Sports Medicine

, Volume 16, Issue 6, pp 400–430 | Cite as

Effect of the Different Phases of the Menstrual Cycle and Oral Contraceptives on Athletic Performance

  • Constance M. Lebrun
Review Article


The female athlete, during her reproductive years, has a complex and ever-changing milieu of female steroid hormones, whether it is the endogenous variations in estradiol and progesterone of a regular menstrual cycle, or the exogenous synthetic hormones of the oral contraceptives. Both estrogens and progestins have individual, interactive and sometimes opposing physiological actions with potential implications for the exercising female.

In retrospective surveys on the menstrual cycle and performance, from 37 to 63% of athletes did not report any cycle ‘phase’ detriment, while 13 to 29% reported an improvement during menstruation. The best performances were generally in the immediate postmenstrual days, with the worse performances during the premenstrual interval and the first few days of menstrual flow. However, this type of study has an inherent built-in bias, and is further limited by the lack of substantiation of cycle phase.

Many of the women studied associated premenstrual symptoms, such as fluid retention, weight gain, mood changes, and dysmenorrhoea with performance decrement. Such factors have also been causally linked with an increase in traumatic musculoskeletal injuries during the premenstrual and menstrual period. Neuromuscular coordination, manual dexterity, judgement and reaction time for complex tests have been shown to be adversely affected in women with premenstrual syndrome or symptoms, but confounding variables may include nutrition status and blood sugar levels. In addition, not all women suffer to the same level with premenstrual symptoms.

Fluctuations in many physiological functions occur throughout the normal menstrual cycle. Results of early studies are difficult to interpret owing to the small numbers of women studied, wide range of fitness levels, and variability in the definitions of cycle phase. Nevertheless, investigators did not document any significant changes in measures of athletic performance as a function of timing of testing during the menstrual cycle. Swimmers have shown a premenstrual worsening of performance times, with improvement during the menstrual phase and on the eighth day of the cycle. An increase in perceived exertion was noted premenstrually and during the early menstrual stage with very intense exercise. In cross-country skiers, the best times were recorded in the postovulatory and postmenstrual phases, prompting the recommendation that training loads be selected according to cycle phase to achieve maximum benefit.

Investigations using estradiol and progesterone levels as a confirmatory index of ovulation have not generally found significant differences across the cycle in either maximal or submaximal exercise responses, although a slight decrease in aerobic capacity during the luteal phase has been reported. In contrast, an enhancement of endurance performance during the luteal phase, without any concomitant changes in cardiovascular variables has also been reported.

There is evidence to suggest a decrement in isometric strength and endurance, potentially related to an increase in deep muscle temperature during the luteal phase, however, little accurate information exists on the influence of menstrual cycle phase on strength.

Increased progesterone and estradiol levels during the luteal phase leads to a net fluid retention because of a complex interaction of the aldosterone/renin/angiotensin systems. Consequently, there are changes in serum electrolytes, osmolality, and minor variations in haemoglobin, but these have no measurable repercussions for performance. Cardiac output is increased, primarily through an increase in plasma volume and stroke volume.

Results of studies, with and without hormonal documentation, are inconsistent regarding heat stress responses during exercise. Similarly trained and acclimated men and women do not display any differences in thermoregulation. Sweat rate is not significantly affected by the alterations in steroid hormones during the menstrual cycle. Nevertheless, the higher core temperature during the luteal phase is postulated to increase cardiovascular strain (as evidenced by an increased heart rate) and level of perceived exertion during exercise. The temperature-induced increase in metabolic rate has also been associated with decreased exercise efficiency and increased mean oxygen consumption.

High progesterone levels during the luteal phase and pregnancy stimulate ventilation and the ventilatory responses to hypoxia and hypercapnia. Success in endurance sports has been correlated with blunted respiratory drives, therefore enhancement of this ventilatory responsiveness may be detrimental in athletes. Nonathletic women have been shown to have altered exercise performance, possibly because of a subjective sensation of dyspnoea, but no effects have been shown with elite female athletes. A synthetic progestin, medroxyprogesterone acetate, when administered to both men and women, causes similar respiratory changes without any corresponding performance decrement. Investigators have not been able to correlate actual progesterone levels with the alterations in ventilatory drives. Estradiol acts to potentiate the action of progesterone through its induction of progesterone receptors.

