Carbohydrate Loading and Female Endurance Athletes: Effect of Menstrual-Cycle Phase
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This study compared 3 d of carbohydrate loading (CHOL; 8.4 g·kg−1·d−1 carbohydrate) in female eumenorrheic athletes with 3 d of an isoenergetic normal diet (NORM; 5.2 g·kg−1·d−1 carbohydrate) and examined the effect of menstrual-cycle phase on performance, muscle-glycogen concentration [glyc], and substrate utilization. Nine moderately trained eumenorrheic women cycled in an intermittent protocol varying in intensity from 45% to 75% VO 2max for 75 min, followed by a 16-km time trial at the midfollicular (MF) and midluteal (ML) phases of the menstrual cycle on NORM and CHOL. Time-trial performance was not affected by diet (CHOL 26.10 ± 1.04 min, NORM 26.16 ± 1.35 min; P = 0.494) or menstrual-cycle phase (MF 26.05 ± 1.10 min, ML 26.23 ± 1.33 min; P = 0.370). Resting [glyc] was lowest in the MF phase after NORM (575 ± 145 mmol·kg−1·dw−1), compared with the MF phase after CHOL (728 mmol·kg−1·dw−1) and the ML phase after CHOL and NORM (756 and 771 mmol·kg−1·dw−1, respectively). No effect of phase on substrate utilization during exercise was observed. These data support previous observations of greater resting [glyc] in the ML than the MF phase of the menstrual cycle and suggest that lower glycogen storage in the MF phase can be overcome by carbohydrate loading.
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CHO loading (8.4-9 g CHO/kg BW/day) in the mid-luteal phase results in no change to a small increase (13%) in muscle glycogen, which could potentially enhance performance.
“To that end, CHO loading (8.4–9 g CHO/kg BW/day) in the mid-luteal phase has resulted in no change to a small increase (13%) in muscle glycogen, which could potentially enhance performance [57,58].”
From Considerations of Low Carbohydrate Availability (LCA) to Relative Energy Deficiency in Sport (RED-S) in Female Endurance Athletes: A Narrative Review (2023) · cites this paper as [58]
The Muscle-Glycogen Measurements section reports essentially no increase in mid-luteal glycogen after loading (756 versus 771 mmol/kg dry weight), and the Menstrual-Cycle Phase and Resting Muscle Glycogen section reports another study’s 13% increase. This paper tested 8.4, not 9, g/kg/day. Its Exercise Performance discussion describes a possible link to improved endurance in that other study, while its own trial found no performance improvement. (LLM, conf=0.84)
Experimental — accuracy not yet measuredCHO loading during the mid-follicular phase results in a 17-31% improvement in muscle glycogen but not performance.
“However, CHO loading during the mid-follicular phase has resulted in a 17–31% improvement in muscle glycogen but not performance [58,59,60].”
From Considerations of Low Carbohydrate Availability (LCA) to Relative Energy Deficiency in Sport (RED-S) in Female Endurance Athletes: A Narrative Review (2023) · cites this paper as [58]
Female athletes using COCs have significantly higher oxidative stress than non-COC user counterparts irrespective of lifestyle habits.
“with significantly higher oxidative stress in female athletes using COCs than their non-COC user counterparts irrespective of lifestyle habits [181].”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [181]
The Subjects section states that none of the nine athletes had taken oral contraceptives for at least six months, so this study did not compare COC users with nonusers. Searches for oxidative stress and COC-related terms found passages about exercise substrate oxidation, not oxidative stress or a comparison irrespective of lifestyle habits; no page number is available in our copy. (LLM, conf=0.78)
Experimental — accuracy not yet measuredEvidence indicated no sex differences in the ability to synthesise glycogen.
“Evidence indicated no sex differences in the ability to synthesise glycogen [86].”
From Regulation of Energy Substrate Metabolism in Endurance Exercise (2021) · cites this paper as [86]
The Muscle-Glycogen Measurements and Summary sections report glycogen storage in female athletes across menstrual-cycle phases and diets, but do not compare women with men. A References entry names a study titled “Muscle glycogen supercompensation: absence of a gender-related difference”; that title alone does not establish that this paper reports the claimed sex comparison. Searches for sex and gender differences in glycogen synthesis found no passage addressing it. (LLM, conf=0.74)
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“Women have higher uncompensated glycogen levels (11,30) and a greater capacity for storing glycogen (11,26) during the luteal phase than the follicular phase.”
