Effect of the Menstrual Cycle on Athletic Performance in NCAA Division III Collegiate Athletes

Background: Gender-specific aspects of physiology influence multiple systems including the cardiovascular, respiratory, neuromuscular, and musculoskeletal systems. Studies have shown that female athletes are 2 to 10 times more susceptible to ligamentous injury than men. Studies contributed these findings to varying anatomical structure between men and women, hormonal changes throughout the menstrual cycle, and some athletes taking oral contraceptives. A female athlete may be just as fit as her male counterpart, yet it is recognized that the menstrual cycle has unique physiological and psychological effects on athletic performance. Fluctuations in sex hormones and symptoms of the menstrual cycle may impact one's ability to train and compete. Objectives: To analyze the effect of the menstrual cycle on athletic performance in NCAA Division III collegiate athletes. Study Design: Prospective, nonexperimental, descriptive study. Methods: Participants were recruited from NCAA Division III universities in Pennsylvania. Data were collected on participants' demographics, menstrual cycle history, use of birth control, premenstrual symptoms, and athletic performance. Athletic performance was examined and compared during the follicular and luteal phases and during nonmenstruating and menstruating days. Results: Eight athletes were included in the analysis. No trends were observed when comparing athletic performance during the follicular and luteal phases. When examining nonmenstruating and menstruating days, most average race times slowed or increased. Conclusion: Incorporating menstrual cycle tracking into a plan of care can help therapists determine best exercises based on phase of cycle. Therapists can also educate patients at risk of injury, modifying training plans and expectations on performance.