The Menstrual Cycle and Exercise: Performance, Muscle Glycogen, and Substrate Responses
Abstract
Six eumenorrheic females (age = 26.3 +/- 2.4 yrs; X +/- SE) exercised until exhaustion (EE; 70% VO2max) at the midluteal (LP, 7-8 days after ovulation) and midfollicular (FP, days 7-8) phases of their menstrual cycles. Phases were confirmed by estradiol and progesterone concentrations. Each EE test was preceded by a depletion exercise bout (DE; 90 min, 60% VO2max and 4 x 1 min, 100% VO2max) and 3 days of rest/diet control. Muscle biopsies 1% (vastus lateralis) were taken post-DE, pre-EE, and post-EE and then analyzed for glycogen content. There was a strong tendency (P less than 0.07) for EE duration to be greater during LP (139.2 +/- 14.9 min) than FP (126 +/- 17.5 min). Glycogen repletion (pre-EE minus post-DE) following DE was greater (P = 0.05) during the LP than FP (88.2 +/- 4.7 vs 72.8 +/- 5.7 mumol/g w. w. muscle). However, EE glycogen utilization (pre-EE minus post-EE/EE time) did not differ between phases (LP = 0.41 +/- 0.08 mumol/g w. w. muscle/min vs FP = 0.33 +/- 0.11 mumol/g w. w. muscle/min; P = 0.17). The results suggest that exercise performance and muscle glycogen content are enhanced during the LP of the menstrual cycle. These findings imply athletic performance may be affected by the phases of the menstrual cycle.
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Metabolic perturbations of exercise are still evident 21 hours after 60-90 min of low to moderate intensity exercise in men but are no longer apparent after 3 hours in women.
“metabolic perturbations of exercise are still evident 21 hours after 60–90 min of low to moderate intensity exercise in men but are no longer apparent after 3 hours in women [155,172,215].”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [215]
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“There is some evidence that the menstrual status of female athletes affects glycogen storage, with greater storage of glycogen occurring during the luteal phase rather than the follicular phase (Nicklas et al., 1989; Hackney et al., 1994).”
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BackgroundD’Souza, A. C., Wageh, M., Williams, J. S., Colenso‐Semple, L. M., McCarthy, D. G., McKay, A. K. A., Elliott-Sale, K. J., Burke, L. M., Parise, G., MacDonald, M. J., et al. (2023) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00346.2023 · Cited by 147 · see citing works
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BackgroundResultInfluentialExercise V˙ e and physical performance at altitude are not affected by menstrual cycle phase
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InfluentialHormonal and metabolic responses to exercise across time of day and menstrual cycle phase
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BackgroundSex Differences in Respiratory Exercise Physiology
Sheel, A. W., Richards, J. C., Foster, G. E., & Guenette, J. A. (2004) · Sports Medicine · doi:10.2165/00007256-200434090-00002 · Cited by 115 · see citing works
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Ormsbee, M. J., Thyfault, J. P., Johnson, E. A., Kraus, R. M., Choi, M. D., & Hickner, R. C. (2007) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00704.2006 · Cited by 99 · see citing works
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International society of sports nutrition position stand: nutritional concerns of the female athlete
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Hackney (1999) · Acta Physiologica Scandinavica · doi:10.1046/j.1365-201x.1999.00605.x · Cited by 88 · see citing works
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Suh, S., Casazza, G. A., Horning, M. A., Miller, B. F., & Brooks, G. A. (2002) · Journal of Applied Physiology · doi:10.1152/japplphysiol.01080.2001 · Cited by 80 · see citing works
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BackgroundInfluentialEffects of the menstrual cycle phase on the blood lactate responses to exercise
McCracken, M. A., Ainsworth, B. E., & Hackney, A. C. (1994) · European Journal of Applied Physiology · doi:10.1007/bf00609412 · Cited by 73 · see citing works
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BackgroundSelf-citationSubstrate metabolism during exercise: Sexual dimorphism and women’s specificities
Boisseau, N., & Isacco, L. (2022) · European Journal of Sport Science · doi:10.1080/17461391.2021.1943713 · Cited by 70 · see citing works
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Gender Differences in Substrate Utilisation During Exercise
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Gender differences in whole-body fat oxidation kinetics during exercise
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Effects of menstrual cycle phase and oral contraceptive use on intermittent exercise
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InfluentialFuelling the female athlete: Carbohydrate and protein recommendations
Moore, D. R., Sygo, J., & Morton, J. P. (2022) · European Journal of Sport Science · doi:10.1080/17461391.2021.1922508 · Cited by 60 · see citing works
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BackgroundInfluentialMenstrual Cycle Hormonal Changes and Energy Substrate Metabolism in Exercising Women: A Perspective
Hackney, A. C. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph181910024 · Cited by 61 · see citing works
Self-citationHormone Responses to Resistance vs. Endurance Exercise in Premenopausal Females
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Impact of menstrual cycle phase on the exercise status of young, sedentary women
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“Maximal or peak oxygen uptake (V _O2maxor V _O2peak), a critical determinant of exercise capacity, appears to be independent of menstrual cycle phase (De Souza et al. 1989; Nicklas et al. 1989; Bemben et al. 1995; Beidleman et al. 1999) although higher values have been reported in the FP (Schoene et al. 1981; Lebrun e…”
BackgroundGender Differences in Carbohydrate Metabolism and Carbohydrate Loading
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BackgroundThe Physiology of the Highly Trained Female Endurance Runner
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“,[34] and Lebrun[110] who all reported an increased fat oxidation during the luteal phase, which could possibly aid endurance performance of the faster endurance events, such as 1500m, because of decreased blood lactate accumulation.”
