Fluid and electrolyte balance considerations for female athletes.
Level 5 - mechanism / opinion, no new human data
Narrative review of physiological mechanisms and empirical literature
PubMed 34121620 · doi:10.1080/17461391.2021.1939428
What was done
This narrative review synthesized literature examining the independent and integrated effects of estrogen and progesterone fluctuations across the menstrual cycle on fluid and electrolyte balance, thermoregulation, and rehydration in exercising females.
What was found
The abstract reports no quantitative data. Mechanistically, estrogen influences the osmotic threshold for arginine vasopressin release and progesterone influences aldosterone production. However, these mechanisms do not translate to consistent differences in resting or exercise plasma volume changes, fluid retention, or electrolyte losses. Estrogen-dominant phases (late-follicular) promote heat dissipation while progesterone-dominant phases (mid-luteal) elevate basal body temperature, but neither consistently alters observed sweat rates, heat stress, or exercise dehydration. Post-exercise fluid retention does not differ significantly across menstrual cycle phases.
Why it matters
Standardized hydration guidelines do not need broad phase-specific adjustments for the average female athlete, though individual variation in hormone fluctuations may warrant targeted monitoring.
Limits
The abstract does not state the number of studies reviewed or search methodology. Findings reflect population averages, which may obscure effects in individuals experiencing extreme hormonal fluctuations, and interactions between estrogen and progesterone remain incompletely characterized.
Cited by
- supports During the luteal phase of the menstrual cycle, progesterone elevation causes increased water retention, abdominal bloating, irregular bowel movements, disturbed sleep, and increased basal body temperature.