The Development of a Valid and Reliable Questionnaire to Measure Menstrual Cycle and Hormonal Contraceptive Knowledge Among Athletes and Sports Performance Support Staff

Article

Larsen, Brianna, Greet, Erica, Bird, Stephen P., Quinn, Karlee, McNamara, Alice and Osborne, John O.. 2025. "The Development of a Valid and Reliable Questionnaire to Measure Menstrual Cycle and Hormonal Contraceptive Knowledge Among Athletes and Sports Performance Support Staff ." Scandinavian Journal of Medicine and Science in Sports. 35 (11). https://doi.org/10.1111/sms.70167
Article Title

The Development of a Valid and Reliable Questionnaire to Measure Menstrual Cycle and Hormonal Contraceptive Knowledge Among Athletes and Sports Performance Support Staff

ERA Journal ID9803
Article CategoryArticle
AuthorsLarsen, Brianna, Greet, Erica, Bird, Stephen P., Quinn, Karlee, McNamara, Alice and Osborne, John O.
Journal TitleScandinavian Journal of Medicine and Science in Sports
Journal Citation35 (11)
Article Numbere70167
Number of Pages19
Year2025
PublisherJohn Wiley & Sons
Place of PublicationUnited Kingdom
ISSN0905-7188
1600-0838
Digital Object Identifier (DOI)https://doi.org/10.1111/sms.70167
Web Address (URL)https://onlinelibrary.wiley.com/doi/10.1111/sms.70167
Abstract

This study aimed to develop the first valid questionnaire to assess menstrual cycle (MC) and hormonal contraceptive (HC) knowledge in athletes and sports performance support staff. Questions were developed following a literature review and four knowledge domains were identified: (1) Normal MC Function, (2) MC Dysfunction, (3) Oral Contraceptive Pills, and (4) Other HCs. Experts (n = 6) reviewed the initial questionnaire, followed by pre-testing with athletes and support staff (n = 19). Validity (item analysis, construct validity) and reliability (test–retest, internal consistency) were assessed following questionnaire administration to athletes and staff without MC education (“Low Knowledge” [LK] group; n = 156) and “High Knowledge” [HK] participants (n = 30) with MC education. Most (n = 122) LK participants completed the questionnaire twice to assess test–retest reliability. Expert review showed good agreement (> 80%) on item clarity and relevancy and pre-testing indicated good content and face validity. The HK group scored significantly higher than LK participants across the questionnaire (43 ± 5 vs. 28 ± 10; p < 0.001; d = 1.48 [1.05, 1.90]) and all knowledge domains (p < 0.05). High item discrimination parameters were found for all domains, indicating effective discrimination between respondents with different knowledge levels. Test–retest reliability was excellent (intra-class correlation coefficient estimates from 0.93 [0.90, 0.95] to 0.98 [0.96, 0.99]), with all domains showing good-to-excellent reliability. Internal reliability (Cronbach's alpha) was considered acceptable (0.93 [0.92, 0.95]; α ≥ 0.7). This questionnaire delivers a valid and reliable tool to assess MC and HC knowledge amongst athletes and support staff and is recommended to guide and evaluate educational interventions to improve menstrual health literacy within sport.

KeywordsMenstrual Cycle; Hormonal Contraceptive; Knowledge; Athletes
Article Publishing Charge (APC) FundingProject Funding
Contains Sensitive ContentDoes not contain sensitive content
ANZSRC Field of Research 2020420702. Exercise physiology
Byline AffiliationsSchool of Health and Medical Sciences
Centre for Health Research
University of South Australia
Queensland Academy of Sport, Australia
MP Sports Physicians, Australia
UiT The Arctic University of Norway, Norway
Sunshine Coast Hospital and Health Service, Australia
University of the Sunshine Coast
Queensland University of Technology
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Bird, Stephen P.. 2021. "The role of performance science in athlete health and wellbeing." Ipswich Jets Athlete Wellbeing Day (2021). Ipswich, Australia 28 Feb 2021
Sports science: recovery in basketball
Bird, Stephen P. and Mihajlovic, Mladen. 2021. "Sports science: recovery in basketball." EuroLeague Players' Association (ELPA) Performance International Congress 2021. Hamburg, Frankfurt 29 May 2021
The underpinning factors of NBA game-play performance: a systematic review (2001-2020)
Huyghe, Thomas, Alcaraz, Pedro E., Calleja Gonzalez, Julio and Bird, Stephen P.. 2022. "The underpinning factors of NBA game-play performance: a systematic review (2001-2020)." The Physician and Sportsmedicine. 50 (2), pp. 94-122. https://doi.org/10.1080/00913847.2021.1896957
Basketball New Zealand infographic: how performance science technology can impact the coaching process
Bird, Stephen P.. 2021. Basketball New Zealand infographic: how performance science technology can impact the coaching process. Wellington, New Zealand. Basketball New Zealand.