BackgroundNo effect of menstrual cycle phase on fuel oxidation during exercise in rowers
Vaiksaar, S., Jürimäe, J., Mäestu, J., Purge, P., Kalytka, S., Шахліна, Л., & Jürimäe, T. (2010) · European Journal of Applied Physiology · doi:10.1007/s00421-010-1730-1 · Cited by 57 · see citing works
“2002), and blood lactate (De Souza et al. 1990; Devries et al. 2006; Horton et al. 2002; Nicklas et al. 1989) concentrations due to the ovarian hormone variations during menstrual cycle.”
BackgroundResultInfluentialEffects of menstrual phase on performance and recovery in intense intermittent activity
Middleton, L. E., & Wenger, H. A. (2005) · European Journal of Applied Physiology · doi:10.1007/s00421-005-0073-9 · Cited by 55 · see citing works
Menstrual Cycle Effects on Exercise-Induced Fatigability
Pereira, H. M., Larson, R. D., & Bemben, D. A. (2020) · Frontiers in Physiology · doi:10.3389/fphys.2020.00517 · Cited by 55 · see citing works
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“It is important to examine the menstrual cycle due to the effects estrogen may have on energy substrate utilization, as the mid-luteal phase is characterized by high estrogen levels, which can enhance lipid utilization with exercise in women [19,33].”
Self-citationCycling time trial performance during different phases of the menstrual cycle
Oosthuyse, T., Bosch, A. N., & Jackson, S. (2005) · European Journal of Applied Physiology · doi:10.1007/s00421-005-1324-5 · Cited by 52 · see citing works
“In the current study, heart rate and ventilation rate during exercise remained unaltered by menstrual phase as is also reported by most previous studies (Beidleman et al. 1999; Bemben et al. 1995; Hackney et al. 1991; Jurkowski et al. 1981; Lebrun et al. 1995; Nicklas et al. 1989).”
BackgroundMethodResultInfluentialOral Contraceptive Phase Has no Effect on Endurance Test
Rechichi, C., Dawson, B., & Goodman, C. (2008) · International Journal of Sports Medicine · doi:10.1055/s-2007-965334 · Cited by 47 · see citing works
“No other studies have reported an increased lactate production during the luteal phase of the menstrual cycle or within an OC cycle, although many studies have demonstrated no difference (3,5,6,22).”
BackgroundPhysical Activity, Fat Balance, and Energy Balance
Hill, J. O., & Commerford, R. (1996) · International Journal of Sport Nutrition · doi:10.1123/ijsn.6.2.80 · Cited by 44 · see citing works
Effects of Female Reproductive Hormones on Sports Performance
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“metabolism’ enhancement during LUT for both muscle glycogen retention and concentration (Nicklas et al., 1989); however, of note was the non-significant change in muscle”
BackgroundResultEstrogen and Substrate Metabolism
Ashley, C. D., Kramer, M. L., & Bishop, P. A. (2000) · Sports Medicine · doi:10.2165/00007256-200029040-00001 · Cited by 42 · see citing works
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“Here, there is evidence that resting glycogen concentrations (33) or glycogen repletion rates (34) are higher in the luteal versus follicular phases, although the findings and their implications are unclear.”
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Self-citationSubstrate oxidation is altered in women during exercise upon acute altitude exposure
Beidleman, B. A., Rock, P. B., Muza, S. R., Fulco, C. S., GIBSON, L. L., Kamimori, G. H., & Cymerman, A. (2002) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-200203000-00008 · Cited by 38 · see citing works
Sex Differences in Energy Metabolism: A Female-Oriented Discussion
Sanchez, B. N., Volek, J. S., Kraemer, W. J., Sáenz, C., & Maresh, C. M. (2024) · Sports Medicine · doi:10.1007/s40279-024-02063-8 · Cited by 38 · see citing works
“The use of percutaneous muscle biopsies to determine muscle glycogen content also pointed toward a tendency to store more glycogen in the luteal phase compared with the follicular phase [16, 34].”
