MRI reveals menstrually-related muscle edema that negatively affects athletic agility in young women

Abstract

ContextAbout 10% of Japanese female athletes are afflicted by menstrually-related edema, mainly in the lower limbs, and, with few studies on this problem, the effect on performance remains unclear.ObjectiveTo quantitatively evaluate fluid retention in the calf in female students over their menstrual cycle using magnetic resonance imaging (MRI) and to determine the relationship of MRI changes and athletic performance.DesignThe menstrual cycle was divided into 5 phases: menstrual, follicular, ovulatory, early luteal, and late luteal with sampling done in either morning (AM) or afternoon (PM) sessions. At each phase, MRI of the calf (7:00–8:00, 14:00–16:00), body composition and hormones (7:00–8:00), and athletic performance (14:00–16:00) were evaluated.Participants13 adult healthy Japanese female students with eumenorrhea.ResultsEstradiol levels decreased significantly in the menstrual phase and the follicular phase compared to the early luteal phase (P = 0.001, P = 0.024 respectively). Menstrual phase estradiol levels were significantly lower compared to the ovulatory phase (P = 0.015), and the late luteal phase (P = 0.003). Progesterone levels decreased significantly in the menstrual phase and the follicular phase compared to the ovulatory phase (P = 0.012, P = 0.009 respectively), the early luteal phase (both P = 0.007), and the late luteal phase (P = 0.028, P = 0.029 respectively), and it along with a significant decrease in the ovulatory phase compared to the early luteal phase (P = 0.010). AM T2 signals were significantly lower in the menstrual phase compared to the ovulatory phase (P = 0.043) but not other phases. PM T2 signals increased significantly in the menstrual phase compared to the follicular phase (P = 0.003), ovulatory phase (P = 0.009), and the late luteal phase (P = 0.032), and the difference between the AM and PM values increased significantly in the menstrual phase compared to the other 4 phases (P<0.01). A negative correlation between fluid retention and agility was observed.ConclusionIn female students fluid retention during the menstrual phase could be a factor that influences athletic agility.

The Relationship Between Quadriceps Femoris Muscle Function and MRI‐Derived Water Diffusion and Adipose Tissue Measurements in Young Healthy Males

“…A limitation of this study is that VI muscle activity was not measured using EMG, and muscle biopsy was not performed. Moreover, this study included only males with low physical activity levels since physical activity and menstrual cycles influenced muscle edema and water diffusivity 26 . The cohort of the present study did not include males with moderate or high physical activity levels or females, and the cohort size was small, which could affect the generalizability of the results.…”

Anthropometric Measures and Prediction of Maternal Sleep-Disordered Breathing

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Assessment of Salivary Nitric Oxide Levels in Elite University Athletes in Japan: Findings From a Cross Sectional Study Design

“…Estrogen, as sex hormones, has been reported to have an antioxidant activity [25]. During the menstrual cycle, the estrogen level is low value in the menstrual phase [26]. Athletic performance is influenced by symptoms occurring before menstruation [27, 28].…”