The Impact of the Menstrual Cycle on Athletic Performance: A Quantitative Study of Hormonal Fluctuations

Based on the Journal of Applied Physiology, Medicine & Science in Sports & Exercise, Sports Medicine, British Journal of Sports Medicine, and other international peer-reviewed journals, this article provides an in-depth analysis of the scientific evidence on “menstrual cycle and exercise performance” in the field of female exercise physiology. It also integrates Taiwan’s local climate, events, and sports culture context to offer evidence-based training and health strategies.

In the realm of female exercise physiology, “menstrual cycle and exercise performance” is a topic with both academic depth and practical value, yet it has long been misunderstood or overlooked. Over the past decades, the knowledge accumulated in sports science has largely been based on studies of healthy adult males, causing many unique physiological characteristics and needs of female exercise physiology to receive systematic attention and research only in recent years. In fact, adolescents, women, and special populations (such as the elderly, pregnant and postpartum women, and those with chronic diseases) differ fundamentally from the “standard young male athlete” in terms of physiological structure, hormonal environment, developmental stage, and health context. If adult male training principles and physiological data are directly applied to them, the results may range from diminished effectiveness to actual health harm. This is precisely why understanding the “menstrual cycle and exercise performance” is so important—it allows us to move beyond the myth of a “one-size-fits-all” approach and provide scientific guidance that truly aligns with the physiology and needs of different populations. As Taiwan moves toward an aging society, gender equality awareness rises, and youth sports participation becomes increasingly common, the local applicability of female exercise physiology is particularly prominent. This article will take you from the physiological mechanisms at the cellular and systemic levels, through empirical research in top international journals, the quantitative relationship between dose and effect, and differences in responses across populations, to directly actionable training applications and Taiwan’s local context. Finally, it will debunk long-standing myths, ensuring your understanding of the “menstrual cycle and exercise performance” is truly built on science rather than hearsay or outdated stereotypes.

Academic Research Review

Regarding the scientific exploration of the “menstrual cycle and exercise performance,” the field of female exercise physiology has accumulated rigorous and rich evidence in recent years. Below are several representative studies selected for their value in methodological design, study populations, and strength of conclusions, which together form our current understanding:

1. McNulty et al. (2020). A meta-analysis of 78 studies in Sports Medicine found that the overall effect of the menstrual cycle on exercise performance is “small and highly individual,” with effect sizes generally below 0.5.

2. Oosthuyse & Bosch (2010). A review in Sports Medicine examined the mechanisms by which estrogen and progesterone affect substrate metabolism, thermoregulation, and substrate utilization.

3. Sims & Heather (2018). Experimental Physiology explored the interaction of the menstrual cycle with plasma volume and core temperature in hot environments.

4. Julian et al. (2017). PLOS ONE compared technical and physical tests between the follicular and luteal phases in female soccer players, finding slightly lower performance in the luteal phase but with minimal differences.

Taken together, these studies show that the scientific picture of the “menstrual cycle and exercise performance” has been continuously refined as research methods improve and awareness of “population specificity” rises. Early studies often interpreted data from adolescents, women, or special populations directly through the framework of adult males, ignoring the fundamental differences brought by developmental stage, hormonal cycles, aging processes, or disease context. In contrast, recent high-quality research increasingly emphasizes research methods “tailored to specific populations”—analyzing adolescents by biological maturity rather than chronological age, incorporating menstrual cycle and energy availability as control variables in female studies, and conducting stratified assessments of synthetic resistance and cardiovascular risk in older adults. This methodological evolution allows us to progress from “treating differences as noise” to “treating differences as the core of research.” It is worth noting that research in this field still faces several challenges: the number of studies on women and special populations remains relatively small compared to men, sample sizes are often limited; longitudinal tracking (especially long-term development in adolescents) is costly; and ethical considerations prevent certain interventions in vulnerable populations. Therefore, when interpreting conclusions, we must both value the population-specific insights these studies reveal and pay attention to the level of evidence and scope of applicability—a conclusion drawn from a specific age, sex, or health status group may not be generalizable to other populations. This dual caution regarding population differences and evidence quality forms the foundation for the scientific application of female exercise physiology and is the consistent stance of this article.

