Does the menstrual cycle affect how well female athletes perform?

Background: Extensive research confirms that hormonal fluctuations during the menstrual cycle significantly influence female athletic performance, with profound implications for public health, including promoting equitable access to sports and enhancing women's overall physical and mental well-being. Numerous scientifically validated methods are available to monitor hormonal status and menstrual cycle phases. However, our prior investigations revealed that these insights are rarely applied in practice due to the complexity and invasiveness of existing methods. This study examines the effects of hormonal fluctuations on elite female basketball players. It assesses practical, non-invasive, cost-effective, and field-applicable methods for hormonal monitoring, with a focus on cervical mucus analysis for estrogen crystallization. The goal is to optimize training, promote equity in women's sports, and support public health strategies for female empowerment through sustained physical activity, addressing the limitations of male-centric training models. Materials and methods: This exploratory field study employed a multifaceted approach, beginning with a comprehensive meta-analysis via literature searches on PubMed, SCOPUS, and Google Scholar to evaluate hormonal impacts on physical performance, supplemented by an expert survey of 20 sports scientists and coaches using Kendall's concordance coefficient for reliability and an experimental phase involving 25 elite female Ukrainian basketball players assessed over three months through daily performance tests (e.g., sprints, jumps, agility drills, and shooting) integrated into six weekly training sessions, with cycle phases tracked via questionnaires, basal body temperature, and the fern leaf method for estrogen levels. Results: Performance peaked during the postmenstrual and post-ovulatory phases (e.g., a 7.5% increase in sprint time and a 5.1% improvement in running jump). It declined in the premenstrual phase (e.g., a 2.3% decrease in acceleration). The estrogen crystallization test using cervical mucus provided preliminary insights into hormonal status but was less precise than laboratory-based methods, such as LC-MS/MS, which remain impractical for routine use due to cost and complexity. The fern test and basal body temperature showed limited precision due to external factors. Conclusions: There is a critical need to develop simple, non-invasive, field-applicable devices for accurate, real-time hormonal monitoring. This will bridge the gap between research and practice, enhancing training personalization, equity in women's fitness and sports, and public health outcomes by increasing female participation in physical activities, reducing gender-based health disparities, and fostering inclusive wellness programs.

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