There is a gender difference in substrate metabolism during exercise. Estrogen and progesterone enhance muscle glycogen storage and uptake. Increased estradiol levels also promote lipolysis and lipid synthesis. A shift in metabolism towards free fatty acids leads to a decrease in glycogenolysis and gluconeogenesis. A greater urinary protein loss during the luteal phase reflects greater protein catabolism. Blood glucose levels vary during the menstrual cycle, but differences are affected by altering the pre-exercise nutritional status of the athletes. Other hormones, particularly catecholamines and growth hormone have also been shown to be important. Increased estradiol levels act to increase growth hormone, which in turn stimulates fat mobilisation.

Oral contraceptives are frequently administered to athletes for a variety of therapeutic reasons. The original formulations contained higher dosages of both estrogens and progestins. Surveys showed that half the women did not notice any difference in performance, and 8% even noted an improvement with higher dosages. Musculoskeletal injuries have been shown to be reduced in women taking oral contraceptives, possibly because of a reduction of dysmenorrhoea and premenstrual symptoms. Some cross-sectional studies have found an increase in oxygen consumption for a standardised workload in women taking oral contraceptives. A slight decrease in maximal aerobic capacity with a decrease in muscle mitochondrial citrate has been demonstrated, suggesting a potential cellular mechanism. Recent investigations have shown a slight decrease in maximum oxgen uptake (V̇O2max), without alterations in any of the cardiovascular variables.

Oral contraceptives appear to have little impact on strength indices, although there is limited evidence of a detrimental effect on isometric endurance. Since the androgenic actions of the progesterone component diminish with the newer preparations, there is likely no significant influence of the exogenous hormones.

Synthetic steroid hormones can influence vascular volume, ventilation and substrate metabolism. Combined oral contraceptives increase cardiac output more than progestin-only formulations implying that the estrogen effect dominates. An augmented stroke volume may potentially increase oxygen delivery to the tissues, and the reduction in menstrual blood loss may also be beneficial for performance. An increase in ventilation has been demonstrated with oral contraceptive use, but the studies which showed small alterations in performance, however, have not shown any of the respiratory changes.

Substrate metabolism is also influenced by oral contraceptives, with varying effects on glucose and insulin. Other hormones such as thyroxine, cortisol, catecholamines and growth hormone have a counterregulatory action. Progesterone acts to oppose insulin binding, through a decrease in insulin receptor numbers. The effects on growth hormone (GH), which is also a potent stimulator of lipolysis, depend on the relative concentrations of estradiol and progesterone, which increase and decrease GH levels, respectively. A net shift towards triglyceride use may be potentially advantageous during extended endurance exercise. Lower blood glucose levels and decreased carbohydrate utilisation found both at rest and during exercise may result from the glycogen-sparing actions of the hormones and may also reflect decreased hepatic production.

In general, the effects of oral contraceptives on athletic performance have diminished with the lower dosages of these medications. The overall advantages, including the noncontraceptive health benefits, probably outweigh any small observed differences. There is, however, a large degree of interindividual variability that must be considered in the clinical situation, both during the menstrual cycle and with administration of oral contraceptives.


