Bringing reproductive, pelvic and breast health to light: insights from the Health of Elite Retired Australian female athletes survey (HER-Aus)

Objectives To describe the reproductive, pelvic and breast health of retired elite Australian female athletes. Methods Data were collected as part of a larger online cross-sectional survey that was cocreated with female athletes and disseminated to Australian retired elite (international-level and national-level) female athletes aged ≥18 years old and retired from elite competition ≥2 years. Results 199 retired female athletes (mean (SD) age 44 (10) years; retired for 16 (9) years; competed for 10 (5) years) across 31 different sports responded to the survey. 23% (46/199) experienced primary amenorrhoea, and 48% (95/197) reported ever experiencing secondary amenorrhoea. Of athletes with pregnancy difficulties (n=45), 42% reported menstrual cycle irregularity during their career. Of athletes who gave birth (n=98), 19% had difficulties conceiving, requiring fertility treatments. The majority of athletes reported current symptoms of urinary incontinence (70% (140/198)) and faecal incontinence (54% (106/197)). 18% (33/188) reported that they currently experience exercise-related breast pain; however, 87% (164/188) reported that breast pain never negatively impacts their current physical activity. Conclusions A high prevalence of reported menstrual irregularities, pelvic floor dysfunction and fertility issues highlights the need for early prevention and intervention measures to address long-term health and the unique challenges faced by female athletes during and after their sporting careers. Data are available on reasonable request.