Understanding Menstrual Function is Important for Athlete Health
The widely endorsed and utilized Preparticipation Physical Evaluation (PPE) includes information provided by athletes and/or parents, and a physical examination performed by a physician or advanced practice professional. Information collected during the PPE alerts the practitioner to conditions that may put them at risk as a result of competitive sport participation. Athletes who experience a menstrual cycle are asked to provide information on their menstrual function, as menstrual dysfunction may indicate other underlying health conditions, which in turn place the athlete at risk for injury. This could include disordered eating or eating disorders, low bone density and bone stress injuries.
Concerns have been raised about the purpose of collecting information about menstrual function, specifically, “who” sees this information. It’s important to understand that the PPE form is a medical-legal document and is subject to privacy laws first and foremost. The Health Insurance Portability and Accountability Act (HIPAA) and the Federal Education Records Protection Act (FERPA) require confidentiality and protection of personal health information (PHI) when students turn in their PPE forms, and athletes have the right to request a restriction or limitation on the health information the school uses or discloses. The HIPAA Privacy Rule allows release of some medical information without an individual’s authorization in certain circumstances. The player’s medical eligibility, “qualified” or “not qualified” to participate, communicated without other medical information can be given to coaches and school administrators and falls within the exempt category.
So, with that understanding, menstrual function cannot be disclosed to ANYONE at a school – not a coach, athletic director or other school administrator. Menstrual function alone is NOT an indication to disqualify an athlete from sports participation. Even if it was, the “reason for disqualification” is protected information and cannot/should not be disclosed to coaches or administrators.
Menstrual function is an important indicator of health in athletes who experience a menstrual cycle. It is important information for physicians performing a PPE, as this information may inform clinical decision making, which in turn helps to keep athletes safe and healthy.
For comments or questions, please contact:
Mary Jane De Souza, PhD, FACSM, FNAK, Executive Director of the Female and Male Athlete Triad Coalition.
Distinguished Professor of Kinesiology and Physiology, Penn State University, University Park, PA 16802.
EMAIL: mjd34@psu.edu
Download the formal statement here.
