Physical activity avoidance during menstruation - the role of coping and self-efficacy

Objectives: The aim of the present study was to investigate self-efficacy and coping strategies in women who avoided physical activity during menstruation (avoiders), adapted their physical activity during menstruation (adaptors) or maintained their normal physical activity during menstruation (non-avoiders).
Design: Online questionnaire study.
Methods: Using an online survey which included sections on menstrual severity, menstrual attitude (menstrual self-evaluation questionnaire), coping (the pre-menstrual coping measure, and the coping inventory for stressful situations) and self-efficacy for exercise, 349 respondents were classified as: avoiders (40.7%), adapters (33.5%), and non-avoiders (25.8%).
Results: Avoiders and adapters had similar menstrual symptoms, with menstrual flow and menstrual pain being greater in avoiders than non-avoiders (p<0.001). The positive elements of menstrual attitude were lower in avoiders compared to non-avoiders (p<0.05). Avoiders had lower task-focussed coping strategies (p<0.05), with pre-menstrual coping showing avoiders to have higher self-care and adjusting energy coping strategies (all p<0.01). Compared to non-avoiders and adapters, avoiders had lower self-efficacy for exercise (p<0.001).
Conclusions: Consistent with previous studies we have identified physical activity avoidance during menstruation to be linked to greater reported menstrual pain, heavy menstrual bleeding, more reported menstrual symptoms, and less positive menstrual behaviours. Uniquely, we have identified that avoiders differ from non-avoiders by being less task focused and adopting more passive and withdrawal menstrual coping strategies. Self-efficacy markers were the main differentiator for avoiders and adapters. Taken together, these findings suggest that self-efficacy and coping strategy may act as important factors for physical activity avoidance during menstruation.