Knowledge and Attitudes Regarding the Menstrual Cycle, Oral Contraceptives, and Sport Performance

The purpose of this study was to construct a questionnaire for athletic coaches that measures (1) general knowledge of the menstrual cycle (MC) and oral contraceptives (OC); (2) specific knowledge of athletes' MC and OC use; and (3) beliefs about the MC, OC use, and sport performance. Focus groups comprising coaches and athletes first assisted in developing items for the questionnaire. Subject matter experts from the field of gynecology further judged the quality of items on the general knowledge portion of the questionnaire. The questionnaire was completed by 207 male (n = 85) and female (n = 122) coaches of middle school, high school, and collegiate teams from across the southeastern United States. Coaches' scores on the 24-item general knowledge section of the questionnaire ranged from 8 to 83 (maximum score available = 90). Female coaches scored significantly higher than did male coaches on the overall general knowledge test, as well as on both subscales of the test (MC and OC subscale). Significant main effects were also found according to the sport coached, the age of the coach, and the ages of the athletes. An item analysis was performed on the general knowledge test to determine item difficulty, item discrimination, and internal consistency. General knowledge test items require little revision and Cronbach's coefficient alpha for the overall test is 0.94 (MC subscale, alpha = 0.93; OC subscale, alpha = 0.84). Responses to items assessing specific knowledge of athletes' MC and OC use proved difficult to measure and to interpret with a reasonable degree of validity. However, in general, female coaches had more knowledge about their athletes' MC and OC use than did male coaches. Moreover, results from a series of logistic regression analyses indicated that gender may be useful in predicting the outcome of knowledge on various items. Responses to the final section of the questionnaire (items assessing coach beliefs) suggest the salience of investigating this research area. Primarily, coaches view the MC as a source of stress for athletes, coaches believe that the MC impairs sport performance, and coaches want documentation of monthly performance change patterns. Recommendations for future research endeavors and considerations of reliability and validity are also discussed.