Basketball New Zealand infographic: female athlete health - Part 2: hormonal contraceptives: what are the options?
Larsen, Brianna and Bird, Stephen P.. 2021. Basketball New Zealand infographic: female athlete health - Part 2: hormonal contraceptives: what are the options? Wellington, New Zealand. Basketball New Zealand.
Impact of COVID-19 on Athlete Mental Health – Strategies to Promote Emotional Wellness
Bird, Stephen P.. 2021. "Impact of COVID-19 on Athlete Mental Health – Strategies to Promote Emotional Wellness." International Journal of Strength and Conditioning. 1 (1), pp. 1-5. https://doi.org/10.47206/ijsc.v1i1.33
Urgent wake up call for the National Basketball Association
Singh, Meeta, Bird, Stephen, Charest, Jonathan, Huyghe, Thomas and Calleja-Gonzalez, Julio. 2021. "Urgent wake up call for the National Basketball Association." The Journal of Clinical Sleep Medicine. 17 (2), pp. 243-248. https://doi.org/10.5664/jcsm.8938
Basketball New Zealand infographic: female athlete health - understanding your menstrual cycle: what’s normal, what’s not?
Larsen, Brianna and Bird, Stephen. 2020. Basketball New Zealand infographic: female athlete health - understanding your menstrual cycle: what’s normal, what’s not? Wellington, New Zealand. Basketball New Zealand.
Basketball New Zealand infographic: immune health: avoiding infection and maintaining immune health in athletes
Bird, Stephen P.. 2020. Basketball New Zealand infographic: immune health: avoiding infection and maintaining immune health in athletes. Wellington, New Zealand. Basketball New Zealand.
On-field conditioning for large groups: the forgotten aspect in strength and conditioning
Bird, Stephen P. and Corcoran, Glenn. 2020. "On-field conditioning for large groups: the forgotten aspect in strength and conditioning." 2020 ASCA International Conference on Applied Strength and Conditioning. Gold Coast, Australia 19 - 21 Nov 2020 Beenleigh, QLD, Australia.
A survey to identify physically demanding tasks performed during storm damage operations by Australian State Emergency Services personnel
Larsen, Brianna, Graham, Tony and Aisbett, Brad. 2013. "A survey to identify physically demanding tasks performed during storm damage operations by Australian State Emergency Services personnel." Applied Ergonomics: human factors in technology and society. 44 (1), pp. 128-133. https://doi.org/10.1016/j.apergo.2012.05.010
Effect of heat on firefighters' work performance and physiology
Larsen, Brianna, Snow, Rodney and Aisbett, Brad. 2015. "Effect of heat on firefighters' work performance and physiology." Journal of Thermal Biology. 53, pp. 1-8. https://doi.org/10.1016/j.jtherbio.2015.07.008
Firefighter feedback during active cooling: a useful tool for heat stress management?
Savage, Robbie J., Lord, Cara, Larsen, Brianna L., Knight, Teagan L., Langridge, Peter D. and Aisbett, Brad. 2014. "Firefighter feedback during active cooling: a useful tool for heat stress management?" Journal of Thermal Biology. 46, pp. 65-71. https://doi.org/10.1016/j.jtherbio.2014.10.003
The injury profile of an Australian specialist policing unit
Larsen, Brianna, Aisbett, Brad and Silk, Aaron. 2016. "The injury profile of an Australian specialist policing unit." International Journal of Environmental Research and Public Health. 13 (4), pp. 1-9. https://doi.org/10.3390/ijerph13040370
Subjective job task analyses for physically demanding occupations: what is best practice?
