🏃‍♀️ Menstrual Cycle and Sport: what the science starts to discover

A Long-Neglected Topic

For decades, research in sport sciences has been largely centered on men. Women were often excluded from studies on performance, endurance, or recovery, mainly to simplify methodology and because of concerns about hormonal variability related to the menstrual cycle.

Today, women represent nearly half of elite athletes and regular sports participants. Ignoring their physiological, hormonal, and social specificities in sports research leads to incomplete—and sometimes inappropriate—recommendations. Understanding the effects of the menstrual cycle on performance and training is not only a scientific issue: it is a matter of health, equity, and performance optimization.

🤯 Why the Question of Sport and The Menstrual Cycle Is Complex

The menstrual cycle includes several phases (follicular phase, ovulation, luteal phase), characterized by significant hormonal fluctuations: estrogen, progesterone, and, in some cases, the influence of hormonal contraception. These fluctuations may potentially affect:

• Physical performance: strength, endurance, recovery, reaction time

• Metabolism: use of fats and carbohydrates during exercise, body temperature

• Perception and well-being: fatigue, pain, mood

However, accurately quantifying these effects across the different phases of the cycle remains challenging and insufficiently understood.

First, most past studies on sport, performance, and metabolism predominantly included men. Although women now account for half of all active athletes (with full gender parity reached for the first time at the Paris 2024 Olympic Games), women remain significantly underrepresented in sports medicine research.

This exclusion can be explained by several factors: a longstanding lack of biomedical interest in women’s health, but also the variability introduced by the menstrual cycle itself. As a result, women were often excluded to simplify study design and interpretation.

Research that overlooks the complexity of female hormones continues to contribute to a major gap in our understanding of hormonal-related adaptations.

For studies that do address the topic, another major challenge remains: reliably determining the menstrual cycle phase of participants. The simplest approach is calendar-based tracking, counting days from the first day of menstruation. However, this method does not account for inter- and intra-individual variability and therefore remains approximate and subjective.

Greater precision can be achieved using urinary ovulation test kits, but these provide only momentary information and do not allow accurate identification of all cycle phases. Hormonal blood testing remains the gold standard for individual hormonal cycle monitoring, but it involves significant logistical and ethical constraints when applied to studies involving multiple female athletes.

All of these factors explain why current findings remain fragmented.

👩‍🔬 What Science Knows — and Does Not Know

Two main observations emerge from the current literature:

• Athletes’ perceptions matter most: between 30% and 100% of women report that their menstrual cycle affects their training or performance.

• Physiological effects are small and heterogeneous: some variables (flexibility, cognition, recovery) may fluctuate across cycle phases, but overall, there is no strong scientific consensus.

  
  

In summary, the menstrual cycle may influence perceived performance and certain physical aspects, but objective evidence remains limited.

🚧 Ongoing Research

The field is rapidly evolving thanks to several research initiatives:

• Longitudinal studies on performance and symptoms with precise hormonal measurements

• Randomized controlled trials comparing cycle-based training periodization with traditional training programs

• Multidimensional analyses integrating physiological, cognitive, psychological, and nutritional factors

  
  

Recent reviews (2024–2025) confirm that objective variations exist but remain small, whereas individual perception is often more pronounced. Personalized monitoring of female athletes is now recommended over universal training periodization strategies.

Recent Studies on the Topic:

• Ekenros et al., 2024 — Randomized controlled trial on training periodization according to the menstrual cycle. Preliminary data suggest a potential effect, but evidence remains insufficient to support a generalized recommendation. Doi: 10.1186/s13063-024-07921-4

• Oester et al., 2024 - Systematic review on athletes’ perceptions and the impact of the menstrual cycle. Reported negative impact ranges from ~3% to 100% depending on studies, largely due to methodological differences and recall bias. https://doi.org/10.1016/j.jsams.2024.02.012

• Jones et al., 2024 — Review and meta-analysis on the menstrual cycle and sports performance (Frontiers in Sports and Active Living). Objective effects on strength and endurance are generally very small or non-significant; some measures (flexibility, timing, cognition) may fluctuate, but overall study quality is often low.. https://doi.org/10.3389/fspor.2024.1296189

• Elorduy-Terrado et al., 2025 — Systematic review confirming that certain parameters (e.g., flexibility, perceived exertion) vary across phases, but methodological heterogeneity and small effect sizes warrant caution. https://doi.org/10.3390/muscles4020015

• Ronca et al. / UCL, 2024–2025 — studies on cognition and menstrual cycle phase. Reaction time and attention may fluctuate depending on cycle phase; however, physical activity level often has a greater influence than cycle phase alone. doi: 10.1186/s40798-025-00924-8

• Carmichael et al., 2025 — Review on menstrual cycle monitoring in applied sports settings. While standardized periodization is not yet supported, personalized tracking (cycle tracking, symptom questionnaires) is recommended to optimize health and training. https://doi.org/10.1177/17479541251333888

Active Figures in France

Juliana Antero

Coordinator of the Empow’Her program (Exploring Menstrual Periods Of Women Athletes to Escalate Ranking), Juliana Antero and her team follow elite female athletes to document the impact of the menstrual cycle on performance and well-being. Their approach combines physiology, epidemiology, and longitudinal monitoring.

The main objective of EMPOW’HER is to maximize elite female athletes’ performance by optimizing training responses through workload adjustments aligned with their physiology and menstrual cycle.

The program is conducted with the support of the INSEP Performance Unit and in collaboration with several French sports federations.

Athletes are monitored daily using connected watches that collect physiological and movement data, as well as a dedicated application in which athletes report subjective perceptions. Hormonal analyses are conducted in parallel. All collected data are analyzed to better understand training responses.

Manon Dauvergne – La Réunion

A sports physiotherapist with a Master’s degree in sport sciences, Manon Dauvergne is pursuing a PhD in sport sciences.

Her doctoral research topic (PhD enrollment since 2023) is: “Effect of menstrual cycle phases in female athletes on neuromuscular performance and adaptations following resistance training.”

From a fundamental perspective, the objective is to better understand how physiological parameters associated with the menstrual cycle influence neuromuscular performance, in order to optimize training through periodized strength programs. Participant recruitment began in 2025.

She studies neuromuscular performance across cycle phases and actively raises public awareness through podcasts and science communication initiatives.

Additional Academic Researchers

• Marine Carpentier (Unité de recherche en Physiologie cardio-respiratoire, Exercice et Nutrition de l'Université Libre de Bruxelles) : A trained physiotherapist with a Master’s degree in sports pathologies, she is completing a PhD focusing on the impact of hormonal cycle and hormonal contraception on cardiovascular function and sports performance.

• Sarah Bagot (Laboratoire AME2P de l'Université Clermont-Auvergne) : Her research examines the interaction between training load and hormonal status on energy metabolism in female athletes.

• Léonie Augé (Université Paris 10) : Works at the intersection of biology and sociology.

Conclusion: An Open but Essential Question

The menstrual cycle is not inherently a limitation for female athletes, but it represents a source of physiological variability that must be understood and integrated.

The challenges are multiple:

• Developing training and recovery recommendations adapted to female physiology

• Recognizing and valuing women’s physiological specificity

• Reducing inequalities in research and clinical care

  
  

With ongoing research and growing awareness, the topic of sport and the menstrual cycle is finally emerging from scientific silence. The coming years promise more robust, personalized, and practical answers for all female athletes, from beginners to elite performers.