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“In eumenorrheic women, because of predictable ovarian hormone fluctuations across themenstrual cycle, substrate mobilization and utilization have been compared between the follicular and the luteal phases but results remain controversial (Hackney et al. 1994; Zderic et al. 2001; Horton et al. 2002; Suh et al. 2002; De…”
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“[23] were also reported using a 16 km time trial on a eumenorrheic female after carbohydrate loading [53].”
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“Therefore, our results showed no significant difference in blood glucose or FFA, similar to the results of studies that unified the diet at rest and after recovery for 3 days (16,22,23).”
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Rehrer, N. J., McLay-Cooke, R. T., & Sims, S. T. (2017) · Sex Hormones, Exercise and Women · doi:10.1007/978-3-319-44558-8_6 · Cited by 6 · see citing works
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“These sub-phases are characterized by notable shifts in hormone levels, including estrogen, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) ( McLay et al., 2007 ).”
BackgroundVillegas-Serna, T., Wilson, L. J., & Curtis, C. (2023) · Journal of Thermal Biology · doi:10.1016/j.jtherbio.2023.103758 · Cited by 4 · see citing works
“Whereas, other studies have shown no changes in exercise performance between MC phases (Dasa et al., 2021; Elliott et al., 2003; McLay et al., 2007; Oosthuyse et al., 2005; Taipale-Mikkonen et al., 2021; Vaiksaar et al., 2011).”
The Menstrual Cycle: A Look Back on the Understanding and Its Impact on Athletic Performance
Gault, M., & Smith, K. (2023) · ACSMʼs Health & Fitness Journal · doi:10.1249/fit.0000000000000897 · Cited by 3 · see citing works
Macronutrient Needs of Active Individuals
Cialdella-Kam, L. A., & Manore, M. M. (2009) · Nutrition Today · doi:10.1097/nt.0b013e3181a4aebc · Cited by 3 · see citing works
“Females also experience cyclic variation in their ability to store glycogen, storing less in the follicular phase than in the luteal phase of the menstrual cycle.(32,33) Despite these differences in glycogen storage, performance in females may not be affected because females rely less on carbohydrate oxidation and mor…”
BackgroundNutritional Considerations for Female Rock Climbers
Leslie-Wujastyk, M., & Gibson-Smith, E. (2024) · Journal of Science in Sport and Exercise · doi:10.1007/s42978-023-00267-4 · Cited by 3 · see citing works
“Although glycogen storage may be reduced in the follicular phase, this difference was not apparent in ranges indicative of a loading protocol and, therefore, loading may be particularly advantageous in this phase to overcome lower resting muscle glycogen [40, 47, 56].”
Sex Hormones and Substrate Metabolism During Endurance Exercise
Isacco, L., & Boisseau, N. (2023) · Springer eBooks · doi:10.1007/978-3-031-21881-1_2 · Cited by 3 · see citing works
McManus, L., Faria, V. S., Scriney, M., & Egan, B. (2025) · Science and Medicine in Football · doi:10.1080/24733938.2025.2501809 · Cited by 2 · see citing works
“Some studies have reported a reduced capacity to store glycogen in the mid-follicular phase compared to the mid-luteal phase (McLay et al. 2007; Nicklas et al., 1989), but this effect can be overcome when greater amounts of CHO are consumed (Campbell et al. 2001; McLay et al. 2007).”
Smith‐Ryan, A. E., Moore, S. R., Arent, M. A., Cantù, E., Cornejo, L., Hackney, A. C., Ihalainen, J. K., Taipale, R. S., & Bruinvels, G. (2026) · Sports Medicine · doi:10.1007/s40279-026-02413-8 · Cited by 2 · see citing works
“The reduced capacity for glycogen storage in the early FP has been found to be negated with a carbohydrate loading protocol of greater than 8 g/kg per day in moderately trained endurance athletes [76].”