Menstrual Cycle Oral Contraceptive Luteal Phase Female Athlete Apply Physiology 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Abraham GE, Maroulis GB, Marshall JB. Evaluation of ovulation and corpus luteum functioning using measurements of plasma progesterone. Obstetrics and Gynecology 44: 522–525, 1974PubMedGoogle Scholar
  2. Ahmed-Sorour H, Bailey CJ. Role of ovarian hormones in the longterm control of glucose homeostasis, glycogen formation and gluconeogenesis. Annals of Nutrition and Metabolism 25: 208–212, 1981PubMedGoogle Scholar
  3. Allsen PE, Parsons P, Bryce GR. Effect of the menstrual cycle on maximum oxygen uptake. Physician and Sportsmedicine 5: 53–55, 1977Google Scholar
  4. Artal R, Platt LD, Sperling M, Kammula RK, Jilek, J et al. Maternal exercise: cardiovascular and metabolic responses in normal pregnancy. American Journal of Obstetrics and Gynecology 140: 123–127, 1981PubMedGoogle Scholar
  5. Artal R, Wiswell R, Romen Y, Dorey F. Pulmonary responses to exercise in pregnancy. American Journal of Obstetrics and Gynecology 154: 378–383, 1986PubMedGoogle Scholar
  6. Bale P, Davies J. Effect of menstruation and contraceptive pill on the performance of physical education students. British Journal of Sports Medicine 17: 46–50, 1983PubMedGoogle Scholar
  7. Bale P, Nelson G. The effects of menstruation on performance of swimmers. Australian Journal of Science and Medicine in Sport March: 19–22, 1985Google Scholar
  8. Beck P. Contraceptive steroids: modification of carbohydrate and lipid metabolism. Metabolism 22: 841–855, 1973PubMedGoogle Scholar
  9. Bemden DA, Boileau RA, Bahr JM, Nelson RA, Misner JE. Effects of oral contraceptives on hormonal and metabolic responses during exercise. Medicine and Science in Sports and Exercise 24: 434–441, 1992Google Scholar
  10. Bonekat HW, Dombovy ML, Staats BA. Progesterone-induced changes in exercise performance and ventilatory response. Medicine and Science in Sports and Exercise 19: 118–123, 1987PubMedGoogle Scholar
  11. Bonen A, Keizer HA. Athletic menstrual cycle irregularity: endocrine response to exercise and training. Physician and Sportsmedicine 12: 78–94, 1984Google Scholar
  12. Bonen A, Haynes FJ, Watson-Wright W, Sopper MM, Pierce GN, et al. Effects of menstrual cycle on metabolic responses to exercise. Journal of Applied Physiology 55: 1506–1513, 1983PubMedGoogle Scholar
  13. Bonen A, Haynes FW, Graham TE. Substrate and hormonal responses to exercise in women using oral contraceptives. Journal of Applied Physiology 70: 1917–1827, 1991PubMedGoogle Scholar
  14. Bonen A, Ling WY, MacIntyre KP, Neil R, McGrail JL, et al. Effects of exercise on serum concentrations of FSH, LH, progesterone, and estradiol. European Journal of Applied Physiology and Occupational Physiology 42: 15–23, 1979PubMedGoogle Scholar
  15. Brooks-Gunn J, Gargiulo JM, Warren MP. The effect of cycle phase on the adolescent swimmers. Physician and Sportsmedicine 14: 182–192, 1986Google Scholar
  16. Brodeur P, Mockus M, McCullough R, Moore LG. Progesterone receptors and ventilatory stimulation by progestin. Journal of Applied Physiology 60: 590–595, 1986PubMedGoogle Scholar
  17. Bullen BA, Skrinar GS, Bertins IZ, Von Mering G, Turnbull BA, et al. Induction of menstrual disorders by strenuous exercise in untrained women. New England Journal of Medicine 312: 1349–1353, 1985PubMedGoogle Scholar
  18. Bunt JC. Metabolic actions of estradiol: significance for acute and chronic exercise response. Medicine and Science in Sport and Exercise 22: 286–290, 1990Google Scholar
  19. Byrne-Quinn E, Weil JV, Sodal IE, Filley GF, Grover RF. Ventilatory control in the athlete. Journal of Applied Physiology 30: 91–98, 1971PubMedGoogle Scholar
  20. Canada. Fitness and Amateur Sport. Sport Canada Policy on Women in Sport. Ottawa. Fitness and Amateur Sport: Condition physique et sport amateur pp. 1–27, 1986Google Scholar
  21. Carpenter AJ, Nunnely SA. Endogenous hormones subtly alter women’s response to heat stress. Journal of Applied Physiology 65: 2313–2317, 1988PubMedGoogle Scholar
  22. Chen H-I, Tang Y-R. Effects of the menstrual cycle on respiratory muscle function. American Review of Respiratory Disease 140: 1359–1362, 1989PubMedGoogle Scholar
