The Effects of Menstrual Cycle Phase on Elite Athlete Performance: A Critical and Systematic Review.
Level 3 - non-randomized controlled study
Systematic review of heterogeneous observational, cross-sectional, and laboratory-based studies rather than randomized controlled trials.
PubMed 34093223 · doi:10.3389/fphys.2021.654585
What was done
This systematic review followed PRISMA guidelines to identify studies examining the link between menstrual cycle phases and performance parameters in elite female athletes. Databases were searched from inception to November 3, 2020. Out of 780 initial search records and 26 additional references, 218 full texts were evaluated for eligibility, and 7 studies met inclusion criteria representing a total of 314 elite female participants (mean age 20.58 ± 1.91 years).
What was found
Among the 7 included studies, 3 used subjective tools (interviews, questionnaires, or prospective diary reports) and 4 conducted objective physical measures or performance testing, with only 2 assessing performance during actual training or competition. Five studies verified cycle phase via blood, saliva, or urine hormone tests, while 2 relied on menstrual calendar diaries. The abstract provides no specific quantitative effect sizes or numerical statistics, noting variable associations across studies for endurance, power resistance, ligament stiffness, decision-making, psychology, and competitiveness, resulting in an inconclusive consensus regarding the magnitude and direction of performance changes.
Why it matters
Despite frequent recommendations to adjust training according to menstrual cycle phase, the available literature in elite female athletes is limited and conflicting, precluding generalized evidence-based training individualization protocols.
Limits
The total evidence base was small (only 7 studies meeting elite athlete criteria). Testing methods lacked standardization, with only two studies evaluating athletes in real-world sports settings and two lacking biological hormonal verification. No meta-analytic pooling was possible due to disparate outcome measures and small cohorts.
Cited by
- supports There is little scientific evidence supporting the need to alter resistance training for different phases of the menstrual cycle.