Bad Blood? Menstrual pain, stigma, and mental illness in competitive sport cultures

月经对女运动员表现和健康的影响已经成为体育界的一个优先问题。月经通常伴随着心理、身体和行为症状，扰乱生活的许多方面的日常功能。世界上有一半的人口会来月经，但它却与重大的社会和文化禁忌联系在一起。伊加·斯瓦泰克（Iga Swiatek）等精英运动员打破了对月经对运动成绩影响的沉默，并在如何管理月经方面缺乏专业知识。目前的研究项目旨在优先考虑女性运动员的声音，以探索竞技体育文化中的月经挑战。大多数月经研究都集中在女性运动员的客观症状上，比如注意力下降和极度疼痛，是如何影响训练和表现的。将月经视为生理问题提高了人们对运动员挣扎的认识，然而，它把月经的“问题”放在了女性的身体里。将自然生物过程妖魔化的风险导致一些运动员宁愿不来月经，而是持续服用激素避孕药。纯生理学的观点忽视了社会和文化对经期经历的影响，也没有考虑精英运动环境可能对运动员经期健康和表现的影响。在普通人群中，月经被认为是不洁和恶心的，会导致心理压力和羞耻。月经问题会导致精神障碍的发展，比如经前烦躁不安，对一些女性来说，还会产生自杀念头。尽管体育运动中的心理健康研究越来越多，但运动员的月经耻辱、羞耻和心理疾病健康尚未得到研究。这种耻辱感让运动员不敢透露月经问题，也无法获得支持。为了解决这些差距，这项研究将把运动员月经经历的关注点从表现影响扩大到更广泛的心理健康。具体来说，通过一系列研究，我们将探索经历严重月经症状和精神疾病的运动员的个人叙述。该研究的第一阶段将采用叙事研究，探索运动员在体育运动中的月经和精神疾病经历，特别是探索运动环境和相关社会因素如何相互作用，形成具有挑战性的月经经历。在此基础上，第二阶段将利用反身性专题分析来探讨运动员如何向教练和/或队友透露月经问题。将明确关注导致披露的原因，披露是如何进行的，以及感知到的反应和相关影响。在第3阶段，参与性研究将用于共同制定一项互动式心理教育干预，以支持女运动员为女运动员提供更健康的运动环境。研究结果将对致力于改善支持女运动员在表演环境中管理月经周期挑战的实践的组织和应用从业者具有相关性。

The impact of menstruation on female athlete performance and wellbeing has emerged as a priority issue within sport. Menstruation is often accompanied by psychological, physical, and behavioural symptoms that disrupt daily functioning in many aspects of life. Half the world's population menstruates, yet it is associated with significant societal and cultural taboo. Elite athletes, such as Iga Swiatek have been credited with breaking the silence on the impact menstruation can have on athletic performance and the lack of professional knowledge on how to manage it. The current programme of research aims to prioritise female athletes' voices to explore menstruation challenges within competitive sport cultures.Most menstrual research has focused on how female athletes objective symptoms, such as reduced focus and extreme pain, disrupt training and performance. Framing menstruation as a physiological issue has raised awareness of athlete's struggles, however, it places the "problem" of menstruation inside women's bodies. The risks associated with demonising a natural biological process has resulted in some athletes preferring not to menstruate at all, by taking continuous hormonal contraception. Purely physiological perspectives ignore the social and cultural influences on menstrual experiences and do not consider the role elite sporting environments may have on athlete menstrual health and performance. Within the general population, menstruation can be deemed unclean and disgusting, leading to psychological stress and shame. Menstrual issues can lead to the development of mental disorders, such as pre-menstrual dysphoric disorder and for some women, suicidal ideation. Despite the proliferation of mental health research in sport, athlete menstrual stigma, shame, and mental ill health are yet to be studied. This stigma leaves athletes too fearful to disclose menstrual issues and unable to access support. Addressing these gaps, this research will broaden the focus of athletes' menstrual experiences beyond performance impacts, to include wider mental health. Specifically, through a series of studies, we will explore personal narratives of athletes who experience severe menstrual symptoms and mental ill health. The first phase of this studentship will deploy narrative research to explore athletes' experiences of menstruation and mental illness in sport, particularly exploring how sport environments and associated social factors interact to shape challenging menstrual experiences. Building upon this, phase 2 will utilise reflexive thematic analysis to explore how athletes disclose menstrual issues to their coaches and/or teammates. There will be an explicit focus on what led to the disclosure, how the disclosure was made, and the perceived response and associated impacts. In phase 3, participatory research will be used to co-produce an interactive psychoeducational intervention to support healthier sport environments for female athletes, by female athletes. Results will hold relevance for organisations and applied practitioners committed to improving practices that support female athletes to manage menstrual cycle challenges in a performance setting.