Larsen, Brianna and Aisbett, Brad. 2012. "Subjective job task analyses for physically demanding occupations: what is best practice?" Ergonomics: an international journal of research and practice in human factors and ergonomics. 55 (10), pp. 1266-1277. https://doi.org/10.1080/00140139.2012.697582
Sleep restriction during simulated wildfire suppression: effect on physical task performance
Vincent, Grace, Ferguson, Sally A., Tran, Jacqueline, Larsen, Brianna, Wolkow, Alexander and Aisbett, Brad. 2015. "Sleep restriction during simulated wildfire suppression: effect on physical task performance." PLoS One. 10 (1), pp. 1-16. https://doi.org/10.1371/journal.pone.0115329
Multiple days of heat exposure on firefighters’ work performance and physiology
Larsen, Brianna, Snow, Rod, Vincent, Grace, Tran, Jacqueline, Wolkow, Alexander and Aisbett, Brad. 2015. "Multiple days of heat exposure on firefighters’ work performance and physiology." PLoS One. 10 (9), pp. 1-16. https://doi.org/10.1371/journal.pone.0136413
Simulated firefighting task performance and physiology under very hot conditions
Larsen, Brianna, Snow, Rod, Williams-Bell, Michael and Aisbett, Brad. 2015. "Simulated firefighting task performance and physiology under very hot conditions." Frontiers in Physiology. 6, pp. 1-9. https://doi.org/10.3389/fphys.2015.00322
The Impact of Heat Exposure and Sleep Restriction on Firefighters’ Work Performance and Physiology during Simulated Wildfire Suppression
Vincent, Grace E., Aisbett, Brad, Larsen, Brianna, Ridgers, Nicola D., Snow, Rod and Ferguson, Sally A.. 2017. "The Impact of Heat Exposure and Sleep Restriction on Firefighters’ Work Performance and Physiology during Simulated Wildfire Suppression." International Journal of Environmental Research and Public Health. 14 (2), pp. 1-15. https://doi.org/10.3390/ijerph14020180
Response of women using oral contraception to exercise in the heat
Minahan, Clare, Melnikoff, Marina, Quinn, Karlee and Larsen, Brianna. 2017. "Response of women using oral contraception to exercise in the heat." European Journal of Applied Physiology. 117, pp. 1383-1391. https://doi.org/10.1007/s00421-017-3628-7
The Effects of Simulated Wildland Firefighting Tasks on Core Temperature and Cognitive Function under Very Hot Conditions
Williams-Bell, F. Michael, Aisbett, Brad, Murphy, Bernadette A. and Larsen, Brianna. 2017. "The Effects of Simulated Wildland Firefighting Tasks on Core Temperature and Cognitive Function under Very Hot Conditions." Frontiers in Physiology. 8, pp. 1-10. https://doi.org/10.3389/fphys.2017.00815
Identifying and characterising the physical demands for an Australian specialist policing unit
Silk, Aaron, Savage, Robbie, Larsen, Brianna and Aisbett, Brad. 2018. "Identifying and characterising the physical demands for an Australian specialist policing unit." Applied Ergonomics: human factors in technology and society. 68, pp. 197-203. https://doi.org/10.1016/j.apergo.2017.11.012
Oral contraceptives augment the exercise pressor reflex during isometric handgrip exercise
Minahan, Clare, O'Neill, Hailey, Sikkema, Nelie, Joyce, Sarah, Larsen, Brianna and Sabapathy, Surendran. 2018. "Oral contraceptives augment the exercise pressor reflex during isometric handgrip exercise." Physiological Reports. 6 (5), pp. 1-8. https://doi.org/10.14814/phy2.13629
Immune Response in Women during Exercise in the Heat: A Spotlight on Oral Contraception
Larsen, Brianna, Cox, Amanda, Quinn, Karlee, Fisher, Rhiannon and Minahan, Clare. 2018. "Immune Response in Women during Exercise in the Heat: A Spotlight on Oral Contraception." Journal of Sports Science and Medicine. 17 (2), pp. 229-236.
