Female para-athletes’ menstrual health: An overlooked chapter in sports research

Abstract

Menstrual cycle (MC)-related health issues can significantly impact female athletes’ performance and well-being. However, research on the female para-population remains limited, with existing studies often focusing on specific sports or disability types. This review aims to summarize existing findings on MC-related concerns among female para-athletes and highlight gaps in current research. Literature search was conducted between December 2024 and June 2025 using PubMed (n = 1504) and Scopus (n = 565), retrieving 2069 articles. Keywords were selected collaboratively and combined using Boolean operators to ensure a comprehensive search. After removing 118 duplicates, 1951 articles were screened by two reviewers. Only 5 articles met the inclusion criteria after title and abstract screening. These 5 articles, when reviewed, revealed a high prevalence of MC-related issues among female para-athletes, with 63.4% reporting that MC affected their health and performance. Moreover, there is a low awareness of MC-related health issues, suggesting a lack of education within the broader para-athletic population. Although previous research has explored various aspects of MC experiences, disability-related factors, such as the type and nature of the disability, have largely been overlooked. Existing evidence is constrained not only by small sample sizes but also by the underrepresentation of para-athletes. Importantly, there is a significant gap in the literature concerning the unique perspectives and challenges faced by female para-athletes from Asian countries, as research focusing on this population remains limited. Thus, there is a pressing need for sport, exercise, and impairment-specific research to better understand the specific MC-related issues and experiences of female para-athletes.