  23. Daggett A, Davies B, Boobis L. Physiological and biochemical responses to exercise following oral contraceptive use. Abstract. Medicine and Science in Sports and Exercise 15: 174, 1983Google Scholar
  24. Dalton K. Menstruation and accidents. British Medical Journal 2: 1425–1426, 1960PubMedGoogle Scholar
  25. Davidson MB, Holzman GB. Role of growth hormone in the alteration of carbohydrate metabolism induced by oral contraceptive agents. Journal of Clinical Endocrinology and Metabolism 36: 246–255, 1973PubMedGoogle Scholar
  26. De Bruyn-Prevost P, Masset C, Sturbois X. Physiological response from 18–25 years women to aerobic and anaerobic physical fitness tests at different periods during the menstrual cycle. Journal of Sports Medicine 24: 144–148, 1984Google Scholar
  27. De Souza MJ, Maresh CM, Maguire MS, Kraemer WH, Flora-Günter, et al. Menstrual status and plasma vasopressin, renin activity and aldosterone exercise responses. Journal of Applied Physiology 67: 736–743, 1989PubMedGoogle Scholar
  28. De Souza MJ, Maguire MS, Rubin K, Maresh CM. Effects of menstrual phase and amenorrhea on exercise responses in runners. Medicine and Science in Sports and Exercise 22: 575–580, 1990PubMedGoogle Scholar
  29. Diamond MP, Wentz AC, Cherrington AD. Alterations in carbohydrate metabolism as they apply to reproductive endocrinology. Fertility and Sterility 50: 387–397, 1988PubMedGoogle Scholar
  30. Dibrezzo R, Fort IL, Brown B. Relationships among strength, endurance, weight and body fat during three phases of the menstrual cycle. Journal of Sports Medicine and Physical Fitness 31: 89–94, 1991PubMedGoogle Scholar
  31. Dombovy ML, Bonekat HW, Williams TJ, Staats BJ. Exercise performance and ventilatory response in the menstrual cycle. Medicine and Science in Sports and Exercise 19: 111–117, 1987PubMedGoogle Scholar
  32. Doolittle TL, Engebretsen J. Performance variations during the menstrual cycle. Journal of Sports Medicine 12: 54–58, 1972Google Scholar
  33. Drinkwater BL, Bremmer B, Chestnut III CH. Menstrual history as a determinant of current bone density in young athletes. Journal of the American Medical Association 263: 545–548, 1990PubMedGoogle Scholar
  34. Drinkwater BL, Nilson K, Chestnut III CH, Bremmer W, Shainholtz S, Southworth M. Bone mineral content of amenorrheic and eu-menorrheic athletes. New England Journal of Medicine 311: 277–281, 1984PubMedGoogle Scholar
  35. Dutton K, Blonkskby BA, Morton AR. CO2 sensitivity changes during the menstrual cycle. Journal of Applied Physiology 67: 517–522, 1989PubMedGoogle Scholar
  36. England SJ, Farhi LE. Fluctuations in alveolar CO2 and in base excess during the menstrual cycle. Respiratory Physiology 26: 157–161, 1976Google Scholar
  37. Erdelyi GJ. Gynecological survey of female athletes. Journal of Sports Medicine and Physical Fitness 2: 174–179, 1962Google Scholar
  38. Eston RG, Burke EJ. Effects of the menstrual cycle on selected responses to short constant-load exercise. Journal of Sports Sciences 2: 145–153, 1984Google Scholar
  39. Fellmann N. Hormonal and plasma volume alterations following endurance exercise: a brief review. Sports Medicine 13: 37–49, 1992PubMedGoogle Scholar
  40. Fomin SK, Pivovarova VI, Voronova VI. Changes in the special working capacity and mental stability of well-trained woman skiers at various phases of the biological cycle. Sports Training Medicine and Rehabilitation 1: 89–92, 1989Google Scholar
  41. Fortney SM, Beckett WS, Carpenter AJ, Davis J, Drew H, et al. Changes in plasma volume during bed rest: effects of the menstrual cycle and estrogen administration. Journal of Applied Physiology 65: 525–533, 1988PubMedGoogle Scholar
  42. Fox EL, Martin FL, Bartels RL. Metabolic and cardiorespiratory responses to exercise during the menstrual cycle in trained and untrained subjects. Abstract. Medicine and Science in Sports and Exercise 9: 70, 1977Google Scholar
  43. Frisch RE. Bodyfat, menarche, fitness and fertility. Human Reproduction 2: 521–533, 1987PubMedGoogle Scholar
  44. Frisch RE, McArthur JW. Menstrual cycles: fatness as a determinant of minimum weight for height necessary for their maintenance or onset. Science 185: 949–951, 1974PubMedGoogle Scholar
