Episode 78: New Research Updates on the Impact of the Menstrual Cycle on Performance and Return to Sport After Periods of Low Energy Availability

Trail Society

In this episode, Keely, Corrine, and Hillary discuss various life events and races before delving into recent research. First, they explore the current state of menstrual cycle research, highlighting areas of improvement and those that still have a way to go. They then discuss the impact of menstrual-related symptoms on mental health and spatial performance. As coaches, they share their approaches to addressing the menstrual cycle for athletes who menstruate, including tracking the cycle and adapting training to meet individual athletes' specific needs. Finally, they touch on Low Energy Availability (LEA) and RED-S, highlighting recent research showing that LEA can manifest in as little as 3 days. They also discuss coaching strategies for helping athletes recover from short-term and long-term LEA periods. Disclaimer: This podcast does not provide medical advice, but rather shares recent information in these two areas. Listeners are advised to always discuss their unique needs with a licensed professional.

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Articles Referenced:

Menstrual Cycle and Performance:

Smith ES, Weakley J, McKay AKA, McCormick R, Tee N, Kuikman MA, Harris R, Minahan C, Buxton S, Skinner J, Ackerman KE, Elliott-Sale KJ, Stellingwerff T, Burke LM. Minimal influence of the menstrual cycle or hormonal contraceptives on performance in female rugby league athletes. Eur J Sport Sci. 2024 Jun 15. doi:10.1002/ejsc.12151. PMID: 38877892.

Menstrual Cycle and Birth Control

Nolan, David, et al. “The Effect of Hormonal Contraceptive Use on Skeletal Muscle Hypertrophy, Power and Strength Adaptations to Resistance Exercise Training: A Systematic Review and Multilevel Meta-Analysis.” Sports Medicine (Auckland, N.Z.), 27 Sept. 2023, pubmed.ncbi.nlm.nih.gov/37755666/, https://doi.org/10.1007/s40279-023-01911-3. Accessed 15 Oct. 2023.

Ihalainen, Johanna K., et al. “Self-Reported Performance and Hormonal-Cycle-Related Symptoms in Competitive Female Athletes.” Women in Sport and Physical Activity Journal, vol. 32, no. 1, 2 July 2024, journals.humankinetics.com/view/journals/wspaj/32/1/article-wspaj.2023-0102.xml, https://doi.org/10.1123/wspaj.2023-0102.

Menstrual Cycle, Behavioral, and Cognitive Parameters

Ronca,F., et al. Attentional, anticipatory and spatial cognition fluctuate throughout the menstrual cycle: Potential implications for female sport. In- Press. Neuropsychologia

17 May 2024. https://www.sciencedirect.com/science/article/pii/S0028393224001246?via%3Dihub

Kullik, Lisa, et al. “The Prevalence of Menstrual Cycle Symptoms and Their Association with Mental Health and Sleep in German Exercising Women and Athletes.” Journal of Science and Medicine in Sport, 1 Feb. 2024, https://doi.org/10.1016/j.jsams.2024.02.008.

LEA, return to sport, impacts of short-term LEA, and menstrual dysfunction

De Souza, Mary Jane, et al. “Randomised Controlled Trial of the Effects of Increased Energy Intake on Menstrual Recovery in Exercising Women with Menstrual Disturbances: The “REFUEL” Study.” Human Reproduction, vol. 36, no. 8, 24 June 2021, pp. 2285–2297, https://doi.org/10.1093/humrep/deab149. Accessed 25 Nov. 2021.

Hutson, Mark J, et al. “High‐Impact Jumping Mitigates the Short‐Term Effects of Low Energy Availability on Bone Resorption but Not Formation in Regularly Menstruating Females: A Randomized Control Trial.” Scandinavian Journal of Medicine & Science in Sports, vol. 33, no. 9, 26 June 2023, pp. 1690–1702, https://doi.org/10.1111/sms.14437. Accessed 7 Dec. 2023.

Hutson, Mark J., et al. “Effects of Low Energy Availability on Bone Health in Endurance Athletes and High-Impact Exercise as a Potential Countermeasure: A Narrative Review.” Sports Medicine, vol. 51, no. 3, 21 Dec. 2020, pp. 391–403, https://doi.org/10.1007/s40279-020-01396-4.