The effect of the menstrual cycle on physical performance is being increasingly recognised as a key consideration for women’s sport and a critical field for further research. This narrative review explores the findings of studies investigating the effects of menstrual cycle phase on perceived and objectively measured performance in an athletic population. Studies examining perceived performance consistently report that female athletes identify their performance to be relatively worse during the early follicular and late luteal phases. Studies examining objective performance (using anaerobic, aerobic or strength-related tests) do not report clear, consistent effects of the impact of menstrual cycle phase on physical performance. Overall sport performance can be influenced by both perceived and physical factors. Hence, to optimise performance and management of eumenorrheic female athletes, there is a need for further research to quantify the impact of menstrual cycle phase on perceived and physical performance outcomes and to identify factors affecting variability in objective performance outcomes between studies.

The effect of the menstrual cycle on athlete performance, wellbeing and perceived exertion and fatigue is not well understood. Furthermore, it has not been investigated specifically in Australian Football athletes. This pilot study aimed to explore how naturally menstruating Australian Football athletes may be affected by menstrual cycle phase. The data collected from the routine monitoring of five naturally menstruating athletes (average menstrual cycle length of 28 ± 3 [SD] days) in one team (athlete age range 18–35 years) competing in the Women’s Australian Football League during the 2019 season were retrospectively analysed to compare performance (countermovement jump parameters and adductor squeeze pressure), perceived exertion, perceived fatigue and wellbeing (perceived sleep quality, stress and soreness) outcomes between the follicular and luteal phases. Performance, perceived exertion, stress and soreness did not appear to be affected by menstrual cycle phase (p > 0.17). However, perceived fatigue appeared to be significantly greater (p = 0.042) and sleep quality worse (p = 0.005) in the luteal phase. This pilot study suggests further research focusing on the effect of menstrual cycle phase on subjective fatigue and wellbeing is warranted.

To identify what coaches, support staff, and athletes believe should be considered when implementing menstrual cycle tracking in sport. Concept mapping (mixed-methods participatory approach). Participants brainstormed statements in response to the focus prompt "What should be considered when tracking menstrual cycles in sport?" Participants then sorted the statements into groups according to meaning and rated each statement on its importance and feasibility to address. Twenty-six participants (12 athletes and 14 coaches/support staff) generated 53 ideas that the research team synthesised to 57 unique statements. Sixteen participants sorted the statements into an average of 8 (±4) groups. Six clusters were identified as the most appropriate representation of the sorting data following multidimensional scaling and hierarchical cluster analysis: 1) Ethics, 2) Tracking Tools and Methods, 3) Performance and Health, 4) Education, 5) Interpretation and Framing and 6) Communication. Participants rated each statement based on their importance (n = 12) and feasibility (n = 10), respectively. The most important (mean = 3.88 out of 5) and feasible (mean = 3.85 out of 5) cluster was Ethics, whilst the least important (mean = 3.17) and feasible (mean = 3.04) was Communication. Ethical considerations pertaining to privacy, consent, and scope of practice should be prioritised when tracking menstrual cycles in sport. A low burden method of tracking, which allows for some individualisation based on athletes' preferences or needs, and menstrual health education should also be undertaken to improve the uptake and impact of menstrual cycle tracking.

Objectives: The aim of this review was to summarise the existing literature concerning the implementation of menstrual cycle tracking in applied sport settings. Methods: For this scoping review, database searches were conducted in ProQuest, PubMed, Scopus, SportDISCUS, and Web of Science. Screening was performed by two independent reviewers to identify academic publications that related to the concept of menstrual cycle tracking in applied sport settings. Results: Twenty-six articles published between 2001 and 2024 fulfilled the inclusion criteria. These were most commonly original research articles (n = 19) and published in the last two years (n = 20). One research protocol paper and six opinion articles published in academic journals were also included. Twelve of the 26 publications recommend implementing tracking in sport settings; many publications also encourage providing education (n = 13) and facilitating more open communication (n = 10) on menstrual-related topics. Where tracking was conducted, this was done using calendar-based methods alone (n = 5) or in conjunction with urinary (n = 3), capillary blood (n = 2) and venous blood (n = 1) hormone measures, and ovulation test kits (n = 1). Conclusions: Menstrual cycle tracking may be a useful tool for promoting self-awareness, identifying menstrual dysfunction, and managing menstrual symptoms. However, in practice there are potential risks, such as loss of privacy or misuse of data. There is also a need for ecologically valid tracking tools that can identify subtle menstrual disturbances, to make tracking more beneficial and efficient.

This study primarily aims to establish current practices to tailor support for female athletes, including menstrual cycle tracking, health screening, female-specific education, and other practical supports to address concerns related to menstruation. A secondary aim was to explore the relationships between the participant characteristics and practices implemented to tailor support for female athletes. One hundred and forty-one practitioners (i.e., coaches, athletic trainers, high performance managers) working with female athletes responded to an online survey between March and December 2023. Frequency analyses demonstrated that it is more common for practitioners to avoid discussing menstrual cycle tracking with athletes than to either encourage or require them to undertake tracking. Tracking was most often undertaken to establish and identify changes to athletes’ usual menstrual characteristics, and to identify and manage menstrual symptoms. In terms of health screening, disordered eating and iron deficiency were screened for most commonly, while screening for pelvic floor dysfunction was least common. Female-specific nutrition, relative energy deficiency, and menstrual cycles were the topics most commonly included in female athlete-specific education targeted at athletes and practitioners. Further analysis revealed that respondents’ tracking and education practices were closely associated. This study provides a snapshot into the practices that are currently implemented to tailor support to female athletes around their menstrual cycle.

This qualitative descriptive study explores the factors influencing the implementation of menstrual cycle tracking. Eight practitioners (female = 5, male = 3) and six female athletes participated in semistructured interviews to share their experiences with and perspectives on menstrual cycle tracking. Interviews were recorded and transcribed verbatim, with data analyzed using reflexive thematic analysis. Three themes were identified: Creating openness and comfortability , struggled bringing that on board , and it’s up to them , which represent the social (e.g., stigma surrounding menstrual cycles), organizational (e.g., practical constraints within specific training environments), and individual (e.g., athletes’ interest in and compliance with tracking) factors influencing the implementation of cycle tracking, respectively. This study highlights the important role of education in addressing these social-, organizational-, and individual-level factors to ensure that athletes and practitioners willing to engage in tracking are equipped to communicate about tracking and act appropriately (i.e., provide feedback or referral) based on tracking data.