Working with Elite Athletic Women’s Menstrual Cycle

by Delaney Stone-Kerr, CSCS
NSCA Coach May 2023
Vol 10, Issue 1


The purpose of this article is to share the importance of the menstrual cycle’s effects on elite athlete performance, and how these effects should influence the training and recovery of high-performing athletic women.

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This article originally appeared in NSCA Coach, a quarterly publication for NSCA Members that provides valuable takeaways for every level of strength and conditioning coach. You can find scientifically based articles specific to a wide variety of your athletes’ needs with Nutrition, Programming, and Youth columns. Read more articles from NSCA Coach »

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  1. Armour, M, Parry, KA, Steel, K, and Smith, CA. Australian female athlete perceptions of the challenges associated with training and competing when menstrual symptoms are present. International Journal of Sports Science and Coaching 15(3): 316-323, 2020.
  2. Belval, LN, Hosokawa, Y, Casa, DJ, Adams, WM, Armstrong, LE, Baker, LB, and Wingo, J. Practical hydration solutions for sports. Nutrients 11(7): 1550, 2019.
  3. Blagrove, RC, Bruinvels, G, and Pedlar, CR. Variations in strength-related measures during the menstrual cycle in eumenorrheic women: A systematic review and meta-analysis. Journal of Science and Medicine in Sport 23(12): 1220-1227, 2020.
  4. Bull, JR, Rowland, SP, Scherwitzl, EB, Scherwitzl, R, Danielsson, KG, and Harper, J. Real-world menstrual cycle characteristics of more than 600,000 menstrual cycles. Digital Medicine 2: 83, 2019.
  5. Carmichael, MA, Thomson, RL, Moran, LJ, and Wycherley, TP. The impact of menstrual cycle phase on athletes’ performance: A narrative review. International Journal of Environmental Research and Public Health 18(4): 1667, 2021.
  6. Delp, M. Effects of Menstrual Cycle Phase on Aerobic Parameters During a Graded-Exercise Test. University of Oklahoma, 2020.
  7. Costello, JT, Bieuzen, F, and Bleakley, CM. Where are all the female participants in sports and exercise medicine research? European Journal of Sport Science 14(8): 847–851, 2014.
  8. Draper, CF. Metabolic signatures in nutrition and health: Shortterm diet response. Interactions 42: 158-179, 2015.
  9. Giersch, GE, Morrissey, MC, Katch, RK, Colburn, AT, Sims, ST, Stachenfeld, NS, and Casa, DJ. Menstrual cycle and thermoregulation during exercise in the heat: A systematic review and meta-analysis. Journal of Science and Medicine in Sport 23(12): 1134-1140, 2020.
  10. González-Alonso, J, Teller, C, Andersen, SL, Jensen, FB, Hyldig, T, and Nielsen, B. Influence of body temperature on the development of fatigue during prolonged exercise in the heat. Journal of Applied Physiology 86(3): 1032-1039, 1999.
  11. Holtzman, B, and Ackerman, KE. Recommendations and nutritional considerations for female athletes: Health and performance. Sports Medicine 51(1): 43-57, 2021.
  12. Kissow, J, Jacobsen, KJ, Gunnarsson, TP, Jessen, S, and Hostrup, M. Effects of follicular and luteal phase-based menstrual cycle resistance training on muscle strength and mass. Sports Medicine 1-7, 2022.
  13. Markofski, MM, and Braun, WA. Influence of menstrual cycle on indices of contraction-induced muscle damage. The Journal of Strength and Conditioning Research 28(9): 2649-2656, 2014.
  14. Mountjoy, M, Sundgot-Borgen, J, Burke, L, Carter, S, Constantini, N, Lebrun, C, and Ljungqvist, A. The IOC consensus statement: Beyond the female athlete triad—Relative energy deficiency in sport (RED-S). British Journal of Sports Medicine 48(7): 491-497, 2014.
  15. Oosthuyse, T, and Bosch, AN. The effect of the menstrual cycle on exercise metabolism: Implications for exercise performance in eumenorrhoeic women. Sports Medicine (Auckland, N.Z.) 40(3): 207-227, 2010.
  16. Romero-Moraleda, B, Del Coso, J, Gutiérrez-Hellín, J, Ruiz- Moreno, C, Grgic, J, and Lara, B. The influence of the menstrual cycle on muscle strength and power performance. Journal of Human Kinetics 68(1): 123-133, 2019.
  17. Suzuki, Y, Sakuraba, K, Sunohara, M, and Takaragawa, M. Variations in iron status linked to menstrual cycles among Japanese female athletes. International Journal of Analytical Bio- Science 6(3): 2018.
  18. Volpe, SL, Poule, KA, and Bland, EG. Estimation of prepractice hydration status of National Collegiate Athletic Association Division I athletes. Journal of Athletic Training 44(6): 624-629, 2009.
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Delaney Stone-Kerr, CSCS

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