The Effect of the Menstrual Cycle on Exercise and Sports Performance

Women’s participation in sport and exercise is increasing; therefore, it is imperative that any potential modulations, either positive or negative, in performance, training, and adaptation can be understood and optimized. Indeed, sex hormones can affect physiological processes within the cardiopulmonary and nervous systems, as well as skeletal muscle properties; the integration of these systems determines performance in a variety of tasks. As such, the cyclical changes in endogenous hormones across the menstrual cycle have the potential to affect the underpinnings of exercise performance; thus, women athletes and those working with them require an understanding of this to potentially optimize long-term outcomes. This chapter aims to discuss the physiological effects of the menstrual cycle outside of the reproductive system, as well as highlight the current literature pertaining to the effect of fluctuations in endogenous sex hormones across the menstrual cycle on exercise performance. Thereafter, practical recommendations that can be made based on the available evidence are discussed.