Beyond the Finnish Line: exploring injury, menstrual dysfunction, and disordered eating

Blurred image of young female athletes running around the track. ATHLETICS AAA Athletics Championships 1500 m, Birmingham.

Paper title:  Self-Reported Restrictive Eating, Eating Disorders, Menstrual Dysfunction, and Injuries in Athletes Competing at Different Levels and Sports

Publication: Nutrients. 2021. 13(9). 3275

Publication date: September 2021


Disordered eating and menstrual dysfunction are common among female athletes competing in elite and non-elite sports. The prevalence and associated risk of injury are dependent on age, participation level, and type of sport. For example, athletes competing in sports that promote leanness are at greater risk of menstrual dysfunction and disordered eating. However, few studies have reported injury risk and association between the participation level, type of sport, disordered eating, and menstrual dysfunction. Therefore, the primary outcome of this study was to investigate the prevalence of disordered eating and menstrual dysfunction and identify the relationship between injury risk across age, type of sport, and participation level.


Researchers conducted a cross-sectional investigation through questionnaire responses from 846 Finnish female athletes. The athletes were elite and non-elite, aged 15-45, and represented 67 different sporting codes. The participants completed self-report questionnaires to assess low energy availability-related issues, disordered eating, menstrual cycle function, and injury history. The investigators also evaluated athletes’ perception of the effect on performance and communication around the menstrual cycle.


The study’s findings indicated that athletes within lean sports reported higher levels of restrictive eating and were at greater risk of injury. Furthermore, younger athletes aged between 15-24 years old were at greater risk of menstrual dysfunction than older athletes. In addition, athletes reporting menstrual dysfunction experienced more days off due to injury. Interestingly, there were no differences found between elite and non-elite level athletes.

In conclusion, clinicians working with female athletes should raise awareness and encourage them to seek appropriate support for menstrual dysfunction and disordered eating. Additionally, the study findings highlight the need to assess athletes’ readiness to participate in sports beyond performance metrics. The inclusion and screening for low energy availability-related issues, disordered eating, and menstrual cycle function is paramount in the holistic management of female athletes. Menstrual dysfunction impacts the health and performance of female athletes. Clinicians should acknowledge and understand the role of menstrual cycle dysfunction and disordered eating to improve the management of active females at all levels of participation.

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