Adding sleep restriction to the equation: impact on wildland firefighters’ work performance and physiology in hot conditions
Vincent, Grace E., Ferguson, Sally, Larsen, Brianna, Ridgers, Nicola D., Snow, Rod and Aisbett, Brad. 2018. "Adding sleep restriction to the equation: impact on wildland firefighters’ work performance and physiology in hot conditions." International Archives of Occupational and Environmental Health. 91, pp. 601-611. https://doi.org/10.1007/s00420-018-1304-9
The Post-Exercise Inflammatory Response to Repeated-Sprint Running in Hypoxia
Morrison, Jaime, Larsen, Brianna, Cox, Amanda J. and Minahan, Clare. 2018. "The Post-Exercise Inflammatory Response to Repeated-Sprint Running in Hypoxia." Journal of Sports Science and Medicine. 17 (4), pp. 533-538.
The effects of hydration on cognitive performance during a simulated wildfire suppression shift in temperate and hot conditions
Cvirn, Michael, Dorrian, Jillian, Smith, Bradley, Vincent, Grace, Jay, Sarah, Roach, Greg, Sargent, Charli, Larsen, Brianna, Aisbett, Brad and Ferguson, Sally. 2019. "The effects of hydration on cognitive performance during a simulated wildfire suppression shift in temperate and hot conditions." Applied Ergonomics: human factors in technology and society. 77, pp. 9-15. https://doi.org/10.1016/j.apergo.2018.12.018
Women’s Football: An Examination of Factors That Influence Movement Patterns
Griffin, Jesse, Larsen, Brianna, Horan, Sean, Keogh, Justin, Dodd, Karl, Andreatta, Melissa and Minahan, Clare. 2020. "Women’s Football: An Examination of Factors That Influence Movement Patterns." Journal of Strength and Conditioning Research. 34 (8), pp. 2384-2393. https://doi.org/10.1519/JSC.0000000000003638
Inflammation and Oral Contraceptive Use in Female Athletes Before the Rio Olympic Games
Larsen, Brianna, Cox, Amanda, Colbey, Candice, Drew, Michael, McGuire, Helen, Fazekas de St Groth, Barbara, Hughes, David, Vlahovich, Nicole, Waddington, Gordon, Burke, Louise, Lundy, Bronwen, West, Nicholas and Minahan, Clare. 2020. "Inflammation and Oral Contraceptive Use in Female Athletes Before the Rio Olympic Games." Frontiers in Physiology. 11, pp. 1-8. https://doi.org/10.3389/fphys.2020.00497
Practice does not make perfect: A brief view of athletes’ knowledge on the menstrual cycle and oral contraceptives
Larsen, Brianna, Morris, Kirstin, Quinn, Karlee, Osborne, Mark and Minahan, Clare. 2020. "Practice does not make perfect: A brief view of athletes’ knowledge on the menstrual cycle and oral contraceptives." Journal of Science and Medicine in Sport. 23 (8), pp. 690-694. https://doi.org/10.1016/j.jsams.2020.02.003
Foam Rolling as a Recovery Tool Following Eccentric Exercise: Potential Mechanisms Underpinning Changes in Jump Performance
Drinkwater, Eric J., Latella, Christopher, Wilsmore, Christopher, Bird, Stephen P. and Skein, Melissa. 2019. "Foam Rolling as a Recovery Tool Following Eccentric Exercise: Potential Mechanisms Underpinning Changes in Jump Performance." Frontiers in Physiology. 10, pp. 1-10. https://doi.org/10.3389/fphys.2019.00768
Effect of Reactive Agility Training Drills on Speed and Agility in Indonesian University Students
Kusnanik, Nining W., Widiyanto, Wahyu E. and Bird, Stephen P.. 2019. "Effect of Reactive Agility Training Drills on Speed and Agility in Indonesian University Students." Journal of Social Sciences Research. 5 (8), pp. 1272-1275.
