Period of Activity: Exploring the relationship between menstruation and physical activity in adolescents

Lisa Ruggles – PhD Psychology Researcher at The University of Buckingham

Why So Many Adolescent Girls Stop Moving: Unpacking a Global Challenge

Across the world, adolescent girls are moving less than ever. An astonishing 84% of girls aged 11–17 are not meeting the World Health Organisation’s (World Health Organisation, 2022) daily guideline of 60 minutes of moderate-to-vigorous physical activity [1].

In the UK, the picture is equally concerning: Only 47% of girls aged 13–16 achieve the recommended activity levels, compared to 64% of boys, with the gender gap widening as girls enter adolescence [2]. Physical activity levels decrease by approximately 7% per year between the ages of 10 and 19, with girls experiencing a steeper decline than boys [3]. Alarmingly, 43% of girls who once considered themselves sporty disengage from sport during puberty [4]. This decline does not happen in isolation. Adolescence is already a vulnerable time, with rising mental health challenges and shifting identities, making girls particularly susceptible to pulling away from physical activity during this critical life stage [4] [5].

The "Why": Fear of Failure, Period Pains and Perfectionism

Why do so many girls stop moving during puberty?

 One culprit is self-critical perfectionism – a harsh, fear-driven mindset tied to fear of failure and embarrassment, which can make sports feel like a high-stakes arena of judgement rather than a place of joy [6] [7].

Then there is menstruation, which brings real physical challenges (like menstrual cramps) and social fears (like leakage or embarrassment), increasing self-consciousness and avoidance behaviours [4].

Together, these factors create a perfect storm that can push girls away from physical activity when they need its mental and physical benefits the most.

Could Self-Compassion Be the Game-Changer?

Self-compassion, or treating oneself with kindness during difficult moments while recognising shared human experiences [8], may help break this cycle.  Research suggests that self-compassion reduces self-critical perfectionism and supports emotional resilience, helping girls navigate setbacks without spiralling into shame [9] [10]. It can even aid in emotional regulation in sports, encouraging a healthier relationship with movement.

Yet, self-compassion often declines during adolescence, with many girls struggling to adopt self-kindness in a culture that primes them for self-criticism [5]. Interestingly, while self-compassion can moderate distress in chronic conditions and potentially aid pain management, its role in addressing menstruation-related barriers to physical activity remains underexplored [11]. Could it be a protective factor that keeps girls moving, even during challenging menstrual cycles?

My Research

I recall embarrassing and shameful experiences during school games lessons, especially when I had my period. My experiences shaped how I viewed physical activity until my late 30s. I left school without any desire to participate in sports or exercise. My life changed when I met a five-year-old whose brain tumour treatment had left him terminally ill. He wanted to help other children like himself, so he set up a charity called Blue Skye Thinking. Two days after I met him, he passed away. I decided to do the thing I hated most in the world – running – to raise money for his charity. After a few months of gruelling runs, I noticed a change in my outlook. To keep it brief, I discovered the power of physical activity and went on to help inactive women, many of whom had similar stories to my own, become active. When I had the opportunity to conduct my own research, I knew I wanted to help break the cycle of inactivity in adolescent girls and learn how to support them to stay active. My PhD is titled "Period of Activity: A study on how the experience of menstruation affects physical activity in adolescents".

Curious about the potential of self-compassion as a protective factor between menstruation and physical activity, my first study explored whether self-critical perfectionism and self-compassion mediated the relationship between menstrual psychological symptoms and physical activity among adolescents.

Using four existing measures, I developed a quantitative survey for willing adolescents to complete online. My dataset included 203 eligible participants aged between 12 and 18, mostly white and from the USA and the UK.

Mediation analysis indicated that while negative affect and cognitive dysregulation during menstruation were associated with higher self-critical perfectionism (and lower self-compassion in the case of negative affect), these internal struggles did not significantly predict physical activity levels. In simpler terms, girls who felt worse mentally around their periods were indeed harsher on themselves and struggled with self-compassion, but this did not translate into lower physical activity levels in my sample.

Is There Really No Link?

It might be tempting to conclude that emotional experiences during menstruation do not affect physical activity, but I am not so sure. Motivations (like scholarships) and environments (like school culture and family support) likely play a role in whether these emotional states translate into behavioural changes. This complexity deserves deeper exploration. Furthermore, there is a privation in available measures that capture the multi-faceted and complex psychological menstrual symptoms, which exclude capturing known challenges during adolescence like self-consciousness and shame.

The Challenges of Researching This Topic

Conducting research with menstruating adolescents is far from straightforward. On multiple occasions, parents blocked participation, sometimes leading schools to withdraw entire year groups from my study due to a handful of parental objections, despite offering alternative activities that were appropriate.

As a parent myself, I understand their concerns. But these barriers highlight a larger issue: Girls’ voices on menstruation and physical activity are often silenced. If we want to change the narrative, we need to encourage girls to share their experiences to inform real solutions.

What’s Next? Using Story Completion to Hear Adolescents’ Voices

To continue this important work, I plan to adopt story completion methods in my upcoming PhD research. This approach will encourage participating adolescents to complete a fictional scenario, allowing them to share views informed by their experiences, cultural knowledge and observations, without directly asking personal questions about their lived experiences.

Story completion could uncover valuable, genuine insights into how adolescents view menstruation and physical activity, aiding in the development of more supportive, practical interventions that encourage girls to stay active during adolescence and boys to advocate for and support them in doing so.

Final Thoughts

Girls deserve to move, to feel strong and to enjoy physical activity throughout their lives. They also deserve to be heard, not silenced, when discussing the barriers they face. By understanding the intersection of self-compassion, perfectionism and menstruation, we can design more effective support systems that help girls move forward and thrive.

Call to Action

If you have any questions or would like to be contacted when my subsequent study goes live, please get in touch:

Website: https://lisaruggles.com 

LinkedIn: @Lisaruggles

Blog editor: Dr Tess Flood

Blog administrator: Dr Jacky Forsyth