Menstrual Cycle and Exercise Performance

Abstract

This article examines the relationship between the menstrual cycle and exercise performance while separating plausible hormonal mechanisms from demonstrated performance outcomes. Ovarian hormone profiles vary across early follicular, late follicular or pre-ovulatory, ovulatory, early luteal, mid-luteal, and late luteal phases, with considerable variation between individuals and from one cycle to the next. Female hormones estradiol and progesterone may influence substrate use, thermoregulation, cardiovascular regulation, neuromuscular function, recovery, mood, and perceived exertion. Their physiological actions, however, have not been shown to produce reliably predictable changes in objective performance at the population level. Current syntheses generally report small, inconsistent, or low-certainty phase-related effects. Menstrual symptoms, perceived readiness, ovulatory status, luteal sufficiency, energy availability, iron status, sleep, training load, and environmental context may be more consequential for an individual athlete than a phase label alone. Persistent methodological limitations include calendar-based phase estimation, insufficient hormonal verification, small samples, heterogeneous athlete classification, and limited use of validated symptom measures. This article therefore supports an individualized, symptom-informed approach that integrates menstrual health with established markers of athlete readiness, while avoiding universal cycle-based training prescriptions.