InfluentialMenstrual Cycle Effects on Perceived Exertion and Pain During Exercise Among Sedentary Women
Hooper, A. E. C., Bryan, A. D., & Eaton, M. (2011) · Journal of Women s Health · doi:10.1089/jwh.2010.2042 · Cited by 37 · see citing works
“13 17 The inconclusive findings could be a result of the use of small samples of highly active women (typically 8–10 women), which are limited in their power to detect psychological effects.”
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Self-citationCaffeine: Implications for Alertness in Athletes
Rogers, N. L., & Dinges, D. F. (2005) · Clinics in Sports Medicine · doi:10.1016/j.csm.2004.12.012 · Cited by 35 · see citing works
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“After a glycogen depletion session (90 min cycling at 60% of VO2max followed by four 1-min sprints at 100% VO2max), muscle glycogen content remains higher during the luteal than follicular phase [40].”
MethodType 1 Diabetes and the Menstrual Cycle: Where/How Does Exercise Fit in?
Toor, S., Yardley, J. E., & Momeni, Z. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20042772 · Cited by 33 · see citing works
“As for muscle glycogen use, it seems that although there may not be a significant difference between menstrual cycle phases in response to aerobic exercise [53], anaerobic/highintensity exercise may elicit a difference in muscle glycogen use between the two phases.”
BackgroundHolschen, J. C. (2004) · Southern Medical Journal · doi:10.1097/01.smj.0000140124.83000.40 · Cited by 33 · see citing works
Ledford, A., & Branch, J. (1999) · The Journal of Strength and Conditioning Research · doi:10.1519/1533-4287(1999)013 · Cited by 29 · see citing works
The Latest on Carbohydrate Loading: A Practical Approach
Sedlock, D. A. (2008) · Current Sports Medicine Reports · doi:10.1249/jsr.0b013e31817ef9cb · Cited by 32 · see citing works
Gurd, B. J., Scheid, J. L., Paterson, D. H., & Kowalchuk, J. M. (2007) · European Journal of Applied Physiology · doi:10.1007/s00421-007-0505-9 · Cited by 31 · see citing works
“…of no differences in the plasma lactate– concentration within the two phases of the menstrual cycle is in agreement with some (Bonen et al. 1983; Nicklas et al. 1989; Dean et al. 2003) but not all (Jurkowski et al. 1981; Lavoie et al. 1987; McCracken et al. 1994; Galliven et al. 1997) studies…”
Willett, H. N., Koltun, K. J., & Hackney, A. C. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18137209 · Cited by 29 · see citing works
“These findings agree with that of previous studies [8,9].”
ResultSelf-citationEffect of a Synthetic Progestin on the Exercise Status of Sedentary Young Women
Redman, L. M., SCROOP, G. C., Westlander, G., & Norman, R. J. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-2401 · Cited by 28 · see citing works
Taipale, R. S., Raitanen, A., Hackney, A. C., Solli, G. S., Valtonen, M., Peltonen, H., McGawley, K., Kyröläinen, H., & Ihalainen, J. K. (2021) · Frontiers in Physiology · doi:10.3389/fphys.2021.761760 · Cited by 27 · see citing works
Self-citationSchlie, J., Krassowski, V., & Schmidt, A. (2025) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00223.2025 · Cited by 28 · see citing works
Considerations for Sex-Cognizant Research in Exercise Biology and Medicine
O’Bryan, S. M., Connor, K. R., Drummer, D. J., Lavin, K. M., & Bamman, M. M. (2022) · Frontiers in Sports and Active Living · doi:10.3389/fspor.2022.903992 · Cited by 24 · see citing works
“, 2005), leading to estrogenmediated signaling that results in increased ability to store glycogen in muscle while increasing free fatty acid availability and use through upregulation of oxidative pathways (Nicklas et al., 1989; Hackney, 1990; Sims and Heather, 2018).”
