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Health is a pre-requisite for optimal performance yet the parameters which govern health and performance of elite female athletes are little understood. The aim of this study was to quantify the health status of elite female athletes, and understand sociocultural factors influencing that status. The survey addressed demographic, health and athletic performance history, training load, contraceptive use, sport-specific appearance and performance pressures, and communication barriers. Three hundred and fifty-seven elite New Zealand female athletes were recruited to complete an on-line survey. Two hundred and nineteen athletes completed the survey. Oligomenorrhea/amenorrhea had been diagnosed in only 12% of athletes compared with 50% of athletes not on hormonal contraception who reported symptoms consistent with this diagnosis. Stress fractures and iron deficiency were common and associated with oligomenorrhoea/amenorrhea (P = 0.002), disordered eating (P = 0.009) or menorrhagia (P = 0.026). Athletes involved in individual sports (P = 0.047) and with higher training volumes (P < 0.001) were more likely to report a medical illness. Seventy-three percent of athletes felt pressured by their sport to alter their physical appearance to conform to gender ideals with 15% engaging in disordered eating practices. Barriers to communicating female health issues included male coaches and support staff, and lack of quality information pertaining to health. Elite female athletes may fail to reach peak performance due to specific health issues and undiagnosed pathology. Sociocultural factors influence the effectiveness of support of female's health and performance. Organizational and cultural change is required if elite female athletes are to combine optimal health with best performance.

ObjectiveThe primary aim of this study was to estimate the prevalence of depressive symptoms and life stress in elite coaches. The secondary aim was to explore the associations of depressive symptoms and life stress with demographic and lifestyle variables.MethodsNational-level coaches were invited to participate in an online survey. Depressive symptoms were measured by the Centre for Epidemiological Studies Depression Scale-Revised (CESD-R). Life stress was measured using daily life hassle frequency and severity scores calculated from the Daily Hassles Questionnaire, with associations evaluated using linear regression.ResultsOf 110 potential participants, 69 completed and two partially completed surveys were received. The majority of respondents were male (77%), coaching individual sports (70%) and aged under 50 (71%). Overall, 14% of coaches reported at least moderate depressive symptoms according to the CESD-R. Those contemplating retirement were more likely to show depressive symptoms. Reported life stress was higher in females and in those contemplating retirement. There was a strong association between life stress and the odds of experiencing depressive symptoms (p=0.006).ConclusionsDepressive symptoms are as prevalent in elite coaches as in general population, with potential risk factors including high levels of life stress and impending retirement.