Female cyclists perceived effects and experiences of the menstrual cycle on training and performance
Burnie, L., Ansdell, P., Allen, G., Pastorio, E., Hicks, K. M., Heron, N., & Brown, N. (2026) · PLoS ONE · doi:10.1371/journal.pone.0343892 · Cited by 2 · see citing works
YALÇIN, S., Bağış, Y. E., Yerlikaya, G., & Beyleroğlu, M. (2023) · Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi · doi:10.37989/gumussagbil.1224750 · Cited by 2 · see citing works
Kubica, C., Ketelhut, S., & Nigg, C. R. (2024) · European Journal of Applied Physiology · doi:10.1007/s00421-024-05545-9 · Cited by 4 · see citing works
“The inconsistent results may be attributed to factors such as training intensity (Oosthuyse and Bosch 2010) and nutritional status (Hulton et al. 2021; McLay et al. 2007), which are often not adequately controlled in research studies.”
BackgroundCabre, H. E. (2025) · Strength and conditioning journal · doi:10.1519/ssc.0000000000000914 · Cited by 1 · see citing works
Taylor, M., Docter, H., Madsen, K., Tjernes, V. S. S., Welde, B., Morseth, B., Haugen, T. A., Sandbakk, Ø. B., Osborne, J. O., & Noordhof, D. A. (2025) · European Journal of Sport Science · doi:10.1002/ejsc.70078 · Cited by 1 · see citing works
“In order to minimize the influence of MC phase on glycogen storage (McLay et al. 2007) participants were provided with personalized dietary recommendations to meet a carbohydrate intake of ≥ 8 g kg − 1 body mass·day − 1 based on a food dairy from the day leading up to the test day.”
McManus, L., Brady, A. J., & Egan, B. (2026) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.2025-0164 · Cited by 1 · see citing works
Carbohydrates Requirements for the Female Athlete
Burke, L. M., & Dziedzic, C. E. (2013) · CRC Press eBooks · doi:10.1201/b13743-3 · Cited by 1 · see citing works
Substrate Utilization in Female Athletes
Maher, A. C., & Tarnopolsky, M. A. (2013) · CRC Press eBooks · doi:10.1201/b13743-2 · Cited by 1 · see citing works
Gender Differences: Considerations for the Female Endurance Athlete
Annett, S., Cassas, K. J., & Bryan, S. T. (2016) · Springer eBooks · doi:10.1007/978-3-319-32982-6_5 · Cited by 1 · see citing works
Effect of the Glycemic Index of Meals on Physical Exercise: A Case Report
Biagini, A., & Albi, E. (2020) · The EuroBiotech Journal · doi:10.2478/ebtj-2020-0021 · Cited by 1 · see citing works
“There is some evidence that the choice of metabolic substrates, in women with eumenorrhea, is also determined by their menstrual status especially during low or moderate intensity exercise (26) – with greater glycogen storage occurring during the luteal phase rather than the follicular phase (27).”
BackgroundMatsuda, T., Ishikawa, A., Kanno, M., Ogata, H., Gam, H., Funaki, A., Ikegami, N., Yamada, M., & Sakamaki‐Sunaga, M. (2022) · Journal of Sports Science and Medicine · doi:10.52082/jssm.2022.191 · Cited by 1 · see citing works
“Although changes in substrate utilization using blood samples have not been shown before and after post-exercise recovery, a previous study demonstrated that muscle glycogen concentrations significantly increased in the luteal phase (LP) with high estrogen levels during the menstrual cycle compared to EF (Nicklas et a…”
BackgroundExercise Metabolism and Menstrual Cycle
Fernández-del-Valle, M. (2023) · Springer eBooks · doi:10.1007/978-3-031-15485-0_7 · Cited by 1 · see citing works
Nutritional Strategies and Sex Hormone Interactions in Women
Rehrer, N. J., McLay-Cooke, R. T., & Sims, S. T. (2023) · Springer eBooks · doi:10.1007/978-3-031-21881-1_12 · Cited by 1 · see citing works
Self-citationOptimal Nutrition for Endurance Exercise: A Systematic Review
Andrus, B. W. (2017) · Journal of Nutritional Health & Food Science · doi:10.15226/jnhfs.2017.00198 · Cited by 1 · see citing works
Effect of carbohydrate ingestion during exercise on performance measures of wheelchair athletes
Hynes, H. (2009) · University Library - University of Saskatchewan (University of Saskatchewan) · Cited by 1 · see citing works
Hamzah, S. H. (2011) · Enlighten: Theses (The University of Glasgow)
Barr, S. I. (2013) · doi:10.1002/9781118692318.ch28
Inigo, M. M. (2012) · ThinkTech (Texas Tech University)
Barnes, P. D. (2010) · UWA Profiles and Research Repository (University of Western Australia)
Dean, E. M., & Ishikawa, S. N. (2014) · Springer eBooks · doi:10.1007/978-1-4899-7427-3_11
Antero, J., & Meignié, A. (2022) · INSEP-Éditions eBooks · doi:10.4000/books.insep.3008
Different perspectives on women’s health, nutrition and endurance exercise
Charkoudian, N., LEE, J. K. W., Giersch, G. E. W., DiPietro, L., & Stachenfeld, N. S. (2023) · Journal of the International Society of Sports Nutrition · doi:10.1080/15502783.2023.2286286
“There are reports suggesting that the luteal phase is associated with decreased [8], increased [9] and unchanged [10] carbohydrate utilization relative to other phases of the menstrual cycle.”
