The Effect of the Menstrual Cycle and Oral Contraceptives on Acute Responses and Chronic Adaptations to Resistance Training: A Systematic Review of the Literature.
Level 1 - systematic review of randomized trials
Systematic review of intervention studies evaluating resistance training responses across menstrual and oral contraceptive cycles.
PubMed 31677121 · doi:10.1007/s40279-019-01219-1
What was done
The authors conducted a systematic review across Embase, PubMed, SPORTDiscus, and Web of Science to evaluate how menstrual cycle phases and oral contraceptive use influence acute responses and chronic adaptations to resistance training. Eligible studies examined training responses across cycle phases, compared natural menstrual cycles to oral contraceptive use, or periodized training by cycle phase. Included studies were critically appraised using the McMaster University Critical Review Form for Quantitative Studies.
What was found
A total of 17 studies comprising 418 female participants (aged 18-38 years) met inclusion criteria. For acute responses across the natural cycle, 4 studies reported phase-related differences while 1 found none. Comparing acute responses between oral contraceptive users and natural cyclers, 2 studies found positive effects of oral contraceptives, whereas 4 reported delayed recovery, elevated muscle damage markers, or both in contraceptive users. For chronic adaptations, 3 studies found follicular phase-based training superior to luteal-phase or regular training, while 1 study found no difference. One study found no difference in strength development between oral contraceptive users and non-users; 1 study showed greater type I muscle fiber area increases in low-androgenic oral contraceptive users versus non-users; and 1 study observed greater strength gains with high-androgenic versus anti-androgenic oral contraceptives.
Why it matters
This review highlights potential influences of female sex hormones and oral contraceptives on muscle adaptations, suggesting follicular phase-based periodization may benefit some individuals. However, the evidence remains too inconsistent to justify rigid phase-based training guidelines.
Limits
The included body of evidence is constrained by small sample sizes (totaling 418 across 17 studies), conflicting directions of effect across acute and chronic outcomes, methodological heterogeneity, and variable classification of hormonal status and oral contraceptive androgenicity.
Cited by
- supports There is little scientific evidence supporting the need to alter resistance training for different phases of the menstrual cycle.