ArticleBMJ open sport & exercise medicine2026
Associations of academic performance, sports participation, disordered eating and menstrual cycle irregularities in adolescents: a population-based study.
Article in BMJ open sport & exercise medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Regular menstruation is an important indicator of well-being in adolescent females. We aimed to assess risk factors associated with menstrual cycle irregularities in a population-based cohort of high school students. Methods: In the fall of 2022, we recruited a cohort of 1161 first-year female students from 21 socio-economically diverse high schools in the capital region of Finland. Participants completed an online survey addressing menstruation, academic performance and sports participation and validated questionnaires (the Sick-Control-One stone-Fat-Food (SCOFF) eating disorder screening tool and School Burnout Inventory). Results: Of 935 (81%) participants (mean age 16) not using hormonal preparations, 336 (37%) reported irregular menstruation. Elevated School Burnout Inventory scores (per point OR 1.03, 95% CI 1.01 to 1.05), lower body mass index (OR 1.86, 95% CI 1.12 to 3.08) and high SCOFF scores (OR 2.09, 95% CI 1.40 to 3.10) were associated with irregular menstruation. Overall physical activity levels showed no significant association with menstruation. In subgroup analysis, low body mass index and disordered eating symptoms were associated with irregular menstruation among casual exercisers whereas school burnout was associated with irregular menstruation among competitive athletes. Conclusion: School-related stress, eating and exercise habits should be evaluated among high school students presenting with menstrual irregularities, as these factors may be relevant in identifying adolescents at risk of more severe reproductive dysfunctions, including amenorrhoea.
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