BackgroundLee, S. J. L., van Rens, F. E. C. A., & Peiffer, J. J. (2024) · International Journal of Sports Physiology and Performance · doi:10.1123/ijspp.2023-0143
Bagot, S., Miles-Chan, J. L., Hackney, A. C., Duclos, M., & Isacco, L. (2025) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.2024-0095
SPORT PERFORMANCE DURING MENSTRUATION: A SCALE DEVELOPMENT STUDY
Ilbak, İ., Akarsu, M., Karadenizli, Z. İ., & Düz, S. (2025) · İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi · doi:10.33715/inonusaglik.1593452
Adaptations énergétiques aux variations de poids et au statut hormonal ovarien chez les athlètes
Bagot, S. (2024) · theses.fr (ABES) · doi:10.70675/13a08bf4ze417z4cb4z80cfz47892200b6c8
Fortis, H. O., Whitehead, A. E., Cronin, C., Johnson, K. O., Shepherd, S. O., Hackney, A. C., Close, G. L., & Strauss, J. A. (2026) · European Journal of Sport Science · doi:10.1002/ejsc.70193
“Female‐specific data are particularly scarce, although existing evidence indicates that pre‐race carbohydrate intake commonly remains below ~6.5 g ⋅ kg − 1 BM (McLay et al. 2007).”
InfluentialJones, R. O., Areta, J. L., Fortis, H. O., Pugh, J. N., & Louis, J. B. (2026) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/sms.70379
“To quantify data points presented exclusively in figures ( n = 17 studies [10, 13, 15, 16, 25–37]), an online plot digitizer was used (Plot Digitizer, POrbital, Mumbai, India), which was tested for accuracy using studies containing data presented in text and figures, which generated a mean…”
Influential
- Authors
- McLay, R. T., Thomson, C. D., Williams, S. M., & Rehrer, N. J.
- Affiliations
- University of Otago (NZ)
- Venue
- International Journal of Sport Nutrition and Exercise Metabolism
- Publisher
- Human Kinetics
- Published
- 2007-04
- Volume
- 17
- Issue
- 2
- Pages
- 189-205
- ISSN
- 1526-484X (ISSN-L)
- 1543-2742
- OpenAlex
- W127280637
- Cited by
- 76
- References
- 28
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 7 · 2023: 12 · 2022: 12 · 2021: 5 · 2020: 5 · 2019: 1 · 2017: 1 · 2016: 3 · 2015: 1 · 2014: 2 · 2013: 4 · 2012: 2
- FWCI
- 2.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Sport Nutrition and Exercise Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- carbohydrate loading, menstrual cycle phases, female endurance athletes, muscle glycogen, time trial performance, substrate utilization, eumenorrhea, exercise performance, glycogen storage
- MeSH terms
- Adult, Dietary Carbohydrates, Energy Metabolism, Female, Glycogen, Humans, Menstrual Cycle, Physical Endurance, Muscle, Skeletal, Cross-Over Studies
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