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The Effect of the Menstrual Cycle and Oral Contraceptives on Acute Responses and Chronic Adaptations to Resistance Training: A Systematic Review of the Literature

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Abstract

Background

Resistance training is well known to increase strength and lean body mass, and plays a key role in many female athletic and recreational training programs. Most females train throughout their reproductive years when they are exposed to continuously changing female steroid hormone profiles due to the menstrual cycle or contraceptive use. Therefore, it is important to focus on how female hormones may affect resistance training responses.

Objective

The aim of this systematic review is to identify and critically appraise current studies on the effect of the menstrual cycle and oral contraceptives on responses to resistance training.

Methods

The electronic databases Embase, PubMed, SPORTDiscus and Web of Science were searched using a comprehensive list of relevant terms. Studies that investigated the effect of the menstrual cycle phase or oral contraceptive cycle on resistance training responses were included. Studies were also included if they compared resistance training responses between the natural menstrual cycle and oral contraceptive use, or if resistance training was adapted to the menstrual cycle phase or oral contraceptive phase. Studies were critically appraised with the McMasters Universities Critical Review Form for Quantitative Studies and relevant data were extracted.

Results

Of 2007 articles found, 17 studies met the criteria and were included in this systematic review. The 17 included studies had a total of 418 participants with an age range of 18–38 years. One of the 17 studies found no significant differences in acute responses to a resistance training session over the natural menstrual cycle, while four studies did find changes. When assessing the differences in acute responses between the oral contraceptive and menstrual cycle groups, two studies reported oral contraceptives to have a positive influence, whilst four studies reported that oral contraceptive users had a delayed recovery, higher levels of markers of muscle damage, or both. For the responses to a resistance training program, three studies reported follicular phase-based training to be superior to luteal phase-based training or regular training, while one study reported no differences. In addition, one study reported no differences in strength development between oral contraceptive and menstrual cycle groups. One further study reported a greater increase in type I muscle fibre area and a trend toward a greater increase in muscle mass within low-androgenic oral contraceptive users compared with participants not taking hormonal contraceptives. Finally, one study investigated androgenicity of oral contraceptives and showed greater strength developments with high androgenic compared with anti-androgenic oral contraceptive use.

Conclusions

The reviewed articles reported conflicting findings, and were often limited by small participant numbers and methodological issues, but do appear to suggest female hormones may affect resistance training responses. The findings of this review highlight the need for further experimental studies on the effects of the menstrual cycle and oral contraceptives on acute and chronic responses to resistance training.

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Data Availability Statement

All data generated for this review are included in the manuscript and/or the supplementary files.

References

  1. Hurley KS, Flippin KJ, Blom LC, Bolin JE, Hoover DL, Judge LW. Practices, perceived benefits, and barriers to resistance training among women enrolled in college. Int J Exerc Sci. 2018;11(5):226–38.

    PubMed  PubMed Central  Google Scholar 

  2. Janse de Jonge X, Thompson B, Han A. Methodological recommendations for menstrual cycle research in sports and exercise. Med Sci Sports Exerc. 2019. https://doi.org/10.1249/mss.0000000000002073(Epub ahead of print).

    Article  PubMed  Google Scholar 

  3. Burrows M, Peters CE. The influence of oral contraceptives on athletic performance in female athletes. Sports Med. 2007;37(7):557–74.

    PubMed  Google Scholar 

  4. Schaumberg MA, Emmerton LM, Jenkins DG, Burton NW, Janse de Jonge XAK, Skinner TL. Use of oral contraceptives to manipulate menstruation in young, physically active women. Int J Sports Physiol Perform. 2018;13(1):82–7.

    PubMed  Google Scholar 

  5. Dragoman MV. The combined oral contraceptive pill—recent developments, risks and benefits. Best Pract Res Clin Obstet Gynaecol. 2014;28(6):825–34.

    PubMed  Google Scholar 

  6. Regidor PA. The clinical relevance of progestogens in hormonal contraception: present status and future developments. Oncotarget. 2018;9(77):34628–38.

    PubMed  PubMed Central  Google Scholar 

  7. Stewart M, Black K. Choosing a combined oral contraceptive pill. Aust Prescr. 2015;38(1):6–11.

    PubMed  PubMed Central  Google Scholar 

  8. Janse de Jonge XA. Effects of the menstrual cycle on exercise performance. Sports Med. 2003;33(11):833–51.

    PubMed  Google Scholar 

  9. Kim YJ, Tamadon A, Park HT, Kim H, Ku SY. The role of sex steroid hormones in the pathophysiology and treatment of sarcopenia. Osteoporos Sarcopenia. 2016;2(3):140–55.

    PubMed  PubMed Central  Google Scholar 

  10. Lowe DA, Baltgalvis KA, Greising SM. Mechanisms behind estrogens’ beneficial effect on muscle strength in females. Exerc Sport Sci Rev. 2010;38(2):61–7.

    PubMed  PubMed Central  Google Scholar 

  11. Greising SM, Baltgalvis KA, Lowe DA, Warren GL. Hormone therapy and skeletal muscle strength: a meta-analysis. J Gerontol A Biol Sci Med Sci. 2009;64A(10):1071–81.

