Abstract Aims: To explore health patterns in female professional football players in the domains of gynaecological health patterns, contraceptive use, body perception and motherhood experiences, including return to play after childbirth. Methods: An online questionnaire was emailed to active female professional football players via email. Participants were asked about their menstrual cycle,contraception use and motherhood. Validated questionnaires were used to assess body dissatisfaction (BD) and drive for thinness (DT). Results: A total of 74 female professional football players were enrolled. The mean age at menarche was 13.5 years, average cycle length of 26 days and a bleeding period of 5 days. Cycle irregularities were experienced by 30% of participants, and menstrual symptoms by 74%. Half of the participants used contraceptives, with 60% using hormonal contraceptives, primarily oral contraceptive pills (38%), followed by implants (20%). Participants had a normal BD score, but a higher-than-expected DT score. The motherhood rate was low (1%), with normal conception, vaginal delivery, return to training after 6 weeks, and return to competition after 12 weeks. Conclusion: Cycle irregularities are common in female professional football players, with a significant number of cycle-related symptoms. The majority on contraceptives preferred hormonal contraceptives, especially oral contraceptive pills (OCP) followed by implants, reflecting trends seen in elite athletes gynaecological health. While body satisfaction scores were normal, there was an unexpectedly high drive-for-thinness score, similar to that observed in lean or weight-category sports. The rate of motherhood was low, consistent with previous findings in professional football players.

The authors have declared no competing interest.

The study received seed funding from the Drake Foundation located in London (UK) and financial support from Mehilainen NEO Hospital located in Turku (Finland), from Sports Hospital Mehilainen located in Helsinki (Finland) and from Nea International bv. located in Maastricht (the Netherlands).

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The Medical Ethics Review Committee of the Amsterdam University Medical Centers (Amsterdam UMC, location AMC) provided ethical approval for the study (Drake Football Study: NL69852.018.19 | W19_171#B202169).

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

All data relevant to the study are included in the article.