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Cohort study, 2023

How do menstrual cycle and birth control pill phases affect female athletes' training and performance?

Female rowers performed better in the middle of their cycle and worse during their period and premenstrual phase. Those taking hormonal contraceptives also performed better when taking the pills.

Early or limited evidence 12 elite French rowers (6 with natural cycles, 5 on hormonal contraception, 1 with amenorrhea)

What they did

Followed 12 elite rowers (6 natural cycle, 5 on birth control) for 4.2 cycles during Olympics prep. Collected 1,281 daily self-reports on sleep, mood, pain, menstrual symptoms, and perceived performance. Coaches rated performance 136 times blinded to menstrual phase. Also measured salivary hormones.

What they found

Rowers with natural cycles reported higher performance and wellness scores at the middle of their cycle and lowest scores during their period and premenstrual phase. Menstrual symptoms during these phases were negatively correlated with performance. Self-reported performance matched coaches' independent evaluations. Those on birth control pills performed better when taking the pills.

What it means for you

If you are a female athlete, your menstrual cycle and birth control pill schedule may affect how you feel and perform. Tracking these may help optimize training. The main limitation is this is a very small sample of elite rowers in one sport, so findings may not apply to other women or sports.

12

elite rowers studied

1,281

daily wellness reports collected

4.2

menstrual cycles followed on average

About the study

Original title
Menstrual cycle and hormonal contraceptive phases' effect on elite rowers' training, performance and wellness
Authors
Antero J, Golovkine S, Niffoi L et al.
Journal
Frontiers in physiology
Year
2023
Study design
Cohort study
Participants
1,281
What was tested
none (observational study of natural cycle and contraceptive phases)
Open access
Yes
Original abstract

Objectives: To investigate the effect of menstrual cycle (MC) and hormonal contraception (HC) phases in elite rowers training, performance and wellness monitoring. Methods: Twelve French elite rowers were follow-up for 4,2 cycles on average in their final preparation for the Olympics and Paralympics Games in Tokyo 2021 through an on-site longitudinal study based on repeated measures. Daily self-reported evaluation using Likert rating scales of wellness (sleep quality, fitness, mood, injuries' pain), menstrual symptoms and training parameters (perceived exertion and self-assessment of performance) were collected (n = 1,281) in parallel to a coach evaluation of rowers' performance (n = 136), blinded to theirs MC and HC phases. Salivary samples of estradiol and progesterone were collected in each cycle to help to classify the MC into 6 phases and HC into 2-3 phases depending on the pills' hormone concentration. A chi-square test normalized by each rower was used to compare the upper quintile scores of each studied variable across phases. A Bayesian ordinal logistic regression was applied to model the rowers' self-reported performance. Results: Rowers with a natural cycle, n = 6 ( + 1 amenorrhea) evaluate their performance and wellness with significant higher score indices at the middle of their cycle. Top assessments are rarer at the premenstrual and menses phases, when they more frequently experience menstrual symptoms which are negatively correlated with their performance. The HC rowers, n = 5, also better evaluate their performance when taking the pills and more frequently experience menstrual symptoms during the pill withdrawal. The athletes self-reported performance is correlated with their coach's evaluation. Conclusion: It seems important to integrate MC and HC data in the wellness and training monitoring of female athletes since these parameters vary across hormonal phases affecting training perception of both athlete and coach.

Reproduced under CC-BY.

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