Impact of Nutrition-Based Interventions on Athletic Performance during Menstrual Cycle Phases: A Review

Abstract

Despite the steady increase in female participation in sport over the last two decades, comprehensive research on interventions attenuating the influence of female menstrual physiology on performance remains scarce. Studies involving eumenorrheic women often only test in one menstrual phase to limit sex hormone variance, which may restrict the application of these findings to the rest of the menstrual cycle. The impacts of nutrition-based interventions on athletic performance throughout the menstrual cycle have not been fully elucidated. We addressed this gap by conducting a focused critical review of clinical studies that reported athletic outcomes as well as menstrual status for healthy eumenorrheic female participants. In total, 1443 articles were identified, and 23 articles were included. These articles were published between 2011 and 2021, and were retrieved from Google Scholar, Medline, and PubMed. Our literature search revealed that hydration-, micronutrient-, and phytochemical-based interventions can improve athletic performance (measured by aerobic capacity, anaerobic power, and strength performance) or attenuate exercise-induced damage (measured by dehydration biomarkers, muscle soreness, and bone resorption biomarkers). Most performance trials, however, only assessed these interventions in one menstrual phase, limiting the application throughout the entire menstrual cycle. Improvements in athletic performance through nutrition-based interventions may be contingent upon female sex hormone variation in eumenorrheic women.

Hormonal contraceptive use, menstrual cycle characteristics and training/nutrition related profiles of elite, sub-elite and amateur athletes and exercisers: One size is unlikely to fit all

“…4 Furthermore, these factors also oppose the suggestion that generalised guidelines can be applied to female athletes and exercisers in relation to tailoring training and/or nutritional strategies based around phases of the menstrual or contraceptive cycles. [12][13][14] In accordance with competitive status, the elite cohorts surveyed here reported higher training loads (e.g. longer training history, increased weekly training frequency, longer training duration, etc.)…”

“…[7][8][9][10][11] On this basis, it may therefore be premature to suggest evidence-based training and/or nutritional guidelines that can be tailored according to phases of the menstrual cycle or types of HC. [12][13][14] HCs can be administered in numerous forms inclusive of oral contraception (OC), hormonal intrauterine devices (global terminology) or systems (United Kingdom terminology) (IUD/S), injections, implants, vaginal rings and transdermal patches. These methods deliver various doses of exogenous steroid hormones that induce a suppressed level of endogenous sex steroid hormones and therefore inhibit ovulation.…”

Nutrition-Related considerations for health and performance in female Volleyball: A narrative review

“…Most evidence suggests that it may be beneficial for female athletes to focus on maintaining high CHO availability in their diet during training, resulting in power gains, increased time to fatigue and less physiological fatigue (Burke & Dziedzic, 2013). Other research found no difference in time to exhaustion or rate of perceived exertion with CHO intake, specifically during the mid-follicular phase of the menstrual cycle (Helm et al, 2021), however, participants consumed only 6.5 g/kg of CHO per day, compared to the recommended 8 g/kg (Rael et al, 2021).…”

“…Further research is needed to assess possible differences in the needs of female athletes compared to males, although individualization of recommendations (Guest et al, 2019) for each athlete will allow for somewhat more gender-specific recommendations (Helm et al, 2021).…”

Correlation Study of Nutritional Status of Female 16-18 Years Old With Premenstrual Syndrome

“…In the opinion of Paath, (Helm, McGinnis, & Basu, 2021) Insufficient or limited nutrition in addition to affecting growth, the function of body organs will also cause disruption of reproductive function. This will have an impact on menstrual disorders, but will improve if the nutritional intake is good."…”