    CAS  PubMed Central  Google Scholar 

  12. Kriengsinyos W, Wykes LJ, Goonewardene LA, Ball RO, Pencharz PB. Phase of menstrual cycle affects lysine requirement in healthy women. Am J Physiol Endocrinol Metab. 2004;287(3):E489–96.

    CAS  PubMed  Google Scholar 

  13. Lariviere F, Moussalli R, Garrel DR. Increased leucine flux and leucine oxidation during the luteal phase of the menstrual cycle in women. Am J Physiol. 1994;267(3 Pt 1):E422–8.

    CAS  PubMed  Google Scholar 

  14. Bailey SP, Zacher CM, Mittleman KD. Effect of menstrual cycle phase on carbohydrate supplementation during prolonged exercise to fatigue. J Appl Physiol. 2000;88(2):690–7.

    CAS  PubMed  Google Scholar 

  15. Lamont LS, Lemon PW, Bruot BC. Menstrual cycle and exercise effects on protein catabolism. Med Sci Sports Exerc. 1987;19(2):106–10.

    CAS  PubMed  Google Scholar 

  16. Oosthuyse T, Bosch AN. The effect of the menstrual cycle on exercise metabolism: implications for exercise performance in eumenorrhoeic women. Sports Med. 2010;40(3):207–27.

    PubMed  Google Scholar 

  17. Law M, Stewart D, Pollock N, Letts L, Bosch J, Westmorland M. Guidelines for critical review of the literature: quantitative studies. Hamilton: McMasters University; 1998.

    Google Scholar 

  18. Pressick EL, Gray MA, Cole RL, Burkett BJ. A systematic review on research into the effectiveness of group-based sport and exercise programs designed for indigenous adults. J Sci Med Sport. 2016;19(9):726–32.

    PubMed  Google Scholar 

  19. Anaf S, Sheppard LA. Physiotherapy as a clinical service in emergency departments: a narrative review. Physiotherapy. 2007;93(4):243–52.

    Google Scholar 

  20. Kraemer RR, Heleniak RJ, Tryniecki JL, Kraemer GR, Okazaki NJ, Castracane VD. Follicular and luteal phase hormonal responses to low-volume resistive exercise. Med Sci Sports Exerc. 1995;27(6):809–17.

    CAS  PubMed  Google Scholar 

  21. Nakamura Y, Aizawa K, Imai T, Kono I, Mesaki N. Hormonal responses to resistance exercise during different menstrual cycle states. Med Sci Sports Exerc. 2011;43(6):967–73.

    CAS  PubMed  Google Scholar 

  22. Reis E, Frick U, Schmidtbleicher D. Frequency variations of strength training sessions triggered by the phases of the menstrual cycle. Int J Sports Med. 1995;16(8):545–50.

    CAS  PubMed  Google Scholar 

  23. Sung E, Han A, Hinrichs T, Vorgerd M, Manchado C, Platen P. Effects of follicular versus luteal phase-based strength training in young women. SpringerPlus. 2014;3:668.

    PubMed  PubMed Central  Google Scholar 

  24. Dalgaard LB, Dalgas U, Andersen JL, Rossen NB, Møller AB, Stødkilde-Jørgensen H, et al. Influence of oral contraceptive use on adaptations to resistance training. Front Physiol. 2019;10:824.

    PubMed  PubMed Central  Google Scholar 

  25. Haines M, McKinley-Barnard SK, Andre TL, Gann JJ, Hwang PS, Willoughby DS. Skeletal muscle estrogen receptor activation in response to eccentric exercise up-regulates myogenic-related gene expression independent of differing serum estradiol levels occurring during the human menstrual cycle. J Sports Sci Med. 2018;17(1):31–9.

    PubMed  PubMed Central  Google Scholar 

  26. Hayward R, Dennehy CA, Rodearmel SJ, Schneider CM. Serum creatine kinase, CK-MB, and perceived soreness following eccentric exercise in oral contraceptive users. Sports Med Train Rehabil. 1998;8(2):193–207.

    Google Scholar 

  27. Hicks K, Onambélé-Pearson G, Winwood K, Morse C, Hicks KM, Morse CI. Oral contraceptive pill use and the susceptibility to markers of exercise-induced muscle damage. Eur J Appl Physiol. 2017;117(7):1393–402.

    CAS  PubMed  PubMed Central  Google Scholar 

  28. Markofski MM, Braun WA. Influence of menstrual cycle on indices of contraction-induced muscle damage. J Strength Cond Res. 2014;28(9):2649–56.

    PubMed  Google Scholar 

  29. Minahan C, Joyce S, Bulmer AC, Cronin N, Sabapathy S. The influence of estradiol on muscle damage and leg strength after intense eccentric exercise. Eur J Appl Physiol. 2015;115(7):1493–500.

    CAS  PubMed  Google Scholar 

  30. Roth SM, Gajdosik R, Ruby BC. Effects of circulating estradiol on exercise-induced creatine kinase activity. J Exerc Physiol Online. 2001;4(2):10–7.

