---
title: Does heart rate variability change across the menstrual cycle?
description: Yes, cardiac vagal activity (a measure of heart rate variability) decreases significantly from the follicular phase to the luteal phase.
url: https://niyora.com/research/papers/a-systematic-review-and-meta-analysis-of-within-person-changes-in-cardiac-vagal-2019/
---

- [Niyora](https://niyora.com/)
- [Research](https://niyora.com/research/)
- [Library](https://niyora.com/research/library/)
- Does heart rate variability change across the menstrual cycle?

Systematic review, 2019

# Does heart rate variability change across the menstrual cycle?

Yes, cardiac vagal activity (a measure of heart rate variability) decreases significantly from the follicular phase to the luteal phase.

 Strong study design

1,004 naturally-cycling premenopausal women across 37 studies

## What they did

They reviewed 37 studies with repeated measures of cardiac vagal activity across at least two menstrual cycle phases in 1,004 women, and combined the results in a meta-analysis.

## What they found

Cardiac vagal activity significantly decreased from the follicular to luteal phase. Larger decreases were found from menstrual to premenstrual phase and from mid-to-late follicular to premenstrual phase.

## What it means for you

Your body's stress regulation (measured by heart rate patterns) decreases before your period, potentially affecting how well you handle stress. Main limitation: all studies were observational with varying methods.

37

studies analyzed

1,004

women studied

-0.39

effect size (follicular to luteal)

## About the study

Original title A Systematic Review and Meta-Analysis of Within-Person Changes in Cardiac Vagal Activity across the Menstrual Cycle: Implications for Female Health and Future Studies Authors Schmalenberger KM, Eisenlohr-Moul TA, Würth L et al. Journal Journal of clinical medicine Year 2019 Study design Systematic review What was tested None - observational study of natural menstrual cycle Open access Yes Read the paper [doi.org/10.3390/jcm8111946](https://doi.org/10.3390/jcm8111946) Original abstract

Interest in cardiac vagal activity (CVA; e.g., parasympathetically-mediated heart rate variability) as a biomarker of physical and mental health has increased exponentially in recent years. However, the understanding of sources of within-person change (i.e., intra-individual variance) in CVA is lagging behind. This systematic review and meta-analysis summarizes and quantifies current empirical evidence of within-person changes in measures of CVA across the menstrual cycle in naturally-cycling premenopausal females. We conducted an extensive literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement in five databases to identify observational studies with repeated measures of CVA in at least two menstrual cycle phases. A broad meta-analysis ( n studies = 37; n individuals = 1,004) revealed a significant CVA decrease from the follicular to luteal phase ( d = -0.39, 95% CI (-0.67, -0.11)). Furthermore, 21 studies allowed for finer-grained comparisons between each of two cycle phases (menstrual, mid-to-late follicular, ovulatory, early-to-mid luteal, and premenstrual). Significant decreases in CVA were observed from the menstrual to premenstrual ( n studies = 5; n individuals = 200; d = -1.17, 95% CI (-2.18, -0.17)) and from the mid-to-late follicular to premenstrual phases ( n studies = 8; n individuals = 280; d = -1.32, 95% CI (-2.35, -0.29)). In conclusion, meta-analyses indicate the presence of CVA fluctuations across the menstrual cycle. Future studies involving CVA should control for cycle phase. Recommendations for covarying or selecting cycle phase are provided.

Reproduced under CC-BY.

Research tells you what helps on average. Niyora helps on the day it hits.

Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor.

Ask AI about this page

Copy prompt

ChatGPT

↗

Claude

↗

Perplexity

↗

Google AI Mode

↗

Grok

↗