  45. Frye AJ, Kamon E. Responses to dry heat of men and women with similar aerobic capacities. Journal of Applied Physiology 50: 65–70, 1981PubMedGoogle Scholar
  46. Gaebelein CJ, Senay, Jr LC. Vascular volume dynamics during ergometer exercise at different menstrual phases. European Journal of Applied Physiology 50: 1–11, 1982Google Scholar
  47. Gamberale F, Strindberg L, Wahlberg I. Female work capacity during the menstrual cycle: physiological and psychological reactions. Scandinavian Journal of Work Environment and Health 1: 120–127, 1975Google Scholar
  48. Garlick MA, Bernauer EM. Exercise during the menstrual cycle: variations in physiological baselines. Research Quarterly of the American Association for Health and Physical Education 39: 533–542, 1968Google Scholar
  49. Goodland RL, Reynolds JG, McCoord AB, Pommerenke WT. Respiratory and electrolyte effects induced by estrogen and progesterone. Fertility and Sterility 4: 300–317, 1953PubMedGoogle Scholar
  50. Goodland RL, Pommerenke WT. cyclic fluctuations of the alveolar carbon dioxide tension during the normal menstrual cycle. Fertility and Sterility 3: 394–401, 1952PubMedGoogle Scholar
  51. Gray DP, Harding E, Dale E. Effects of oral contraceptives on serum lipid profiles of women runners. Fertility and Sterility 39:510–514, 1983PubMedGoogle Scholar
  52. Greenblatt RB. Oral contraceptives: the state of the art. Clinical Therapeutics 8: 6–27, 1985PubMedGoogle Scholar
  53. Hackney AC. Effects of the menstrual cycle on resting muscle glycogen content. Hormone and Metabolic Research 22: 647, 1990PubMedGoogle Scholar
  54. Hackney AC, Curley CS, Nicklas BJ. Physiologic responses to sub-maximal exercise at the mid-follicular, ovulatory and mid-luteal phases of the menstrual cycle. Scandinavian Journal of Medicine and Science in Sport 1: 94–98, 1991Google Scholar
  55. Hessemer V, Bruck K. Influence of menstrual cycle on shivering, skin blood flow and sweating responses measured at night. Journal of Applied Physiology 59: 1902–1910, 1985aPubMedGoogle Scholar
  56. Hessemer V, Bruck K. Influence of menstrual cycle on thermoregulatory, metabolic and heart rate responses to exercise at night. Journal of Applied Physiology 59: 1911–1917, 1985bPubMedGoogle Scholar
  57. Higgs SL, Robertson LA. Cyclic variations in perceived exertion and physical work capacity in females. Canadian Journal of Applied Sport Sciences 6: 191–196, 1981Google Scholar
  58. Highet R. Athletic amenorrhea: an update on aetiology, complications and management. Sports Medicine 7: 82–108, 1989PubMedGoogle Scholar
  59. Horvath SM, Drinkwater BL. Thermoregulation and the menstrual cycle. Aviation Space Environmental Medicine 53: 790–794, 1982Google Scholar
  60. Huisveld IA, Hospers JEH, Bemink MJ, Erich WBM, Bouma BN. The effect of oral contraceptives and exercise on hemostatic and fibrinolytic mechanisms in trained women. International Journal of Sports Medicine 4: 97–103, 1983PubMedGoogle Scholar
  61. Hunter S, Schraer R, Landers DM, Buskirk ER, Harris DV. The effects of total oestrogen concentration and menstrual-cycle phase on reaction time performance. Ergonomics 22: 263–268, 1979PubMedGoogle Scholar
  62. Ingman O. Menstruation in Finnish top-class sportswomen. In: Karvonen (Ed.) Sports Medicine, pp. 96–99, Finnish Association of Sports Medicine, Helsinki, 1953Google Scholar
  63. Jurkowski JEH, Jones NL, Toews CJ, Sutton JR. Effects of menstrual cycle on blood lactate, O2 delivery and performance during exercise. Journal of Applied Physiology 51: 1493–1499, 1981PubMedGoogle Scholar
  64. Jurkowski JEH, Jones NL, Walker WE, Younglai EV, Sutton JR. Ovarian hormonal responses to exercise. Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology 44: 109–114, 1978Google Scholar
  65. Kanaley JA, Boilean RA, Bahr JA, Misner JE, Nelson RA. Substrate oxidation and GH responses to exercise are independent of menstrual phase and status. Medicine and Science in Sports and Exercise 24: 873–880, 1992PubMedGoogle Scholar
  66. Keizer HA, Poortman J, Bunnik GSJ. Influence of physical exercise on sex-hormone metabolism. Journal of Applied Physiology 48: 765–769, 1980PubMedGoogle Scholar
