Influence of Menstrual Cycle or Hormonal Contraceptive Phase on Physiological Variables Monitored During Treadmill Testing

Female athletes train and compete under the potential influence of hormonal fluctuations during the menstrual cycle or during use of various hormonal contraceptives. Dysmenorrhea and premenstrual symptoms are common in the general population, as well as side effects of hormonal contraceptives. More detailed knowledge concerning prevalence and perceived impact of these symptoms on training and performance in different sports is required. The aim of the study was to 1) characterize perceptions of training and performance during the menstrual cycle phases and by hormonal contraceptive use in a large population of female athletes; 2) explore whether symptoms experienced are related to perceived performance; and 3) examine potential differences in these factors between athletes at different levels of performance. The study was based on self-reported data from 1,086 athletes from 57 sports at different performance levels via a web-based questionnaire. Thirty-seven percent (n = 407) of the athletes did not use hormonal contraceptives. In this group, menstrual cycle related symptoms were common across all athlete levels, particularly dysmenorrhea (74%, n = 300) and premenstrual symptoms (78%, n = 318), which also influenced perceived performance of aerobic fitness, muscle strength, mental sharpness, balance, and sleep quality. Sixty-three percent (n = 679) of the athletes used various hormonal contraceptives and 40% (n = 272) perceived a variety of side-effects. Physical performance was experienced equally independent of time-point of the pill-chart except for the period of inactive pills, which was associated with more negative impact. Nonetheless, only 18% (n = 191) of the athletes considered menstrual cycle or hormonal contraceptive issues when planning their training or competitions. These results indicate that greater focus is needed to identify and effectively treat different menstrual cycle and hormonal contraceptive related symptoms on an individual level.

Aerobic metabolism dominates Olympic rowing, but research on the relative contribution of strength and power demands is limited. This study aimed to identify the contribution of different strength determinants for distinct phases of rowing ergometer performance. The crosssectional analysis comprised of 14 rowing athletes (4 female, 10 male, age: 18.8 ± 3.0y, 16.9 ± 2.2y). Measurements included anthropometrics, maximal strength of leg press, trunk extension and flexion, mid-thigh pull (MTP) and handgrip strength, VO 2 max, and a 2000 m time trial, where peak forces at the start, middle and end phase were assessed. Additionally, rate of force development (RFD) was assessed during the isometric leg press and MTP with intervals of 150, 350 ms and 150, 300 ms, respectively. Stepwise regression models for ergometer performance showed that the start phase was mainly explained by maximal trunk extension and RFD 300 ms of MTP (R 2 = 0.91, p < 0.001) and the middle section by VO 2 max, maximal leg press strength and sitting height (R 2 = 0.84, p < 0.001). For the end phase, a best fit was observed for trunk flexion, RFD 350 ms of leg press, body height and sex (R 2 = 0.97 p < 0.001), whereas absolute VO 2 max, trunk flexion and sex explained variance over the entire 2000 m time trial (R 2 = 0.98, p < 0.001). It appears that for the high acceleration in the start phase, force transmission through maximum strength for trunk extension is essential, while fast power production along the kinetic chain is also relevant. Additionally, the results support that maximal force complements the reliance on VO 2 max. Further intervention studies are needed to refine training recommendations.

The underrepresentation of the female population in exercise sciences could be attributed, at least in part, to difficulty in appropriately accounting for the effects of the menstrual cycle (MC). Previous studies examining the effects of the MC on aerobic performance and subjective measures of aerobic performance show conflicting results.Purpose: The study examined how the MC affects the objective and subjective measures of aerobic performance within untrained female participants and in comparison with untrained male participants assessed at similar time intervals.Methods: Twenty-one participants (12 females and 9 males) completed a graded exercise test (GXT) on a cycle ergometer. The female participants were tested during their early follicular (EF; menses), ovulatory (O), and mid-luteal (ML) phases of the MC. The male participants were included as the control group and were randomly assigned to a menstrual cycle phase for each visit. During GXT, maximal oxygen consumption (VO2max), respiratory exchange ratio (RER), maximal heart rate (HRmax), peak blood lactate, and rating of perceived exertion (RPE) were determined. Twenty-four hours post-exercise, the perceived recovery status (PRS) was assessed. The MC phase was estimated using basal body temperature (BBT) in the female participants.Results: The male participants obtained a higher peak power and VO2max compared to the female participants (p &lt; 0.05). All objective measures of aerobic performance did not significantly differ across the MC phases or time points that were tested. In the untrained female participants, an effect of the MC phase on RPE was found, with RPE being higher at EF (8.92 ± 0.79) compared to O (7.67 ± 1.23; p &lt; 0.05) and ML (7.75 ± 1.06; p &lt; 0.05). In addition, an effect of the MC phase on PRS was found, with perceived recovery being lower at EF (6.83 ± 0.94) compared to O (8.83 ± 1.12) and ML (8.67 ± 0.65; all p &lt; 0.005) for the untrained female participants. No significant differences in RPE and PRS were found between tests in the untrained male participants. The female participants had lower perceived recovery following EF (6.83 ± 0.94) compared with the male participants (9.00 ± 1.00; p &lt; 0.001).Conclusion: The untrained female participants perceived greater exertion during GXT and impaired recovery following GXT in EF compared to O and ML. These results may be attributed to either a drop in female sex hormone concentrations or discomfort associated with menses. The male participants did not exhibit any changes over time. Future studies using subjective parameters such as perceived exertion to track the internal load of training in the naturally menstruating female population should consider menses.