Core Mechanisms

Female sex hormones fluctuate regularly throughout the menstrual cycle, theoretically affecting metabolism, body temperature, and fluid balance, but empirically, the average impact on performance is actually quite small and highly individualized. During the follicular phase (days 1 to 14 of the menstrual cycle), estrogen gradually rises. Estrogen promotes fat oxidation and spares glycogen, theoretically benefiting prolonged endurance. After ovulation, entering the luteal phase (days 15 to 28), progesterone rises, and its most notable physiological effect is raising baseline core temperature by approximately 0.3 to 0.5°C, which increases the heat dissipation burden in hot environments. Plasma volume slightly decreases during the luteal phase, potentially affecting cardiac output and heat dissipation. However, the large meta-analysis by McNulty et al. clearly indicates that the effect size of these hormonal fluctuations translating into actual performance differences is very small, and inter-individual differences far exceed differences between cycle phases—some people experience a noticeable decline in performance during premenstrual syndrome, while others feel almost no effect. Therefore, rather than applying the general rule that “a certain phase is definitely stronger or weaker,” a more practical approach is for each athlete to record their training sensations and data across cycle phases, identify their own patterns, and pay special attention to heat dissipation and hydration during the luteal phase in hot-weather events.

To truly understand the “menstrual cycle and exercise performance,” one must return to the unique physiological context of female exercise physiology: how the developing body, fluctuating hormones, aging systems, or disease effects alter exercise responses at the cellular, tissue, and systemic levels. The table below summarizes the key points of this topic across different physiological levels, helping you build a complete mechanistic picture:

| Physiological Level | Key Mechanisms | Implications for Training and Health |

|—|—|—|

| Endocrine/Hormonal | Population differences in sex hormones, growth and metabolic hormones | Affects adaptation direction, energy regulation, and reproductive/skeletal health |

| Bone and Muscle | Bone mass accumulation/loss, muscle fiber composition, and protein synthesis | Determines bone density, strength development, and injury risk |

| Cardiovascular and Metabolic | Population-specific characteristics of cardiac remodeling, oxygen uptake, and substrate utilization | Affects endurance performance, recovery, and long-term health |

| Neural and Psychological | Neuromuscular control, motivation, and psychosocial needs | Determines skill development, injury prevention, and sustained participation |

Particular emphasis should be placed on the two dimensions of “developmental stage” and “individual differences.” The same intervention may produce vastly different or even opposite effects under different maturity levels, ages, sexes, hormonal states, or health conditions—this is precisely where female exercise physiology is most susceptible to being misled by oversimplified recommendations. For adolescents, for example, the effects, risks, and optimal timing of a training stimulus differ before and after PHV. For women, energy availability and menstrual function are key regulators behind many physiological responses. For older adults, synthetic resistance and the rate of decline make the meaning of “stimulus intensity” different from that in younger people. The “menstrual cycle and exercise performance” deserves in-depth exploration precisely because it can specifically influence certain key aspects of female exercise physiology. The more thoroughly you understand the mechanisms, the better you can judge “for whom, at what stage, what to do, and how much,” rather than blindly applying unsuitable general rules. This ability to adjust according to population and individual context is precisely the dividing line between those who understand female exercise physiology and those who train blindly.

Dose-Response Relationship

In female exercise physiology, “dose determines effect” is a core principle, but this dose often needs to be recalibrated for specific populations. Stimuli that are too low fail to reach the adaptation threshold and produce no benefit; loads that are too high may exceed the compensatory capacity of vulnerable populations, causing injury, developmental disruption, or health damage. The table below summarizes the dose-response relationship between “menstrual cycle and exercise performance” and serves as the most important quantitative reference when designing training and health plans for specific populations:

Dose / Condition	Physiological State	Effects and Key Points
Early follicular phase (days 1–5)	Menstruation; some experience high fatigue and discomfort	Arrange flexibly based on individual symptoms; recovery or technical sessions can be scheduled
Late follicular phase (days 6–14)	Estrogen peak	Those feeling good can schedule high-intensity and strength blocks
Luteal phase (days 15–28)	Core body temperature rises; possible PMS	Aerobic focus; enhance heat dissipation and hydration in hot conditions
Individualized tracking	Record RPE, sleep, and performance across phases	Building a personal cycle profile is more valuable than applying general rules

