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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
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.