Injury Risk and Overall Well-Being During the Menstrual Cycle in Elite Adolescent Team Sports Athletes

Background/Objectives: The impact of the menstrual cycle on the well-being and injury risk of young elite female athletes is poorly understood. This study assessed how the menstrual cycle phase influences perceived well-being and injury risk among young elite female team athletes aged 14-18 throughout a season. Methods: Wellness data, time-loss injuries, and menstrual cycle information were prospectively recorded for 59 young elite female team players throughout one season. The menstrual cycle was categorized into four phases using a standardized model: early follicular (menstruation), late follicular, early luteal, and late luteal (pre-menstrual) phases. Results: Significant differences were observed in wellness data, especially in sleep and fatigue, with poorer sleep quality and greater fatigue reported during the early luteal and late luteal (pre-menstrual) phases (p < 0.001). Furthermore, the luteal phase of the menstrual cycle was significantly associated with a higher incidence of sports injuries, particularly for joint/ligament and muscle/tendon injuries (p = 0.024 and p = 0.040, respectively). Conclusions: In elite female team athletes, poor sleep, increased fatigue, and elevated injury risk were significantly observed during the luteal phases of the menstrual cycle (early and pre-menstrual). These findings emphasize the importance of individualized monitoring and adaptive training strategies to mitigate the physiological effects of the menstrual cycle on athletic performance and injury risk.