norms in sport. Most athletes experienced negative menstruation symptoms, but many did not speak with coaches about menstruation, highlighting menstruation’s current position as a siloed topic in sport, usually reserved just for women coaches. Athletes did not discuss menstruation due to discomfort, coach ignorance, menstruation stigmas, and fears of consequences. Athletes largely agreed coaches knowing and discussing menstruation would bring benefits, such as performance improvements, stronger coach–athlete relationships, and erasure of menstruation stigma. Overall, barriers to menstruation discussions include stigma, antagonism and pessimism, and maintenance of a masculine norm. A model of gender-responsive coaching around menstruation is proposed for coaches and sport organizations, which promotes integration and proactivity, tolerance and trust, and protection of athlete voice and agency.

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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.