Movement demands and running intensities of semi-professional rugby league players in a 9’s tournament
Inglis, Paul and Bird, Stephen P.. 2017. "Movement demands and running intensities of semi-professional rugby league players in a 9’s tournament." Journal of Sports Science and Medicine. 16 (1), pp. 22-26.
The role of the trunk control in athletic performance of a reactive change-of-direction task
Edwards, Suzi, Austin, Aaron and Bird, Stephen P.. 2017. "The role of the trunk control in athletic performance of a reactive change-of-direction task." Journal of Strength and Conditioning Research. 31 (1), pp. 126-139. https://doi.org/10.1519/JSC.0000000000001488
Current issues affecting strength and conditioning coaches: professional standards, coaching structures, mentorships and remuneration guidelines
Bird, Stephen P. and Mitchell, John. 2019. "Current issues affecting strength and conditioning coaches: professional standards, coaching structures, mentorships and remuneration guidelines." Journal of Australian Strength and Conditioning. 27 (5), pp. 33-37.
National Basketball Strength and Conditioning Association (NBSCA) Performance Summit 2019 – Chicago in Review
Bird, Stephen, Huyghe, Thomas and DeLosAngeles, Ernest. 2019. "National Basketball Strength and Conditioning Association (NBSCA) Performance Summit 2019 – Chicago in Review." NSCA Coach. 6 (4), pp. 18-29.
When winning matters: lessons learned from sport's elite
Beveridge, Rob and Bird, Stephen P.. Salmon, James (ed.) 2020. When winning matters: lessons learned from sport's elite. Diamond Creek, Victoria Australia. Ultimate World Publishing.
Resistance training for children and youth: a position stand from the Australian Strength and Conditioning Association (ASCA) (Original publication 2007, updated March 2017)
Wilson, Greg, Bird, Stephen P., O'Connor, Donna and Jones, Julian. 2017. Resistance training for children and youth: a position stand from the Australian Strength and Conditioning Association (ASCA) (Original publication 2007, updated March 2017). Helensvale, Queensland, Australia. Australian Strength and Conditioning Association.
Basketball New Zealand guidelines: safe return to training for players in preparation for a condensed National Basketball League season following Covid-19 restrictions
Bird, Stephen P., Osborne, Hamish, King, Leonard, Belles, Lidia, Nolan, Emily and McLellan, Chris. 2020. "Basketball New Zealand guidelines: safe return to training for players in preparation for a condensed National Basketball League season following Covid-19 restrictions." New Zealand Journal of Sports Medicine. 47 (1), pp. 49-53.
Basketball New Zealand infographic: return to training 50-30-20-10 rule [for basketball players]
Bird, Stephen and Donaghy, Michael. 2020. Basketball New Zealand infographic: return to training 50-30-20-10 rule [for basketball players]. Wellington, New Zealand. Basketball New Zealand.
Basketball New Zealand infographic: recovery points checklist
Bird, Stephen and Donaghy, Michael. 2020. Basketball New Zealand infographic: recovery points checklist. Wellington, New Zealand. Basketball New Zealand.
Basketball New Zealand infographic: recovery benefits
Bird, Stephen and Donaghy, Michael. 2020. Basketball New Zealand infographic: recovery benefits. Wellington, New Zealand. Basketball New Zealand.
Updated protocol and guest participant results from the ACCeRT clinical study
Rogers, Elaine S., Sasidharan, Rita, Sequeira, Graeme M., Wood, Matthew R., Bird, Stephen P., Keogh, Justin W.L., Arroll, Bruce, Stewart, Joanna and MacLeod, Roderick D.. 2020. "Updated protocol and guest participant results from the ACCeRT clinical study." Journal of Basic Research in Medical Sciences. 7 (1), pp. 10-21.
Nutritional knowledge of youth academy athletes
Bird, Stephen P. and Rushton, Benjamin D.. 2020. "Nutritional knowledge of youth academy athletes." BMC Nutrition. 6, pp. 1-8. https://doi.org/10.1186/s40795-020-00360-9
Podcasts as an eLearning educational tool
Bird, Stephen P.. 2020. "Podcasts as an eLearning educational tool." University of Southern Queensland 25th Postgraduate and Early Career Researcher Group Research Symposium: Uncertain times: Adaptability in the areas of work, study and research. Online 24 Jun 2020
Basketball New Zealand COVID-19 return to training and competition framework: guidelines for safe return to training and competition for coaches and players
King, Leonard, Osborne, Hamish, Bird, Stephen P. and Huyghe, Thomas. 2020. Basketball New Zealand COVID-19 return to training and competition framework: guidelines for safe return to training and competition for coaches and players. Wellington, New Zealand. Basketball New Zealand.