  67. Keizer HA, Rogol AD. Physical exercise and menstrual cycle alterations: what are the mechanisms? Sports Medicine 10: 218–235, 1990PubMedGoogle Scholar
  68. Keizer, HA, Van Schaik FW, DeBeer EL, Schiereck P, Van Heeswyk G. Exercise-induced changes in estradiol metabolism and their possible physiological meaning. Medicine and Sport Baseline 14: 125–140, 1981Google Scholar
  69. Kendrick ZV, Steffen CA, Rumsey WL, Goldberg DI. Effect of estradiol on tissue glycogen metabolism in exercised oophorectomized rats. Journal of Applied Physiology 63: 492–496, 1987PubMedGoogle Scholar
  70. Kral J, Markalous K. The influence of menstruation on sport performance. In: Mollwitz, A. Proceedings of the 2nd International Congress on Sports Medicine, Thieme-Stratton, Leipzig, 1939Google Scholar
  71. Lamont LS. Lack of influence of the menstrual cycle on blood lactate. Physician and Sportsmedicine 14: 159–163, 1986Google Scholar
  72. Lamont LS, Lemon PWR, Brust BC. Menstrual cycle and exercise effects on protein catabolism. Medicine and Science in Sports and Exercise 192: 106–110, 1987Google Scholar
  73. Lavoie JM, Dionne N, Helie R, Brisson GR. Menstrual cycle phase dissociation of blood glucose homeostasis during exercise. Journal of Applied Physiology 62: 1084–1089, 1987PubMedGoogle Scholar
  74. Lebrun CM, McKenzie DC, Prior JC, Taunton JE. Effects of menstrual cycle phase on athletic performance. Submitted for publication, 1993aGoogle Scholar
  75. Lebrun CM, McKenzie DC, Prior JC, Taunton JE. Effects of a triphasic oral contraceptive on athletic performance. Submitted for publication, 1993bGoogle Scholar
  76. Lehtovirta P, Kuikka J, Pyorala T. Hemodynamic effects of oral contraceptives during exercise. International Journal of Gynaecology and Obstetrics 15: 35–37, 1977PubMedGoogle Scholar
  77. Littler WA, Bojorges-Bueno R, Banks J. Cardiovascular dynamics in women during the menstrual cycle and oral contraceptive therapy. Thorax 29: 567–570, 1974PubMedGoogle Scholar
  78. Loucks AB. Effects of exercise training on the menstrual cycle: existence and mechanisms. Medicine and Science in Sports and Exercise 22: 275–280, 1990PubMedGoogle Scholar
  79. Loucks AB, Horvath SM. Athletic amenorrhea: a review. Medicine and Science in Sports and Exercise 17: 56–72, 1985PubMedGoogle Scholar
  80. Martin BJ, Sparks KE, Zwillich CW, Weil JV. Low exercise ventilation in endurance athletes. Medicine and Science in Sports and Exercise 11: 181–185, 1979Google Scholar
  81. Matute ML, Kalkhoff RL. Sex steroid influence on hepatic gluconeogenesis and glycogen formation. Endocrinology 92: 762–768, 1973PubMedGoogle Scholar
  82. McNeill AW, Mozingo E. Changes in the metabolic cost of standardized work associated with the use of an oral contraceptive. Journal of Sports Medicine 21: 238–244, 1981Google Scholar
  83. Merions DR, Haskell WL, Vranizon KM, Phelps J, Woods PD, et al. Relationship of exercise, oral contraceptive use and body fat to concentrations of plasma lipids and lipoprotein cholesterol in young women. American Journal of Medicine 78: 913–919, 1985Google Scholar
  84. Möller-Nielsen J, Hammar M. Women’s soccer injuries in relation to the menstrual cycle and oral contraceptive use. Medicine and Science in Sports and Exercise 21: 126–129, 1989PubMedGoogle Scholar
  85. Möller-Nielsen J, Hammar M. Sports injuries and oral contraceptive use: is there a relationship? Sports Medicine 12: 152–160, 1991PubMedGoogle Scholar
  86. Montes A, Lally D, Hale RW. The effects of oral contraceptives on respiration. Fertility and Sterility 39: 515–519, 1983PubMedGoogle Scholar
  87. Moore LG, McCullough RE, Weil JV. Increased HVR in pregnancy: relationship to hormonal and metabolic changes. Journal of Applied Physiology 62: 158–163, 1987PubMedGoogle Scholar
  88. Nicklas BJ, Hackney AC, Sharp RL. The menstrual cycle and exercise: performance, muscle glycogen and substrate responses. International Journal of Sports Medicine 10: 264–269, 1989PubMedGoogle Scholar
  89. Notelovitz M, Zauner C, Mckenzie L, Suggs Y, Fields C, Kitchens C. The effect of low-dose contraceptives on cardiorespiratory function, coagulation, and lipids in exercising young women: A preliminary report. American Journal of Obstetrics and Gynecology 156: 591–598, 1987PubMedGoogle Scholar
