About the Female Athlete Performance Group

An introduction by Susie Elms, Chair of the Female Athlete Performance Working Group

Our work with female athletes is a crucial area. One that requires dedication and openness to continue to learn and understand how best to support our female athletes as they progress through the performance pathway. We’re also very aware that there is a need for learning and awareness, wider than the performance audience. All in the working group feel very strongly about that.

To extend our learning wider, we launched the Working with Female Athletes platform on sportscotland’s learning website in November 2022. This provides access to free resources and learning for girls, women, parents, teachers, coaches, volunteers, staff, indeed anyone with an interest. This also includes a link to the e-learning module: Working with Female Athletes  Although a licence is required to access the e-learning, free licences are provided for all.


The Female Athlete Performance working group

The working group was established in 2010, originally named, Understanding the Female Athlete, chaired by Dr Brian Walker, SIS Head of Sports Medicine. This brought together a group of inter-disciplinary specialists from a diversity of support services, with the aim of developing our understanding of female athletes and the related support being delivered. After Dr Walker retired, it was an honour to take on the role as chair, and we established the Female Athlete Performance Working Group.

The group is made up of professionals and practitioners across the SIS to provide a wider understanding of delivery from a multi-disciplinary perspective. The current working group includes the following sportscotland staff.

  • Maggie Bush, Physiotherapist
  • Susie Elms, Head of Performance Lifestyle (Chair)
  • Nikki Gibson, Performance Physiologist
  • Abbie Hewitt, Regional Performance Manager
  • Dr Michelle Jeffrey, Sports Medicine Doctor
  • Karina Leahy, Physiotherapist
  • Zoe Moffat, Sport Psychologist
  • Catriona Munro, Senior Physical Preparation Coach
  • Irene Riach, Head of Performance Nutrition


The working group established a plan to enable us to focus on key areas of development. This incorporated three main strategies:

  • Strategy 1: Understanding:Evidence based practice and applied research.
  • Strategy 2: Implementing:Education and learning.
  • Strategy 3: Influencing:Our culture


Pilot Study Phase 1: Direct delivery to sports

Sitting under the Implementing Education and Learning strategy, in 2021 - 2022, we ran a pilot working remotely and directly with five sports (curling, cycling, hockey, netball, and judo), where we combined the Female Athlete Health Check questionnaire alongside a pathway of education and learning with each sport.

This incorporated the development of content and access to e-learning resources and remote workshops aligned to the roll out of the Female Athlete Health Check to athletes. Staff from the working group facilitated sessions with the sports, athletes and staff through different touch points using presentations plus questions and answer sessions.

From the pilot we collated the following data and findings:

  • From the athletes who have been through the medical screening to date, we have found that 68% of athletes required a medical follow up.
  • We found that 67% of athletes did have a monthly menstrual cycle, however, 32% did not. This doesn’t always require medical intervention as it may be a result of contraception, or even pregnancy, however, not having a regular monthly menstrual cycle could also be a red flag for an athlete’s overall health and wellbeing.
  • We asked whether athletes were on hormonal contraceptives or not, and found that 49% of athletes were using contraceptives. This won’t necessarily have any implications for female athletes, but it may be important for coaches to know – especially if they are attempting to maximise a training adaption in line with rising and falling levels of sex hormones.
  • We also asked about whether athletes had experienced changes in their menstrual cycle in the last year. Again, this could be a prompt for medical review. We found that nearly 23% of our athletes had experienced changes.
  • Finally, we wanted to understand what premenstrual symptoms our athletes are experiencing. Cramping, fatigue and bloating were the most common physical symptoms, experienced by 68%, 66% and 51% respectively. 47% of athletes also experienced changes in their appetite, 41% felt more irritable and 40% noticed changes in their mood.
  • Our overall conclusion is that there is no one size fits all model for female athletes, however, these statistics could help coaches, support staff and even athletes themselves understand the potential impact of PMS on different training phases.


Pilot study Phase 2: Remote roadshow for all sports, athletes, and staff

We rolled out Phase 2 of the pilot on the 1st of November 2022. This incorporated sending out a digital version of Female Athlete Health Check questionnaire to all female athletes, engaging the respective SGB and SIS staff. We launched the Working with Female Athletes learning platform on the same day. Since then, we have delivered remote ‘roadshow’ presentations to SIS Performance Staff on the 23rd of February, Athletes and SGB Staff on the 27th of February and to sportscotland staff on International Women’s Day on the 8th of March. The key aim is still to align learning and support in a collaborative way with female athletes and staff.


Looking ahead.

Our ambition for the working group is that all athletes, coaches, and staff are comfortable having conversations about female athlete health and understand the approaches to take to positively impact on training/performance. Our forward plans include, developing ‘the how’. How to enable a culture and environment where everyone feels they can talk about female athlete health. Our intention is to engage the following approaches to support this.

  • Review and implement our learning from Phase 1 and Phase 2 of the Female Athlete Health Pilot.
  • Engage Athlete Voice groups, where female athletes have a dedicated space to explore thinking and ideas.
  • Encourage nominations for Female Athlete Health Reps for each sport, to act as a catalyst for discussion and areas for development for female athletes. We currently have 25 reps across 22 sports.
  • Continued development of new resources. Our most recent release in June 2023, was the e-learning module, Bras and Breast Health.  
  • Collaborate and engage with partners in applied research and resource development in pregnancy, post-partum support, RED-S, stress incontinence, peri menopause/menopause etc.
  • alongside the connection to research and the engagement of female athletes to listen to their experiences and recommendations for our future planning.


If you have any questions, please contact us on femaleathletehealth@sisport.com                                                                                                                                                                                                                      

Links to our resources are below: