A first-of-its-kind Australian assessment tool developed by researchers is set to transform how menstrual health is understood and managed in sport.
Led by University of Southern Queensland (UniSQ) researcher Dr Brianna Larsen – supported by the Australian Institute of Sport (AIS) – the validated menstrual health literacy assessment provides the first comprehensive measure of understanding among athletes, coaches, and performance support staff.
The tool was developed following earlier research, which found athletes and coaches answered just 57 per cent of menstrual health questions correctly on average, revealing a significant knowledge gap despite increasing attention on women’s sport.
Developed as a 15-minute questionnaire, the tool comes as many female athletes report that their menstrual cycle negatively impacts training and competition, with hormonal contraception commonly used to manage symptoms or avoid menstruation altogether. Disordered menstruation is also prevalent and often goes undiagnosed, showing the need for better education and awareness.
The tool enables athletes, coaches, and support staff to assess their understanding of the menstrual cycle and hormonal contraceptives and use clear evidence to guide decisions.
Dr Larsen called the initiative a potential game-changer for women’s sport.
“By improving knowledge, athletes can make more informed decisions about their menstrual cycle and the use – or non-use – of hormonal contraception, while performance support staff are better placed to assist them,” she said.
“When athletes have a better understanding of their menstrual health, they’re more likely to pick up on abnormal symptoms early and seek professional advice sooner, helping them take a more personalised approach that protects wellbeing and optimises performance.”
Supported by the AIS Research and Development Grant program, the tool was developed with input from more than 200 Australian elite athletes, coaches, and performance support staff.
It measures knowledge in four key areas important to athlete health and performance: normal menstrual cycle function, menstrual cycle dysfunction, oral contraceptive pills, and other hormonal contraceptives such as IUDs and implants.
Dr Larsen said her previous research highlighted an urgent need for better menstrual health education in high-performance sport.
“On average, athletes and coaches correctly answered just 57 per cent of questions,” she said.
“While these results show improvement over similar research from five years ago, they still reveal a clear need to strengthen education and awareness within high-performance environments.
“Training modifications based on menstrual cycle phase are becoming increasingly common, yet coaches and athletes often implement them without sufficient foundational knowledge. This tool aims to change that.”
The tool comes at a critical time, as more women participate in sport, women’s competitions receive greater visibility, and interest grows in women’s sports science.
“Importantly, organisations can also use it after delivering education programs, allowing them to measure whether learning interventions actually improve menstrual health literacy,” Dr Larsen said.
Sporting organisations, coaches and high-performance staff are encouraged to use the free questionnaire as a starting point to assess menstrual health literacy and guide targeted education, boosting knowledge, awareness, and outcomes for female athletes nationwide.
At UniSQ, the ‘Girls 2 Win’ student-athlete program, led by Dr Larsen, has included the questionnaire to help young female athletes understand the unique aspects of their physiology and how it may impact health and performance.
Since 2016, Dr Larsen has worked in the field of menstrual cycle physiology and athlete education, and she has led menstrual health workshops for major sporting bodies, including the AIS, Queensland Academy of Sport (QAS), National Rugby League, and Swimming Australia.
Her research team included Professor Stephen Bird (UniSQ), Erica Greet (University of South Australia), Karlee Quinn (QAS), Alice McNamara (MP Sports Physicians), and John Osborne (Arctic University of Norway).
