Protein Requirements of Pre-Menopausal Female Athletes: Systematic Literature Review

Mercer, Drew; Convit, Lilia; Condo, Dominique; Carr, Amelia J.; Hamilton, D. Lee; Slater, Gary; Snipe, Rhiannon M. J.

doi:10.3390/nu12113527

Cited by 20Muscle metabolism and nutritionSports Performance and TrainingExercise and Physiological Responses

Protein Requirements of Pre-Menopausal Female Athletes: Systematic Literature Review

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Mercer, Drew, Convit, Lilia, Condo, Dominique, Carr, Amelia J., Hamilton, D. Lee, Slater, Gary, Snipe, Rhiannon M. J.·2020·Nutrients

DOI 10.3390/nu12113527PMC PMC7696053

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Abstract

This systematic literature review aimed to determine the protein requirements of pre-menopausal (e.g., 18–45 years) female athletes and identify if the menstrual cycle phase and/or hormonal contraceptive use influence protein requirements. Four databases were searched for original research containing pre-menopausal female athletes that ingested protein alongside exercise. The Academy of Nutrition and Dietetics Quality Criteria Checklist was used to determine study quality. Fourteen studies, which included 204 recreationally active or competitive females, met the eligibility criteria for inclusion in this review, and all were assessed as positive quality. The estimated average requirement (EAR) for protein intake of pre-menopausal recreational and/or competitive female athletes is similar for those undertaking aerobic endurance (1.28–1.63 g/kg/day), resistance (1.49 g/kg/day) and intermittent exercise (1.41 g/kg/day) of ~60–90 min duration. The optimal acute protein intake and influence of menstrual cycle phase or hormonal contraceptive use on protein requirements could not be determined. However, pre- and post-exercise protein intakes of 0.32–0.38 g/kg have demonstrated beneficial physiological responses in recreational and competitive female athletes completing resistance and intermittent exercise. The protein requirements outlined in this review can be used for planning and assessing protein intakes of recreational and competitive pre-menopausal female athletes.

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A 30 μg ethynyl estradiol dose from a third-generation OC was associated with a significantly greater increase in type I muscle fiber area compared to a 20 μg dose of ethynyl estradiol and non-users.
“and a significantly greater increase in type I muscle fiber area compared to a 20 μg dose of ethynyl estradiol and non-users”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [227]
The Discussion (§4.4; page unavailable) reports increased type I muscle fibre cross-sectional area in oral-contraceptive users compared with non-users during 10 weeks of resistance training. It does not identify a 30 μg ethynyl estradiol dose, compare it with a 20 μg dose, or report a significantly greater increase for a third-generation contraceptive. (LLM, conf=0.86)
Experimental — accuracy not yet measured
A 30 μg ethynyl estradiol dose from a third-generation OC was associated with a trend toward a greater increase in muscle mass compared to a 20 μg dose of ethynyl estradiol and non-users.
“a 30 μg ethynyl estradiol dose from a third-generation OC was associated with a trend toward a greater increase in muscle mass”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [227]
The Discussion (§4.4; page unavailable) reports a trend toward increased muscle mass in oral-contraceptive users compared with non-users during 10 weeks of resistance training. It does not identify a 30 μg ethynyl estradiol dose or compare it with a 20 μg dose. Its mention of third-generation contraceptives concerns a separate finding about myofibrillar protein synthesis. (LLM, conf=0.88)
Experimental — accuracy not yet measured
The dosage provided by ethinyl estradiol may be a key variable to consider relative to the skeletal muscle adaptations that are observed.
“This study highlights that the dosage provided by ethinyl estradiol may also be a key variable to consider relative to the skeletal muscle adaptations that are observed [227].”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [227]
Section 4.4 says the type or dose of hormones in contraceptives may affect protein requirements and reports differences in muscle protein synthesis and training adaptations among contraceptive users. It does not identify ethinyl estradiol dosage specifically as a variable affecting skeletal muscle adaptations. (LLM, conf=0.83)
Experimental — accuracy not yet measured
No changes in muscle strength related to training were found in the study of 30 μg versus 20 μg ethynyl estradiol OC doses and non-users.
“though no changes in muscle strength related to training were found”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [227]
The Discussion (§4.4; page unavailable) reports muscle-fibre and muscle-mass findings for oral-contraceptive users versus non-users during resistance training, but does not report strength outcomes or compare 30 μg and 20 μg doses. A search for muscle strength found strength findings elsewhere in the review, but none for the claimed contraceptive-dose comparison. (LLM, conf=0.76)
Experimental — accuracy not yet measured

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Background
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International society of sports nutrition position stand: nutritional concerns of the female athlete
Sims, S. T., Kerksick, C. M., Smith-Ryan, A. E., Janse de Jonge, X. A. K., Hirsch, K. R., Arent, S. M., Hewlings, S. J., Kleiner, S. M., Bustillo, E., Tartar, J. L., et al. (2023) · Journal of the International Society of Sports Nutrition · doi:10.1080/15502783.2023.2204066 · Cited by 91 · see citing works
“and colleagues [228] published an in-depth review that indicates the estimated average requirement for protein intake of eumenorrheic recreationally active and/or competitive female athletes is similar for aerobic endurance exercise (1.”
Background
Understanding the female athlete: molecular mechanisms underpinning menstrual phase differences in exercise metabolism
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Fuelling 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

Authors: Mercer, D., Convit, L., Condo, D., Carr, A. J., Hamilton, D. L., Slater, G., & Snipe, R. M. J.
Affiliations: Deakin University (AU)
University of the Sunshine Coast (AU)
Corresponding author: Snipe, Rhiannon M. J.
ORCID: Convit, Lilia
Condo, Dominique
Carr, Amelia J.
Hamilton, D. Lee
Slater, Gary
Snipe, Rhiannon M. J.
Venue: Nutrients
Publisher: MDPI AG
Published: 2020-11-16
Volume: 12
Issue: 11
Pages: 3527
ISSN: 2072-6643 (ISSN-L)
DOI: 10.3390/nu12113527
PMC: PMC7696053
OpenAlex: W3104445196
Cited by: 20
References: 100
Citations by year: 2025: 4 · 2024: 2 · 2023: 7 · 2022: 2 · 2021: 5
FWCI: 0.41
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (vor)
Locations: Nutrients (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Own your potential (DEAKIN) (submittedVersion)
Figshare (submittedVersion, cc-by)
Topics: Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
Keywords: protein requirements, menstrual cycle phases, hormonal contraceptive use, resistance training, intermittent exercise, recreational athletes, competitive athletes
MeSH terms: Adult, Energy Intake, Contraceptives, Oral, Dietary Proteins, Female, Humans, Menstrual Cycle, Nutritional Requirements, Physical Endurance, Exercise, Athletes

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Protein Requirements of Pre-Menopausal Female Athletes: Systematic Literature Review

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