Menstrual Health in Indian Sport: Perspectives and Knowledge of Female Athletes, Male Co-Athletes, Coaches, and Support Staff

PURPOSE: To investigate menstrual health perspectives and knowledge among Indian female athletes, male co-athletes, coaches, and support staff, and to examine subgroup differences by sex, role, competition level, education, and prior menstrual cycle (MC) education. METHODS: A cross-sectional online questionnaire (42 items) was completed by 251 participants (110 female athletes, 41 male co-athletes, 52 coaches, and 48 support staff) from 30 sports across 26 Indian states and 3 union territories. Perspectives were assessed through 8 binary questions on MC impact, importance, stigma, tracking, integration into planning, and communication comfort. The knowledge section (20 items) covered MC, menstruation, MC symptoms, and hormonal contraceptive use. Data were analyzed using descriptive statistics, logistic regression for perspective items, and linear regression for knowledge scores. RESULTS: Most respondents (∼88%) acknowledged the MC's impact on training and performance, but fewer reported tracking or integrating it into planning, especially support staff (∼23%), compared to coaches (∼75%) and female athletes (∼64%). Communication comfort was perceived as gender-asymmetric, with greater ease discussing MC information with female (∼92%) than male (∼55%) coaches. Knowledge scores were higher in females than males (P < .001) and highest in support staff compared with coaches and athletes (P < .05). International-level participants scored lower on knowledge than those at national or college-to-state levels (P < .05). CONCLUSIONS: This multistakeholder survey highlights a clear recognition of the MC's impact on athletic performance, yet reveals significant gaps in practice, communication, and education. Targeted, role-specific education and standardized routines for tracking and communication are essential to bridge these gaps and enhance athlete support.