The Effect of the Menstrual Cycle on Exercise Metabolism

Abstract

The female hormones, oestrogen and progesterone, fluctuate predictably across the menstrual cycle in naturally cycling eumenorrhoeic women. Other than reproductive function, these hormones influence many other physiological systems, and their action during exercise may have implications for exercise performance. Although a number of studies have found exercise performance - and in particular, endurance performance - to vary between menstrual phases, there is an equal number of such studies reporting no differences. However, a comparison of the increase in the oestrogen concentration (E) relative to progesterone concentration (P) as the E/P ratio (pmol/nmol) in the luteal phase in these studies reveals that endurance performance may only be improved in the mid-luteal phase compared with the early follicular phase when the E/P ratio is high in the mid-luteal phase. Furthermore, the late follicular phase, characterized by the pre-ovulatory surge in oestrogen and suppressed progesterone concentrations, tends to promote improved performance in a cycling time trial and future studies should include this menstrual phase. Menstrual phase variations in endurance performance may largely be a consequence of changes to exercise metabolism stimulated by the fluctuations in ovarian hormone concentrations. The literature suggests that oestrogen may promote endurance performance by altering carbohydrate, fat and protein metabolism, with progesterone often appearing to act antagonistically. Details of the ovarian hormone influences on the metabolism of these macronutrients are no longer only limited to evidence from animal research and indirect calorimetry but have been verified by substrate kinetics determined with stable tracer methodology in eumenorrhoeic women. This review thoroughly examines the metabolic perturbations induced by the ovarian hormones and, by detailed comparison, proposes reasons for many of the inconsistent reports in menstrual phase comparative research. Often the magnitude of increase in the ovarian hormones between menstrual phases and the E/P ratio appear to be important factors determining an effect on metabolism. However, energy demand and nutritional status may be confounding variables, particularly in carbohydrate metabolism. The review specifically considers how changes in metabolic responses due to the ovarian hormones may influence exercise performance. For example, oestrogen promotes glucose availability and uptake into type I muscle fibres providing the fuel of choice during short duration exercise; an action that can be inhibited by progesterone. A high oestrogen concentration in the luteal phase augments muscle glycogen storage capacity compared with the low oestrogen environment of the early follicular phase. However, following a carbo-loading diet will super-compensate muscle glycogen stores in the early follicular phase to values attained in the luteal phase. Oestrogen concentrations of the luteal phase reduce reliance on muscle glycogen during exercise and although not as yet supported by ...

The effects of menstrual cycle phase on physical performance in female soccer players

“…Conversely, it has been shown in previous studies, that exercise time to exhaustion is improved during the LP. This has been speculated that the role oestrogen plays on enhanced lipid metabolism, with spared glycogen and usually a supressed lactate response to exercise in the LP[32]. As seen in the present study, significant differences were found in lactate concentration between phases at 3 and 5 min post exercise.…”

“…As seen in the present study, significant differences were found in lactate concentration between phases at 3 and 5 min post exercise. Therefore, there is the potential that the energy pathways may have been taxed differently between phase, for example it has been implicated previously that during the LP there is a lower contribution of anaerobic glycolysis and hence reduced La values[32]. A conclusive statement about this, however, is beyond the current scope of this study and perhaps requires deeper investigation with more sophisticated methodology (e. g. indirect calorimetry).…”

Estrogen/ERR-α signaling axis is associated with fiber-type conversion of upper airway muscles in patients with obstructive sleep apnea hypopnea syndrome

“…Estrogen could influence exercise metabolism28 and pharyngeal dilator muscle activity29. A significant increase in genioglossus electromyogram (EMGgg) was found in the postmenopausal group re-examined after hormone therapy2930.…”

Sex‐based differences in endurance exercise muscle metabolism: impact on exercise and nutritional strategies to optimize health and performance in women

“…Another sex hormone that might potentially alter substrate metabolism during exercise in women is progesterone. A complete examination of how progesterone and oestrogen interact in regulation of substrate metabolism during exercise is beyond the scope of this review, and the reader is directed to a review by Oosthuyse & Bosch () for more information. Briefly, progesterone is considered to act in an opposing manner to oestrogen; however, its role in influencing substrate utilization during exercise has not been fully established.…”