Menstrual Cycle Effects on Perceived Exertion and Pain During Exercise Among Sedentary Women

Abstract

Background: Increasing cardiovascular fitness through exercise participation among sedentary people is important for decreasing all-cause mortality. From an intervention perspective, identifying modifiable factors that maximize the successful initiation of exercise is of utmost importance. For women, cyclic hormonal variations can influence aspects of health and health behaviors, from smoking cessation efficacy to physiological responses to exercise. The purpose of this study was to examine the influence of menstrual cycle phase and hormonal contraceptive (HC) use on subjective response to an initial bout of moderate intensity exercise among previously sedentary women (n ¼ 117). Methods: Women completed a treadmill exercise challenge session at 65% of their previously determined maximum oxygen consumption (Vo 2 max) during the early follicular, late follicular, or luteal phase. Participants reported ratings of perceived exertion and pain using Borg's Rating of Perceived Exertion (RPE) and CR10 scales at 10, 20, and 30 minutes during the exercise session.Results: There was a significant menstrual phaseÂbirth control interaction on change in RPE [F(2, 111) ¼ 3.75, p < 0.05] and change in perceived pain [F(2, 110) ¼ 3.31, p < 0.05]. Women in the early follicular phase who were not using HCs had significantly greater increases in RPE and increases in pain compared with women in the late follicular and luteal phases. Conclusions: Our results indicate that the use of HC and cycle phase influence sedentary women's subjective response to exercise. These results have important implications for the timing of exercise interventions aimed at increasing exercise among sedentary women.

The Effect of Gender and Menstrual Phase on Serum Creatine Kinase Activity and Muscle Soreness Following Downhill Running

“…Previous findings that reported no difference in muscle soreness following eccentric exercise between follicular and luteal phase may be confounded by the inclusion of part OC users and nonusers [22] or measurement in mid-follicular phase with rising oestrogen concentrations [20]. In support of the current findings, a previous study reports greater perception of pain and rating of perceived exertion during exercise in women during the EF phase compared with the LF or ML phase [43]. The influence of the menstrual cycle on pain perception is complicated and not clearly described [44].…”

Menstrual and oral contraceptive cycle phases do not affect submaximal and maximal exercise responses

“…An important observation was that the RPE at minute 30 of the MLSS ride was significantly higher in the mid‐follicular phase compared with the mid‐luteal phase of the menstrual cycle but did not differ between oral contraceptive cycle phases. Although there is minimal information about the influence of hormonal fluctuations on subjective responses to exercise, a large study (n = 117) found steeper increases in pain and RPE across an exercise bout in the early‐follicular phase compared with the late‐follicular or luteal phases in sedentary non‐hormonal contraceptives users, but not among hormonal contraceptives users . It was suggested that differences in the responses between groups may be a result of less variability in hormones across the hormonal contraceptive cycle .…”

“…Although there is minimal information about the influence of hormonal fluctuations on subjective responses to exercise, a large study (n = 117) found steeper increases in pain and RPE across an exercise bout in the early‐follicular phase compared with the late‐follicular or luteal phases in sedentary non‐hormonal contraceptives users, but not among hormonal contraceptives users . It was suggested that differences in the responses between groups may be a result of less variability in hormones across the hormonal contraceptive cycle . Because RPE may be difficult to differentiate from pain, another explanation could be that RPE values at the end of the MLSS trial may have been affected by a decreased perception of pain in the mid‐luteal phase compared with the late‐follicular phase (known as the “luteal analgesia” effect) .…”

“…40 It was suggested that differences in the responses between groups may be a result of less variability in hormones across the hormonal contraceptive cycle. 40 Because RPE may be difficult to differentiate from pain, another explanation could be that RPE values at the end of the MLSS trial may have been affected by a decreased perception of pain in the mid-luteal phase compared with the late-follicular phase (known as the "luteal analgesia" effect). 41 Although it is unclear why perception of effort was different when all physiological responses remained the same, it would be interesting to know how this elevated RPE in the mid-follicular phase would have affected performance during Table 3 and results section for statistical significances a longer ride.…”

Evoked Pain Analgesia in Chronic Pelvic Pain Patients Using Respiratory-Gated Auricular Vagal Afferent Nerve Stimulation

“…We did not evaluate study subjects during a specific phase of menstrual cycle. While the effects of menstrual cycle phase on pain sensitivity have been controversial [30], we chose not to control for this factor as 1) we anticipated that multiple subjects would be menopausal due to either posthysterectomy or other endometriosis treatment; 2) our study outcomes focused on within‐session change scores; and 3) multiple subjects would be on oral contraceptives that are known to blunt any potential cycle‐related variability in pain sensitivity [31,32].…”