Season suspension and summer extension: Unique opportunity for professional team-sport athletes and support staff during and following the COVID-19 crisis
Huyghe, Thomas G., Bird, Stephen P., Calleja-Gonzalez, Julio and Alcaraz, Pedro E.. 2020. "Season suspension and summer extension: Unique opportunity for professional team-sport athletes and support staff during and following the COVID-19 crisis." Frontiers in Sports and Active Living. 2 (98). https://doi.org/10.3389/fspor.2020.00098
Welcome to the International Universities Strength and Conditioning Association Journal: publishing research with a view to the future
Bird, Stephen P.. 2020. "Welcome to the International Universities Strength and Conditioning Association Journal: publishing research with a view to the future." International Universities Strength and Conditioning Association Journal. 1 (1).
Bridging the gap: why strength and conditioning practitioners and researchers should collaborate
Langford, Andrew and Bird, Stephen P.. 2020. "Bridging the gap: why strength and conditioning practitioners and researchers should collaborate." International Universities Strength and Conditioning Association Journal. 1 (1).
The impact of sleep restriction and simulated physical firefighting work on acute inflammatory stress responses
Wolkow, Alexander, Ferguson, Sally A., Vincent, Grace E., Larsen, Brianna, Aisbett, Brad and Main, Luana C.. 2015. "The impact of sleep restriction and simulated physical firefighting work on acute inflammatory stress responses." PLoS One. 10 (9), pp. 1-17. https://doi.org/10.1371/journal.pone.0138128
Task-specific effects of modular body armor
Larsen, Brianna, Netto, Kevin and Aisbett, Brad. 2014. "Task-specific effects of modular body armor." Military Medicine: international journal of AMSUS. 179 (4), pp. 428-434. https://doi.org/10.7205/MILMED-D-13-00318
Sleep, recovery and athletic performance: A brief review and recommendations
Bird, Stephen P.. 2013. "Sleep, recovery and athletic performance: A brief review and recommendations." Strength and Conditioning Journal. 35 (5), pp. 43-47. https://doi.org/10.1519/SSC.0b013e3182a62e2f
Exploring the front squat
Bird, Stephen P. and Casey, Sean. 2012. "Exploring the front squat." Strength and Conditioning Journal. 34 (2), pp. 27-33. https://doi.org/10.1519/SSC.0b013e3182441b7d
Body armor, performance, and physiology during repeated high-intensity work task
Larsen, Brianna, Netto, Kevin, Skovli, Daniel, Vincs, Kim, Vu, Sarah and Aisbett, Brad. 2012. "Body armor, performance, and physiology during repeated high-intensity work task." Military Medicine: international journal of AMSUS. 177 (11), pp. 1308-1315. https://doi.org/10.7205/MILMED-D-11-00435
Implementation of recovery strategies: 100-point weekly recovery checklist
Bird, Stephen P. 2011. "Implementation of recovery strategies: 100-point weekly recovery checklist." International Journal of Athletic Therapy and Training. 16 (2), pp. 16-19. https://doi.org/10.1123/ijatt.16.2.16
The effect of body armor on performance, thermal stress, and exertion: a critical review
Larsen, Brianna, Netto, Kevin and Aisbett, Brad. 2011. "The effect of body armor on performance, thermal stress, and exertion: a critical review." Military Medicine: international journal of AMSUS. 176 (11), pp. 1265-1273. https://doi.org/10.7205/MILMED-D-10-00470
Exploring the deadlift
Bird, Stephen and Barrington-Higgs, Benjamin. 2010. "Exploring the deadlift." Strength and Conditioning Journal. 32 (2), pp. 46-51. https://doi.org/10.1519/SSC.0b013e3181d59582