  90. Percival-Smith RKL, Yuzpe AA, Desrosiers JAJ, Rioux JE, Guilbert E. Cycle control on low-dose oral contraceptives: a comparative trial. Contraception 42: 253–262, 1990PubMedGoogle Scholar
  91. Pernoll ML, Metcalfe J, Kovack PA, Wachtel R, Dunham MJ. Ventilation during rest and exercise in pregnancy and postpartum. Respiration Physiology 25: 295–310, 1975PubMedGoogle Scholar
  92. Petrofsky JS, Lind AR. The relationship of body fat content to deep muscle temperature and isometric endurance in man. Clinical Science 48:405–412, 1975Google Scholar
  93. Petrofsky JS, Ledonne DM, Rinehart JS, Lind AE. Isometric strength and endurance during the menstrual cycle. European Journal of Applied Physiology and Occupational Physiology 35: 1–10, 1976PubMedGoogle Scholar
  94. Pierson WR, Lockhart A. Effect of menstruation on simple reaction and movement time. British Medical Journal 1: 796–797, 1963PubMedGoogle Scholar
  95. Pivamik JM, Marichal CJ, Spillman T, Morrow Jr JR. Menstrual cycle phase affects temperature regulation during endurance exercise. Journal of Applied Physiology 72: 543–548, 1992Google Scholar
  96. Posthuma BW, Bass JJ, Bull SB, Nisker JA. Detecting changes in functional ability in women with premenstrual syndrome. American Journal of Obstetrics and Gynecology 156: 275–278, 1987PubMedGoogle Scholar
  97. Prange-Hansen A, Weeke J. Fasting serum growth hormone levels and growth hormone responses to exercise during normal menstrual cycles and cycles on oral contraceptives. SCandinavian Journal of Clinical Laboratory Investigation 34: 199–205, 1974Google Scholar
  98. Prior JC. Progesterone as a bone-trophic hormone. Endocrine Reviews 11: 386–398, 1990PubMedGoogle Scholar
  99. Prior JC, Vigna YM. Absence of motimina: The clinical or self-diagnosis of anovulation. Society Menstrual Cycle Research. Ann Arbor, Michigan June (Abstract), JuneGoogle Scholar
  100. Prior JC, Vigna YM. Gonadal steroids in athletic women: contraception, complications and performance. Sports Medicine 2:287–295, 1985PubMedGoogle Scholar
  101. Prior JC, Vigna YM, Alojads N. Conditioning exercise decreases premenstrual symptoms: a prospective controlled six months trial. Fertility and Sterility 47: 402–408, 1987PubMedGoogle Scholar
  102. Prior JC, Vigna YM. Ovulation disturbances and exercise training. Clinics in Obstretics and Gynecology 34: 180–190, 1991Google Scholar
  103. Prior JC, Vigna YM, McKay DW. Reproduction for the athletic woman: new understandings of physiology and management. Sports Medicine 14: 190–199, 1992PubMedGoogle Scholar
  104. Prior JC, Vigna YM, Schechter MT, Burgess AE. Spinal bone loss and ovulatory disturbances. New England Journal of Medicine 323: 1221–1227, 1990PubMedGoogle Scholar
  105. Quadagno D, Faquin L, Lim G-N, Kuminka W, Moffatt R. The menstrual cycle: does it affect athletic performance? Physician and Sportsmedicine 19: 121–124, 1991Google Scholar
  106. Regensteiner JG, Woodard WD, Hagerman DD, Weil JV, Pickett CK, et al. Combined effects of female hormones and metabolic rate on ventilatory drives in women. Journal of Applied Physiology 66: 808–813, 1989PubMedGoogle Scholar
  107. Regensteiner JG, McCullough RG, McCullough RE, Pickett CK, Moore LG. Combined effects of female hormones and exercise on hypoxic ventilatory response. Respiration Physiology 82: 107–114, 1990PubMedGoogle Scholar
  108. Reinke U, Ansah B, Voigt KD. Effect of the menstrual cycle on carbohydrate and lipid metabolism in normal females. Acta Endocrinologica 69: 762–768, 1972PubMedGoogle Scholar
  109. Robertson LA, Higgs LS. Menstrual cycle variations in physical work capacity, post-exercuse blood lactate, and perceived exertion. Canadian Journal of Applied Sports Sciences 8: 220, 1983Google Scholar
  110. Rougier G, Linquette Y. Menstruation and physical exercise. Presse Medicale 70: 1921–1923, 1962PubMedGoogle Scholar
  111. Sargent F, Weinman KP. Eccrine sweat gland activity during the menstrual cycle. Journal of Applied Physiology 21: 1685–1687, 1966PubMedGoogle Scholar
  112. Schelkun PH. Exercise and ‘the Pill’: putting a rumor to rest. Physician and Sportsmedicine 19: 143–152, 1991PubMedGoogle Scholar