BackgroundMenstrual cycle, exercise and health
Dawson, E. A., & Reilly, T. (2008) · Biological Rhythm Research · doi:10.1080/09291010802067213 · Cited by 25 · see citing works
“Nicklas et al. (1989) found that although glycogen utilisation was not affected by menstrual cycle phase, glycogen Phases are early follicular (low estrogen and progesterone), midfollicular (elevated estrogen and low progesterone), and midluteal (elevated estrogen and progesterone); OC indicates…”
BackgroundŠtefanovský, M., Péterová, A., Vanderka, M., & Lengvarský, L. (2016) · Acta Gymnica · doi:10.5507/ag.2016.015 · Cited by 24 · see citing works
Manual handling performance: the effects of menstrual cycle phase
Birch, K. M., & Reilly, T. P. (1999) · Ergonomics · doi:10.1080/001401399184974 · Cited by 23 · see citing works
Evaluation of gender differences in physiology: an introduction
Tarnopolsky, M. A., & Saris, W. H. M. (2001) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/00075197-200111000-00004 · Cited by 22 · see citing works
Fat metabolism and acute resistance exercise in trained women
Allman, B. R., Morrissey, M. C., Kim, J., Panton, L. B., Contreras, R. J., Hickner, R. C., & Ormsbee, M. J. (2019) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00752.2018 · Cited by 22 · see citing works
Ghazel, N., Souissi, A., Chtourou, H., et al. (2020) · Research in Sports Medicine · doi:10.1080/15438627.2020.1860045 · Cited by 21 · see citing works
“It has been suggested that MCP does not influence muscle glycogen intake during a short period of intense exercise (Nicklas et al., 1989).”
BackgroundWilliams, J. S., Stone, J. C., Masood, Z., Bostad, W., Gibala, M. J., & MacDonald, M. J. (2023) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00111.2023 · Cited by 23 · see citing works
Botcazou, M., Gratas‐Delamarche, A., Allain, S., Jacob, C., Bentué‐Ferrer, D., Delamarche, P., & Zouhal, H. (2006) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/h06-038 · Cited by 21 · see citing works
Substrate utilization during exercise in postmenopausal women on hormone replacement therapy
Johnson, L., Kraemer, R., Kraemer, G., Haltom, R., Cordill, A., A.Welsch, M., Durand, R., & Castracane, D. (2002) · European Journal of Applied Physiology · doi:10.1007/s00421-002-0686-1 · Cited by 20 · see citing works
“Two studies have reported that a glycogen-sparing effect in muscle (Hackney 1990) and lower R values (Nicklas et al. 1989) occur during the luteal phase when estrogen concentrations are high compared to the follicular phase when they are lower.”
BackgroundDelp, M., Chesbro, G. A., Pribble, B. A., Miller, R. M., Pereira, H. M., Black, C. D., & Larson, R. D. (2024) · Frontiers in Physiology · doi:10.3389/fphys.2023.1297242 · Cited by 19 · see citing works
Short-term training attenuates muscle TCA cycle expansion during exercise in women
Dawson, K. D., Howarth, K. R., Tarnopolsky, M. A., Wong, N. D., & Gibala, M. J. (2003) · Journal of Applied Physiology · doi:10.1152/japplphysiol.01118.2002 · Cited by 19 · see citing works
“Similarly, studies that have directly examined the effect of menstrual cycle phase on muscle glycogen utilization during exercise have yielded equivocal data (17, 24).”
ResultSmith, E. S., McCormick, R., McKay, A. K. A., Ackerman, K. E., Elliott-Sale, K. J., Stellingwerff, T., Harris, R., & Burke, L. M. (2024) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000003587 · Cited by 20 · see citing works
“Indeed, most studies of performance across the MC are undertaken in a controlled laboratory environment (16,17), in which participants are often blinded, fasted, and lack real-world motivation to perform.”
Sex Hormones and Substrate Metabolism During Endurance Exercise
Isacco, L., & Boisseau, N. (2016) · Springer eBooks · doi:10.1007/978-3-319-44558-8_3 · Cited by 19 · see citing works
- Authors
- Nicklas, B., Hackney, A., & Sharp, R.
- Affiliations
- Iowa State University (US)
- ORCID
- Sharp, R.
- Venue
- International Journal of Sports Medicine
- Publisher
- Georg Thieme Verlag KG
- Published
- 1989-08
- Volume
- 10
- Issue
- 04
- Pages
- 264-269
- ISSN
- 0172-4622 (ISSN-L)
- 1439-3964
- OpenAlex
- W1975400802
- Cited by
- 194
- References
- 0
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 9 · 2023: 11 · 2022: 12 · 2021: 10 · 2020: 5 · 2019: 7 · 2018: 3 · 2017: 4 · 2016: 4 · 2015: 5 · 2014: 1 · 2013: 6 · 2012: 2
- FWCI
- 1.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Keywords
- menstrual cycle, exercise performance, muscle glycogen, glycogen repletion, glycogen utilization, luteal phase, follicular phase, exhaustive exercise, substrate metabolism, female athletes, estradiol, progesterone, vastus lateralis
- MeSH terms
- Adult, Estradiol, Exercise Test, Fatty Acids, Nonesterified, Female, Glycogen, Heart Rate, Humans, Lactates, Menstrual Cycle, Muscles, Oxygen Consumption, Progesterone, Exercise, Lactic Acid
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