    Google Scholar 

  31. Savage KJ, Clarkson PM. Oral contraceptive use and exercise-induced muscle damage and recovery. Contraception. 2002;66(1):67–71.

    CAS  PubMed  Google Scholar 

  32. Kraemer WJ, Nindl BC, Volek JS, Marx JO, Gotshalk LA, Bush JA, et al. Influence of oral contraceptive use on growth hormone in vivo bioactivity following resistance exercise: responses of molecular mass variants. Growth Horm IGF Res. 2008;18(3):238–44.

    CAS  PubMed  Google Scholar 

  33. Sakamaki-Sunaga M, Min S, Kamemoto K, Okamoto T. Effects of menstrual phase-dependent resistance training frequency on muscular hypertrophy and strength. J Strength Cond Res. 2016;30(6):1727–34.

    PubMed  Google Scholar 

  34. Wikstrom-Frisen L, Boraxbekk CJ, Henriksson-Larsen K. Effects on power, strength and lean body mass of menstrual/oral contraceptive cycle based resistance training. J Sports Med Phys Fitness. 2017;57(1–2):43–52.

    PubMed  Google Scholar 

  35. Nichols AW, Hetzler RK, Villanueva RJ, Stickley CD, Kimura IF. Effects of combination oral contraceptives on strength development in women athletes. J Strength Cond Res. 2008;22(5):1625–32.

    PubMed  Google Scholar 

  36. Ruzic L, Matkovic BR, Leko G. Antiandrogens in hormonal contraception limit muscle strength gain in strength training: comparison study. CMJ. 2003;44(1):65–8.

    PubMed  Google Scholar 

  37. Faria AC, Bekenstein LW, Booth RA Jr, Vaccaro VA, Asplin CM, Veldhuis JD, et al. Pulsatile growth hormone release in normal women during the menstrual cycle. Clin Endocrinol. 1992;36(6):591–6.

    CAS  Google Scholar 

  38. Hansen AP, Weeke J. Fasting serum growth hormone levels and growth hormone responses to exercise during normal menstrual cycles and cycles of oral contraceptives. Scand J Clin Lab Invest. 1974;34(3):199–205.

    CAS  PubMed  Google Scholar 

  39. Hornum M, Cooper DM, Brasel JA, Bueno A, Sietsema KE. Exercise-induced changes in circulating growth factors with cyclic variation in plasma estradiol in women. J Appl Physiol. 1997;82(6):1946–51.

    CAS  PubMed  Google Scholar 

  40. Vandever MA, Kuehl TJ, Sulak PJ, Witt I, Coffee A, Wincek TJ, Reape KZ. Evaluation of pituitary-ovarian axis suppression with three oral contraceptive regimens. Contraception. 2008;77(3):162–70.

    CAS  PubMed  Google Scholar 

  41. Collins BC, Mader TL, Cabelka CA, Iñigo MR, Spangenburg EE, Lowe DA. Deletion of estrogen receptor α in skeletal muscle results in impaired contractility in female mice. J Appl Physiol. 2018;124(4):980–92.

    CAS  PubMed  PubMed Central  Google Scholar 

  42. Thomas A, Bunyan K, Tiidus PM. Oestrogen receptor-alpha activation augments post-exercise myoblast proliferation. Acta Physiol. 2010;198(1):81–9.

    CAS  Google Scholar 

  43. Kadi F, Schjerling P, Andersen LL, Charifi N, Madsen JL, Christensen LR, et al. The effects of heavy resistance training and detraining on satellite cells in human skeletal muscles. J Physiol. 2004;558(Pt 3):1005–12.

    CAS  PubMed  PubMed Central  Google Scholar 

  44. De Souza MJ. Menstrual disturbances in athletes: a focus on luteal phase defects. Med Sci Sports Exerc. 2003;35(9):1553–63.

    PubMed  Google Scholar 

  45. Schaumberg MA, Jenkins DG, Janse de Jonge XAK, Emmerton LM, Skinner TL. Three-step method for menstrual and oral contraceptive cycle verification. J Sci Med Sport. 2017;20(11):965–9.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. School of Environmental and Life Sciences, Faculty of Science, The University of Newcastle, 10 Chittaway Road, PO Box 127, Ourimbah, NSW, 2258, Australia

    Belinda Thompson, Ashley Almarjawi, Dean Sculley & Xanne Janse de Jonge

Authors
  1. Belinda Thompson
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  2. Ashley Almarjawi
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  3. Dean Sculley
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  4. Xanne Janse de Jonge
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Corresponding author

Correspondence to Xanne Janse de Jonge.

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Funding

This research was supported by an Australian Government Research Training Program (RTP) Scholarship.

Conflict of Interest

Belinda Thompson, Ashley Almarjawi, Dean Sculley and Xanne Janse de Jonge declare that they have no conflicts of interest relevant to the content of this review.

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Thompson, B., Almarjawi, A., Sculley, D. et al. The Effect of the Menstrual Cycle and Oral Contraceptives on Acute Responses and Chronic Adaptations to Resistance Training: A Systematic Review of the Literature. Sports Med 50, 171–185 (2020). https://doi.org/10.1007/s40279-019-01219-1

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