  113. Schoene RB, Robertson HT, Pierson DJ, Peterson AP. Respiratory drives and exercise in menstrual cycles of athletic and nonathletic women. Journal of Applied Physiology 50: 1300–1305, 1981PubMedGoogle Scholar
  114. Selye H. The effect of adaption to various damaging agents on the female sex organs of the rat. Endocrinology 25: 615–624, 1939Google Scholar
  115. Shangold MM. Menstrual irregularity in athletes: basic principles, evaluation and treatment. Canadian Journal of Applied Sport Sciences 7: 68–73, 1982Google Scholar
  116. Shangold MM, Freeman R, Thysen B, Gatz M. The relationship between long distance running, plasma progesterone and luteal phase length. Fertility and Sterility 31: 130–133, 1979PubMedGoogle Scholar
  117. Shangold MM, Levine HS. The effect of marathon training upon menstrual function. American Journal of Obstetrics and Gynecology 143: 862–869, 1982PubMedGoogle Scholar
  118. Shangold MM, Mirkin G (Eds). In: Women and exercise: physiology and sports medicine, pp. 140–141, FA Davis Co., Philadelphia, 1988Google Scholar
  119. Shangold MM, Rebar RW, Wentz AC, Schiff I. Evaluation and management of menstrual dysfunction in athletes. Journal of the American Medical Association 263: 1665–1669, 1990PubMedGoogle Scholar
  120. Skatrud JB, Dempsey JA, Kaiser DG. Ventilatory response to medroxy-progesterone acetate in normal subjects: time course and mechanism. Journal of Applied Physiology 44: 939–944, 1978PubMedGoogle Scholar
  121. Skouby SO, Kühl C, Mølsted-Pedersen L, Petersen K, Christensin MS. Triphasic oral contraception: metabolic effects in normal women and those with previous gestational diabetes. American Journal of Obstetrics and Gynecology 153: 495–500, 1985PubMedGoogle Scholar
  122. Southam AL, Gonzaga FP. Systemic changes during the menstrual cycle. American Journal of Obstetrics and Gynecology 91: 142–165, 1965PubMedGoogle Scholar
  123. Stephenson LA, Kolka MA, Wilkerson JE. Perceived exertion and anaerobic threshold during the menstrual cycle. Medicine and Science in Sports and Exercise 14: 218–222, 1982aPubMedGoogle Scholar
  124. Stephenson LA, Kolka MA, Wilkerson JE. Metabolic and thermoregulatory responses to exercise during the human menstrual cycle. Medicine and Science in Sports and Exercise 14: 270–275, 1982bPubMedGoogle Scholar
  125. Sutton Jr FD, Zwillich CW, Creagh CE, Pierson DJ, Weil JV. Progesterone for outpatient treatment of Pickwickian Syndrome. Annals of Internal Medicine 83: 476–479, 1975PubMedGoogle Scholar
  126. Tarnopolsky LJ, MacDougall JD, Atkinson SA, Tarnopolsky MA, Sutton JR. Gender differences in substrate for endurance exercise. Journal of Applied Physiology 68: 302–308, 1990PubMedGoogle Scholar
  127. Vellar OD. Changes in hemoglobin concentration and hematocrit during the menstrual cycle. Acta Obstetrica Gynecologica Scandinavia 53: 243–246, 1974Google Scholar
  128. Vollman RF. The menstrual cycle. In: Friedman (Ed.) Major problems in obstetrics and gynecology, Vol. 7, W.B. Saunders Co., Toronto, 1977Google Scholar
  129. Walters WAW, Lim YL. Cardiovascular dynamics in women receiving oral contraceptive therapy. Lancet 2: 879–881, October 1969PubMedGoogle Scholar
  130. Wearing MP, Yuhosz M, Campbell R, Love E. The effect of the menstrual cycle on tests of physical fitness. Journal of Sports Medicine and Physical Fitness 12: 38–41, 1972PubMedGoogle Scholar
  131. Wells CL, Horvath SM. Heat stress responses related to the menstrual cycle. Journal of Applied Physiology 35: 1–5, 1973PubMedGoogle Scholar
  132. Wells CL, Horvath SM. Responses to exercise in a hot environment as related to the menstrual cycle. Journal of Applied Physiology 36: 299–302, 1974PubMedGoogle Scholar
  133. Wirth JC, Lohman TG. The relationship of static muscle function to use of oral contraceptives. Medicine and Science in Sports and Exercise 14: 16–20, 1982PubMedGoogle Scholar
  134. Zaharieva E. Survey of sportswomen at the Tokyo Olympics. Journal of Sports Medicine and Physical Fitness 5: 215–219, 1965PubMedGoogle Scholar

Copyright information

© Adis International Limited 1993

Authors and Affiliations

  • Constance M. Lebrun
    • 1
  1. 1.Allan McGavin Sports Medicine CentreUniversity of British ColumbiaNorth VancouverCanada

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