Objective: To evaluate whether a slow and deep breathing (SDB) intervention is acceptable to pregnant women. Methods: The trial aims to recruit 67 pregnant women who have developed pregnancy-induced hypertension (clinicaltrials.gov: NCT04059822). SDB will be undertaken daily for 10 min using a video aid and women will self-monitor blood pressure (BP) daily. At 36-weeks gestation women will complete an online questionnaire. Adherence, recruitment rates, and acceptance of the intervention will be evaluated. Conclusion: The findings from this trial will evaluate if women accept SDB as a treatment method. Initial analysis will evaluate if BP and/or obstetric interventions reduce following SDB intervention.

Introduction: Cold water swimming has increased in popularity and women wish to swim throughout pregnancy. There is a lack of evidenced‐based guidance to make decisions about the safety of immersion in cold water during pregnancy.Methods: Closed social media groups were asked for specific questions in relation to cold water swimming and pregnancy. This highlighted concerns including water temperature, risks to the mother and fetus, and water quality. To find evidence‐based answers, a series of meetings brought together clinicians and researchers with expertise in cold water physiology, exercise physiology, fertility, obstetrics, neonatology, midwifery, water epidemiology, public health and representatives from the Open Water Swimming Society and an Open Water swimming social enterprise.Results: Published data were examined via a scoping review process and four studies and eight reports were identified. Recommendations were made with evidence graded (mostly grade 4 expert opinion).Conclusion: Research gaps highlight the need for research to enable accurate advice to determine whether it is safe for pregnant women to swim outdoors in cold water.

Background: Cold water swimming is growing in popularity, especially among women. We have previously reported that women felt that cold water swimming helps with their menstrual and menopause symptoms. But little is known about the habits of women who cold water swim. Objectives: To determine the habits of women who cold water swim. Design: This was a mixed-methods study. Methods: An online survey asked women who cold water swim about their experience of swimming and how this affected their menstrual and menopause symptoms. The survey was advertised for 2 months on social media, with a focus on advertising in cold water swimming Facebook groups. In this article, only the questions on the women’s swimming habits were analyzed. Results: The analysis of 1114 women, mainly from the United Kingdom, revealed that most had been swimming for 1–5 years (79.5%). Most swim in the sea (64.4%), and only 15.5% swim alone. The majority (89.0%) swim all year around, swimming for mainly 30–60 min in the summer and 5–15 min in the winter. The women mostly swim wearing swimming costumes (skins) throughout the year. The majority of the free-text responses showed women found mental and physical benefits from cold water swimming. Conclusion: It was not surprising to learn that women swim for longer in the summer than the winter, but hearing how they feel cold water swimming helps their physical and mental health is important. With the limitations on access and safety of many wild swimming sites in the United Kingdom, it is time to ensure that cold water swimming is safer and more supported.

Slow and deep breathing is recommended as an effective treatment for hypertension using the RESPeRATE device. However, the acute cardiovascular responses to slow and deep breathing, including the potential mechanisms underlying its antihypertensive effect, are not fully understood. This study characterised the acute cardiovascular responses to three differing, 10‐min bouts of slow and deep breathing. Twelve participants completed four conditions in a randomised order: (1) RESPeRATE, (2) dynamic slow and deep breathing frequency, (3) fixed breathing frequency of 6 breaths min ⁻¹ , and (4) spontaneous breathing. Comparing mean values for all variables obscured the cardiovascular perturbations created by slow and deep breathing. However, intra‐ and inter‐breath differences (minimum vs. maximum) in arterial blood pressure were significantly larger during slow and deep breathing compared with spontaneous breathing. The amplitude of systolic blood pressure oscillations increased by up to 10.2% (11.4 mmHg) during inspiration and 8.4% (10.0 mmHg) during expiration (spontaneous breathing; 2.9% (3.4 mmHg) and 3.4% (4.2 mmHg), respectively). Cardiovascular responses were maximised at ∼6 breaths min ⁻¹ , but further research is needed to identify the optimal breathing frequency to induce maximal cardiovascular perturbations.

Menopause may contribute to declining aerobic capacity alongside aging; whether this is related to declines in physical activity or alterations in physiology is unclear. This study examined the effect of menopause on maximal and submaximal cardiopulmonary variables in an incremental aerobic capacity assessment in active women. Sixty‐nine women, aged between 18 and 60 years, categorized as premenopausal (PRE), late premenopausal (LPRE), perimenopausal (PERI), and postmenopausal (POST) completed a cycle ergometer ramp aerobic capacity test, body composition analysis, and blood hormone testing. Naturally menstruating women were tested in the early follicular phase of the menstrual cycle. One‐way ANOVAs were utilized to analyze the effect of menopause phase on outcome variables. Participant groups had similar V̇O_2peak, physical activity levels, and endogenous sex hormone profiles (p > 0.05), but POST had lower muscle mass than PRE, LPRE, and PERI (p < 0.05). There were no differences in maximal or submaximal cardiopulmonary variables (p > 0.05). Age and V̇O_2peak were not correlated (r = −0.23, p = 0.06). Contrary to prior reports, maintenance of aerobic capacity is possible throughout midlife and menopause in women with high activity levels. Compared to premenopausal and late premenopausal women, perimenopausal and postmenopausal women demonstrated minimal changes in maximal and submaximal cardiopulmonary variables.

Background: Oestradiol has been implicated as a factor in substrate utilisation in male and mouse studies but the effect of acute changes during the menstrual cycle is yet to be fully understood. Objective: To determine the role of oestradiol in respiratory exchange ratio (RER) during exercise at various intensities. Methods: This systematic review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. From inception to November 2023, four online databases (Cochrane, SPORTDiscus, MEDline and Web of Science) were searched for relevant articles. Studies that reported a resting oestradiol measurement in naturally menstruating women with exercise at a percentage of maximal aerobic capacity (%V˙O_2max) were included. Mean and standard deviation for oestradiol, RER and exercise intensity were extracted and study quality assessed using a modified Downs and Black checklist. Risk of bias was assessed using I₂ measure of heterogeneity and Egger’s regression test, assessment of bias from methodological quality was identified by sensitivity analysis. Eligible datasets were extracted for pairwise comparisons within a meta-analysis and correlation between change in oestradiol and change in RER. Data were also pooled to produce a mean and standard deviation for RER for menstrual stage and for low and high oestradiol groups. Results: Twenty-four articles were identified, over 50% were identified as high quality. Sixteen articles included datasets eligible for meta-analysis. Eleven articles utilised a submaximal constant-load exercise intensity, finding a standardised mean difference of − 0.09 ([CI: −0.35–0.17], p = 0.5) suggesting no effect of menstrual phase on constant-load exercise RER. In six articles using incremental exercise tests to exhaustion, a standardised mean difference of 0.60 ([CI 0.00–1.19], p = 0.05) was identified towards a higher maximal RER attained in follicular compared to luteal phase. There was no correlation (R = −0.26, p = 0.2) between change in oestradiol and change in RER between phases. All 24 articles, totalling 650 participants, were included in pooled analysis. When grouped by menstrual cycle phase or when grouped by oestradiol levels, RER was higher in the follicular phase than the luteal phase at low and high constant load exercise intensities. Discussion: Findings from the pooled-analysis and meta-analysis suggest that there may be menstrual cycle phase differences in RER that are intensity dependent. These differences may be related to sex hormone levels, but this was not supported by evidence of correlation between differences in RER and differences in oestradiol. At present, it remains best practice to assess performance in the same menstrual cycle phase if seeking to assess change from baseline.