Changes in Self-Reported Physical Fitness, Performance, and Side Effects Across the Phases of the Menstrual Cycle Among Competitive Endurance Athletes

Abstract

Purpose: To investigate changes in self-reported physical fitness, performance, and side effects across the menstrual cycle (MC) phases among competitive endurance athletes and to describe their knowledge and communication with coaches about the MC. Methods: The responses of 140 participants (older than 18 y) competing in biathlon or cross-country skiing at the (inter)national level were analyzed. Data were collected via an online questionnaire addressing participants’ competitive level, training volume, MC history, physical fitness, and performance during the MC, MC-related side effects, and knowledge and communication with coaches about the MC and its effects on training and performance. Results: About 50% and 71% of participants reported improved and reduced fitness, respectively, during specific MC phases, while 42% and 49% reported improved and reduced performance, respectively. Most athletes reported their worst fitness (47%) and performance (30%) and the highest number of side effects during bleeding (P < .01; compared with all other phases). The phase following bleeding was considered the best phase for perceived fitness (24%, P < .01) and performance (18%, P < .01). Only 8% of participants reported having sufficient knowledge about the MC in relation to training, and 27% of participants communicated about it with their coach. Conclusions: A high proportion of athletes perceived distinct changes in fitness, performance, and side effects across the MC phases, with their worst perceived fitness and performance during the bleeding phase. Because most athletes indicate a lack of knowledge about the MC’s effect on training and performance and few communicate with coaches on the topic, the authors recommend that more time be devoted to educating athletes and coaches.

Hormonal Contraceptive Use in Football Codes in Australia

“…While these athletes are considered to be playing at the top-level of competition for their sport, given the infancy of these competitions, little research is available on these athletes to inform athlete management practices. Additionally, most research regarding the menstrual cycle and hormonal contraceptive use to date has been conducted on the general population (Schaumberg et al, 2018;Mackay et al, 2019;Freemas et al, 2020) or endurance athletes (Redman and Weatherby, 2004;Solli et al, 2020). Further research is therefore necessary to report the prevalence and reasons for HC use within female football codes to help shape athletes' management and monitoring practices.…”

The Impact of Menstrual Cycle Phase on Athletes’ Performance: A Narrative Review

“…In the studies that did observe a MC effect to performance, there were inconsistencies in findings but strength and aerobic performance were most commonly reported to be impaired during the late luteal phase, and anaerobic performance was most frequently reduced in the late follicular phase. With regards to perceived performance, the late luteal phase was also one of the phases athletes perceived their performance declined [ 75 , 76 ]. The research that finds the MC does have a mediating role in physical performance shows that MC phases affect strength, aerobic and anaerobic performance differently.…”

“…It is apparent that many athletes believe their performance fluctuates with MC phase; indeed, all included studies reported that MC phase impacted athletes’ perceived performance [ 72 , 73 , 74 , 75 , 76 ]. A large proportion, 50–71% and 49–65%, of participants reported feeling their performance in training and competition, respectively, is impaired in certain MC phases [ 72 , 74 , 76 ]. Perceived strength, speed and power ratings were also altered during certain MC phases [ 75 ].…”

“…Perceived strength, speed and power ratings were also altered during certain MC phases [ 75 ]. Athletes most commonly perceived performance to be best in all phases of the MC except the early follicular and late luteal phases [ 76 ] and performance was perceived to be impaired in the early follicular and late luteal phases compared to the rest of the MC [ 72 , 75 , 76 ]. The perceived performance detriment in the early follicular and late luteal phases coincides with the occurrence of menstrual symptoms; a common reason attributed to this perceived performance decline was experiencing fatigue [ 72 ] or lethargy [ 74 ]—which are common menstrual symptoms experienced around menstruation in the general reproductive aged population [ 77 ]—menstrual pain and other menstrual symptoms [ 74 ].…”

“…The existence of low and high responders should also be investigated; Julian et al [ 116 ] suggested that some athletes may be more or less susceptible to changes in performance as a result of MC phase. Given that some athletes report their performance to be affected by MC phase and others do not [ 72 , 76 ], and it is known that some females are more susceptible to experiencing severe menstrual symptoms than others [ 117 ], it is feasible there are individual differences in the extent to which MC phase affects performance. It would be useful to determine if low and high responders to these MC phase effects exist, and if they do, how these responders can be identified.…”