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Athletic development specialists dedicated to the art and science of excellence in movement

The Effect of Menstrual Cycle Phase on Athletic Performance

There are many things to consider with coaching.  Preparing athletes is far more than simply writing a schedule and plugging in the numbers.  Individualized treatment is also paramount for rehabilitation, as understanding the whole person is more important than endless recycling of one’s favorite treatment.  

One significant factor that’s often relegated to taboo status in the coaching field is female menstruation.  Any male coach who values their safety knows better than to openly discuss such matters (at least until a sufficient comfort level is established), especially in this era of heightened litigation.  But the fact that it can make for an awkward conversation doesn’t negate its existence....  

Much of the literature in this area has focused on performance metrics, with some belief that certain phases may derail certain athletic qualities.  Though there has been some evidence to suggest phase may affect certain athletic qualities, overall there has been no definitive link with phases.  A brief survey….  

Lebrun (1995) examined an expansive battery of athletic qualities in healthy females and noted “No significant differences were observed between [follicular] and [luteal] tests in weight, percent body fat, sum of skinfolds, hemoglobin concentration, hematocrit, maximum heart rate, maximum minute ventilation, maximum respiratory exchange ratio, anaerobic performance, endurance time to fatigue (at 90% of VO2max), or isokinetic strength of knee flexion and extension.  The only difference noted was that both absolute and relative VO2max, were slightly lower in [luteal] than in [follicular].” 

Lebrun (2001) later concluded that “investigations to date have not consistently demonstrated significant differences in aerobic capacity, anaerobic capacity, aerobic endurance, or muscle strength in any specific menstrual cycle phase."

Smekal (2007) also noted, “We did not find performance changes associated with menstrual cycle. Our data do not support findings that the menstrual cycle influences lactate "thresholds" and ventilatory "thresholds."”

However, the cyclical nature of athletic READINESS is a much different matter.  Readiness is a general term, but is commonly measured via autonomic nervous system condition and indirectly through neuromuscular coordination.  Most athletes can mobilize their physical and mental resources to hit their workout numbers in the short term, but if the body is not ready to ABSORB the training, the long term return on investment may suffer.  While phase might not have direct effect on performance, it could have a long term indirect effect based on how the athlete responds to short term training.

For example, Yidirir (2002) noted “increased sympathetic activity in the luteal phase” as detected by changes in heart rate variability in a sample of female cyclists.

Dimitriev (2007) studied ten cyclists age 19-23 for two months and concluded “that sympathetic nervous activity in the luteal phase is greater than in the follicular phase, whereas parasympathetic nervous activity is predominant in the follicular phase.”  Specifically, they noted a decrease in certain heart rate variability measures in the luteal phase as compared to the follicular.  

As the literature has elsewhere shown, decreases in heart rate variability may signal increased stress and reduced readiness for hard training.  However, such numbers must be considered in the broad scope of any training plan.  Research design is likely not equipped to analyze the effect of training hard during a time in which the athlete should be recovering.  But we do know that certain changes are happening and these changes may have significant implications based on what we know about the nervous system. 

Neuromuscular control is another area in which there are signs that menstrual cycle phase may play a role, but thus far the evidence has been mixed.   Belanger (2013) recently reviewed twenty eight articles examining this question and concluded, “There is evidence to support the hypothesis that the ACL changes throughout the menstrual cycle, with it becoming more lax during the pre-ovulatory (luteal) phase. Overall, these reviews found statistically significant differences for variation in ACL laxity and injury throughout the menstrual cycle, especially during the pre-ovulatory phase….However, the quality of the assessments was low and the evidence is still very limited.”

Conclusion

This topic is a classic intersection of science and art.  A strict view of the science would indicate that cyclical variations have limited effect on athletic performance.  But a closer look reveals that menstrual cycle phase may have a profound effect on physical readiness and ultimately how the athlete responds to any given workout.  Though short term workout performance may not be affected (at least significantly), the cumulative long term effects deserve attention for workout selection. 

References

Dimitriev DA, Saperova EV, Dimitriev AD, Karpenko IuD.  [Features of cardiovascular functioning during different phases of the menstrual cycle].  Ross Fiziol Zh Im I M Sechenova. 2007 Mar;93(3):300-5.

Yildirir A, Kabakci G, Akgul E, Tokgozoglu L, Oto A.  Effects of menstrual cycle on cardiac autonomic innervation as assessed by heart rate variability.  Ann Noninvasive Electrocardiol. 2002 Jan;7(1):60-3.

Lebrun CM, McKenzie DC, Prior JC, Taunton JE.  Effects of menstrual cycle phase on athletic performance.  Med Sci Sports Exerc. 1995 Mar;27(3):437-44.

Smekal G, von Duvillard SP, Frigo P, Tegelhofer T, Pokan R, Hofmann P, Tschan H, Baron R, Wonisch M, Renezeder K, Bachl N.  Menstrual cycle: no effect on exercise cardiorespiratory variables or blood lactate concentration.  Med Sci Sports Exerc. 2007 Jul;39(7):1098-106.

Lebrun CM, Rumball JS.  Relationship between athletic performance and menstrual cycle.  Curr Womens Health Rep. 2001 Dec;1(3):232-40.

Belanger L, Burt D, Callaghan J, Clifton S, Gleberzon BJ.  Anterior cruciate ligament laxity related to the menstrual cycle: an updated systematic review of the literature.  J Can Chiropr Assoc. 2013 Mar;57(1):76-86.

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