The effects of menstrual cycle phase, oral contraceptive use, and the associated symptoms on performance & recovery in females

McNulty, Kelly Lee (2022) The effects of menstrual cycle phase, oral contraceptive use, and the associated symptoms on performance & recovery in females. Doctoral thesis, Northumbria University.

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Abstract

As the number of women participating in sport and exercise has increased, there is a need for sport and exercise science research that considers the influence of woman-specific physiology on exercise performance outcomes and responses to exercise. As such, the purpose of this thesis was to investigate the effect of the menstrual cycle (MC), oral contraceptive pill (OCP) use, and related symptoms, on exercise performance and recovery outcomes in recreationally active sportswomen. In Chapters 3 and 4, the effects of MC phase and OCP use on exercise performance were investigated, respectively, by conducting a systematic review and meta-analysis on the literature to date. Together, these Chapters showed that exercise performance might be trivially reduced during the early follicular phase of the MC, compared to all other phases, and that OCP use might result in slightly inferior exercise performance, on average, when compared to naturally menstruating women. However, as the effects tended to be trivial and variable across studies, and study quality was judged as poor, general guidelines on exercise performance across the MC, and with OCP use, could not be formed. Whilst Chapters 3 and 4 amalgamated studies that assessed exercise performance across the MC, and with OCP use, they did not consider the impact of cycle related symptoms and perceived effects on exercise outcomes. Therefore, Chapter 5 examined the type, frequency, and severity of cycle related symptoms experienced by naturally menstruating women and combined, monophasic, oral contraceptive pill (mOCP) users, and their perceived effects on exercise performance and recovery time post exercise. This Chapter showed that symptoms are commonly reported in sportswomen, with no difference in symptomology between naturally menstruating women and mOCP users. Importantly, the magnitude of symptoms experienced was greater whilst bleeding, which was associated with a perceived reduction in exercise performance and a longer recovery time post exercise. Chapter 6 extended the findings in previous Chapters by investigating the effect of the MC and mOCP use, alongside related symptoms, on physical and perceptual measures of exercise performance and recovery time post an exercise session. The results revealed that performance was reduced when participants were bleeding compared to all other phases. Moreover, whilst recovery time post exercise was not directly affected by phase or group, perceptions of recovery differed. It is possible that the reduced performance whilst bleeding and perceptions of recovery were influenced by the experience of cycle related symptoms. Collectively, the work in this thesis provides a novel insight into the importance of considering not only reproductive hormonal milieus, but also the individual lived experiences of the MC and mOCP use on exercise performance and recovery outcomes in sportswomen.

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