As the table shows, the dose-response relationship in female exercise physiology often follows a threshold or inverted U-shaped curve: before reaching the effective dose, benefits increase with dose; but beyond a certain critical point, there are no additional benefits, while risks and costs rise sharply—this is especially critical for vulnerable populations (developing adolescents, women prone to energy imbalance, and older adults with reduced compensatory capacity). This means that “finding the optimal dose for the specific population and individual” matters far more than “blindly pursuing more and stronger.” In practical application, it is recommended to continuously monitor responses using objective indicators (such as performance, recovery, health markers, and subjective perception) and calibrate according to population characteristics and individual data. Remember: the group average in research reports is a starting point, not an endpoint; each person’s maturity, hormonal status, health background, and genetics will cause the optimal dose to shift individually. Only by calibrating with your own data and professional assessment can group science be safely translated into a personal prescription.

Differences Across Populations

The impact of “menstrual cycle and exercise performance” is not equal for everyone. Age and maturity, sex, training status, hormonal state, health conditions, and genetic background all significantly modulate individual response magnitude. Ignoring these differences and applying a one-size-fits-all recommendation is one of the most common—and most dangerous—mistakes in the application of female exercise physiology.

Population Dimension	Response Characteristics	Practical Recommendations
Beginners vs. advanced athletes	Advanced athletes have mature adaptations and better tolerance but smaller marginal gains	Beginners should progress conservatively, building a foundation before increasing load
Males vs. females	Hormonal, body composition, skeletal, and metabolic characteristics differ	Females require individualized assessment of energy, iron, and bone health
Young vs. older	Older individuals recover more slowly, have anabolic resistance, and accelerated decline	Older adults need sufficient stimulus intensity but longer recovery and screening
Developmental stage	Maturity influences adaptation direction, risk, and timing	Plan training based on biological maturity rather than chronological age

Regarding specific population considerations for this topic: adolescent girls often have irregular cycles after menarche, and insufficient energy availability can lead to menstrual dysfunction; in elite female athletes, amenorrhea should be treated as a warning sign, not a badge of “training hard enough.”

When interpreting individual differences, one must also be wary of a statistical trap: research reports mostly present “group average responses,” but beneath the average often lies enormous individual variability. In the same intervention, some may be strong responders while others barely respond. This is why even if a study shows “average effectiveness,” you still need to confirm applicability through professional assessment and your own response. Taking common athletic populations in Taiwan as an example—whether it’s adolescents burdened with heavy schoolwork, women balancing family and training, or middle-aged and older adults pursuing healthy aging—correctly understanding the physiological characteristics of your own population is the only way to avoid the ineffective or even harmful consequences of “copying someone else’s training plan.” After understanding population differences, you will realize: truly professional female exercise physiology recommendations are always individualized prescriptions that vary “by person and by stage,” not one-size-fits-all slogans.

Practical Training Application

Theory must ultimately translate into concrete training and health practices. Below is a practical framework for turning “menstrual cycle and exercise performance” into specific applications:

• Population matching: All training and health recommendations must first ask, “Is this suitable for this population?”—adolescents need development and protection, women need energy and bone health, older adults need safety and functional maintenance; the starting points differ.

• Progression and monitoring: Progress gradually from an appropriate starting point, continuously monitor responses with objective indicators (performance, recovery, health markers) and subjective perception, and adjust dynamically based on individual conditions.

• Health before performance: For vulnerable populations, long-term health (development, bone, endocrine, cardiovascular) always takes priority over short-term performance; never sacrifice health for a temporary number.

• Holistic context: Training is only one piece of the puzzle; sleep, nutrition (especially energy availability), recovery, psychological and social support are equally critical—no single intervention can compensate for overall imbalance.

• Professional collaboration: When dealing with growing adolescents, female-specific health issues, or older adults and those with chronic conditions, seeking collaborative assessment from coaches, medical, nutritional, and psychological professionals in a timely manner is the safeguard for safety and effectiveness.

As a practical planning example, when designing a program, you should first clarify the population characteristics and health context of the individual, then set reasonable goals, doses, and monitoring indicators accordingly. The most common mistake people make is directly applying practices seen on social media or in adult elites to adolescents, women, or older adults, ignoring the underlying physiological differences—this is precisely what female exercise physiology strives to avoid. Daily training and life are the best laboratory for observing population and individual responses and building personalized data.

