Carmichael, M. A., Thomson, R. L., Moran, L. J., & Wycherley, T. P. (2021). The Impact of Menstrual Cycle Phase on Athletes' Performance: A Narrative Review. International journal of environmental research and public health, 18(4). https://doi.org/10.3390/ijerph18041667
Carmichael MA, Thomson RL, Moran LJ, Wycherley TP. The Impact of Menstrual Cycle Phase on Athletes' Performance: A Narrative Review. International journal of environmental research and public health. 2021;18(4). doi:10.3390/ijerph18041667
Carmichael, Mikaeli Anne, et al. "The Impact of Menstrual Cycle Phase on Athletes' Performance: A Narrative Review." International journal of environmental research and public health, vol. 18, no. 4, 2021.
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Menstrual cycle phase has mixed effects on athlete performance tests
A narrative review of studies in athletes with regular cycles found that objective performance tests show no consistent effect of menstrual cycle phase. Athletes rated their own performance as worse in the early follicular and late luteal phases. Of 35 objective studies, 20 found no effect and 15 found an effect on at least one outcome.
Key Findings
Five studies examined perceived performance, and all five reported that menstrual cycle phase affected how athletes rated their performance.
Between 50–71% of participants reported impaired performance in training in certain phases, and 49–65% reported impaired performance in competition.
Among 35 studies of objectively measured performance, 15 reported that at least one outcome was affected by cycle phase and 20 found no evidence of an effect.
Of 16 studies of anaerobic performance, 13 found no effect of cycle phase, and three reported at least one anaerobic outcome that changed.
Strength and aerobic outcomes were most commonly reported as lower in the late luteal phase, and anaerobic outcomes most often lower in the late follicular phase.
Interpretation
The review is a narrative synthesis of studies in athletes with regular cycles. Athletes' ratings of their own performance agree across the five studies, while the objective tests give mixed results. Athletes in the included studies attributed the reported dips to symptoms such as fatigue, menstrual pain and worry about flooding. The review counts how often outcomes changed across phases. The authors note that only five of the 35 objective studies had more than 20 participants. Hormonal contraceptive use and irregular cycles were outside its scope.
RRM Context
Restorative reproductive medicine treats the ovulatory cycle as a vital sign. The athletes in these studies connect performance dips to cycle symptoms. The authors cite earlier reviews that listed missing hormone measurements to confirm cycle phase among the field's limits. Cycle charting records the phases of an individual athlete's own cycle.
Our editorial summary of this paper, not the article's abstract.
Abstract
The effect of the menstrual cycle on physical performance is being increasingly recognised as a key consideration for women's sport and a critical field for further research. This narrative review explores the findings of studies investigating the effects of menstrual cycle phase on perceived and objectively measured performance in an athletic population. Studies examining perceived performance consistently report that female athletes identify their performance to be relatively worse during the early follicular and late luteal phases. Studies examining objective performance (using anaerobic, aerobic or strength-related tests) do not report clear, consistent effects of the impact of menstrual cycle phase on physical performance. Overall sport performance can be influenced by both perceived and physical factors. Hence, to optimise performance and management of eumenorrheic female athletes, there is a need for further research to quantify the impact of menstrual cycle phase on perceived and physical performance outcomes and to identify factors affecting variability in objective performance outcomes between studies.