It is recommended to integrate training logs with health monitoring, recording key indicators (such as growth and injuries in adolescents, menstrual and iron status in women, strength and recovery in older adults) alongside training content and physical responses. After weeks to months of accumulation, the value of this personalized database will far exceed any general guideline. Furthermore, don’t overlook the often-underestimated component of “recovery and long-term development”—for vulnerable populations, sacrificing recovery and health in pursuit of short-term gains often leads to injury, burnout, or health problems, ultimately stalling the engine of long-term progress. Treat population matching and health priority as core training principles and take them seriously—your results and safety will be markedly different.

Local Application in Taiwan

Taiwan’s unique climate, terrain, social structure, and sports culture add distinctive local color to the application of “menstrual cycle and exercise performance.” Climatologically, the hot and humid summers and cold and damp winters pose additional challenges for different populations (especially adolescents and older adults with different thermoregulatory capacities); topographically, the extreme elevation gain from sea level to Wuling at 3,275 meters provides a rich training environment; socially, Taiwan is entering an aged society, faces heavy academic pressure, and has rising gender equality awareness—all of which profoundly shape the exercise circumstances of various populations.

Taking local scenarios as examples: adolescent athletes often operate under the dual pressure of academics and training, lacking systematic recovery and long-term development planning; female recreational athletes face insufficient attention to energy availability, iron, bone health, and female-specific health issues; older adults need friendly, safe exercise environments and communities that accommodate different abilities. By leveraging Taiwan’s dense convenience store supply points, diverse cycling and running routes, and the growing sports community, and by designing population-appropriate activities (such as multi-sport development for adolescents, female-friendly equipment and environments, and group rides for older adults), the science of female exercise physiology can truly reach every sports enthusiast in Taiwan, promoting health and sports participation for all.

Common Myth-Busting

Myth: “Women absolutely cannot exercise during their period, or performance inevitably declines during menstruation.” Meta-analyses show that the average impact of the menstrual cycle on performance is very small, and most women actually find that moderate exercise alleviates discomfort; the real issue is not “whether you can exercise during your period,” but whether energy and iron intake are sufficient.

Such myths spread widely because they “sound reasonable,” are easily passed by word of mouth, or stem from inappropriately applying concepts developed for adult men to other populations. Yet the value of science lies precisely in testing intuition with rigorous evidence: many seemingly self-evident beliefs do not hold up under rigorous research on specific populations. The field of female exercise physiology is especially rife with outdated stereotypes and oversimplified claims that compress complex population differences, developmental stages, and individual variation into a single slogan. The next time you hear a categorical exercise recommendation aimed at adolescents, women, or special populations, it is worth asking: “What is the level of evidence behind this claim? Was it based on research on this specific population? Or is it simply extrapolated from conclusions drawn from other groups?” Cultivating this evidence-based, population-specific critical thinking is far more valuable than memorizing any single conclusion, and it is a crucial step toward making female exercise physiology more scientific and preventing injury.

Conclusion

“The menstrual cycle and athletic performance” is a topic in female exercise physiology that combines both theoretical depth and practical value. As the evidence from international journals reviewed in this article shows, adolescents, women, and special populations have unique physiological characteristics and needs in exercise—they are by no means “scaled-down” or “special-case” versions of adult men. Understanding and respecting these differences is precisely the starting point for scientific, individualized training. The key lies in grasping the mechanisms, calibrating the dosage, adjusting according to population and individual, and always prioritizing long-term health over short-term performance. For sports enthusiasts in Taiwan, while mastering scientific principles, it is equally important to integrate local climate, environmental, and social contexts, translating general principles into prescriptions suited to one’s own population and individual needs. May every adolescent, woman, and older adult who sweats through exercise at every stage of growth and life safely, healthily, and sustainably enjoy the joy and benefits of sport through the wisdom of female exercise physiology. The value of exercise has never been limited by age, gender, or circumstance—let science become a force that benefits everyone.

Related Reading

• The Impact of Media Coverage on Women’s Sports: A Study on Gender Equality in Sports Media
• Dose-Response Study of High-Intensity Training and Menstrual Dysfunction in Women
• Sex Differences in Heat Adaptation: A Study on Sweat Rate and Core Temperature Regulation in Women
• Disordered Eating and Exercise in Adolescent Females: A Prevalence Survey Among Taiwanese High School Students