Menstrual cycle phase and elite female soccer match-play: influence on various physical performance outputs

The Dose-Response in Elite Soccer: Preliminary Insights From Menstrual-Cycle Tracking During the FIFA Women's World Cup 2019

PURPOSE

This preliminary study examined the influence of estimated menstrual-cycle (MC) phase on responses to soccer matches and training sessions in preparation for and during the FIFA (Fédération internationale de football association) Women's World Cup 2019.

METHODS

Twenty outfield players representing a national team were tracked over a 45-day period. External (10-Hz global positioning system; total and distance covered at high-metabolic power [≥20 W·kg-1]) and internal load measures (minutes ≥80% heart-rate maximum, sessional ratings of perceived exertion) were collected during all training and matches, with single-item wellness measures (fatigue, soreness, sleep quality, and sleep duration) collected each morning prior to activity. MC phase was estimated individually via an algorithm, informed from pretournament survey responses and ongoing symptom reporting (FitrWoman). Model comparison statistics were used to determine the impact of estimated MC phase in nonhormonal contraceptive users (n = 16).

RESULTS

Sessional rating of perceived exertion responses to total distances ≥5 km were higher during the luteal phase (+0.6-1.0 au; P ≤ .0178) versus menstruation (phase 1), but no other observable dose-response trends were observed. Sleep, fatigue, and soreness ratings were not typically associated with MC phase, with the exception of exacerbated fatigue ratings in luteal versus follicular phase 48 hours postmatch (-0.73 au, P = .0275).

CONCLUSIONS

Preliminary findings suggest that estimated MC phase may contribute to the understanding of the dose-response to soccer training and matches.

Monitoring of sprint and change of direction velocity, vertical jump height, and repeated sprint ability in sub-elite female football players throughout their menstrual cycle

AIMS

The aim of this study was to investigate the associations between the early follicular (EF, i.e., menstruation), late follicular (LF), and middle luteal (ML) phases of the menstrual cycle and different factors that may influence football performance.

METHODS

To this end, 11 eumenorrheic sub-elite female football players underwent field tests to assess sprint speed, lower extremity power, repeated sprint ability, velocity on change of direction, and technical skills at each cycle phase.

RESULTS

Performance during the 15-m change of direction ability test, 15-m ball dribbling test, squat jump height, total sprint time [sum of 7 sprints] and decrement score [(mean sprint time/best sprint time × 100) - 100], maximum and mean heart rate, and perceived exertion did not significantly differ among menstrual cycle phases. Conversely, the linear sprint velocity over 10, 20, 30-m distances was decreased in EF vs LF (10-, 20- and 30-m) and in ML vs LF (10- and 20-m) (p < 0.05). The 40-m sprint velocity did not change in the different menstrual cycle phases.

CONCLUSION

Overall, our study suggests that sex hormone fluctuations during the menstrual cycle are not associated with vertical jump, velocity on change of direction, and repeated sprint ability, but may influence linear sprint velocity over short distances (10, 20, and 30 m).

Role of the Menstrual Cycle on Performance and Injury Risk: A Survey of Female Professional Rugby Players in the United Kingdom

BACKGROUND

Female athletic performance and injury risk is impacted by variations in the menstrual cycle (MC), but the understanding of the impacts and mechanisms influenced by the menstrual cycle on exercise performance are not fully delineated.

AIMS AND OBJECTIVES

Evaluate associations between the menstrual cycle, perceived performance, and injury risk of elite female rugby players using an online survey.

METHODS

An anonymous online questionnaire was completed by 150 elite female rugby players from two English rugby leagues, the Betfred Women's Super League (BWSL) and the Allianz Premier 15s (AP15s). The collected data were analysed thematically.

RESULTS

The Chi-square test was used to assess associations between age groups and contraception usage, weight change, and training and playing performance; none of the associations were statistically significant (all p values > 0.05). Thematic analysis of 11,660 words of data revealed four themes: (a) MC impact on training and competition, (b) education and period management plans, (c) openness of conversations and comfort taking time off, and (d) injury risk. The impacted performance areas were physical (83.7%), psychological (85.7%), and nutritional (80.3%); players experienced decreased appetite, nausea, fatigue, strength declines, heighted emotions, and worsened focus. In total, 87.8% of athletes perceived the MC to negatively impact performance, 85.7% of players desired to be educated further to prevent injuries, improve nutrition, and training adaptions, 51.7% of participants perceived risk of injury to be higher during MC, and 86.4% of participants did not feel comfortable taking time off due to the MC, worrying that selection would be affected and about opinions from others.

CONCLUSION

A clear negative impact on perceived performance and injury risk was reported by survey participants. The interaction of physical, psychological, and nutritional factors, and a lack of awareness and education emphasise the need for further comprehensive studies and interventions, with measures such as MC monitoring and profiling, education, and training adaptions to develop openness, knowledge, and understanding.

Impact of the Menstrual Cycle on Physical Performance and Subjective Ratings in Elite Academy Women Soccer Players

Our study aimed to combine psychological and physical factors to explore the impact of the menstrual cycle on performance in elite academy women soccer players through weekly monitoring. Eighteen elite academy women soccer players were monitored. Players reported daily through an online anonymous survey if they were in menstruation. Players answered the Hooper Questionnaire daily, performed an Illinois Agility Test (IAT) twice a week, and rated their perceived exertion (RPE) after every training session. Tests were associated with a complete menstrual cycle reported through the online anonymous survey to determine the two weeks of the follicular phase and the two weeks of the luteal phase. Of the 18 players, 10 completed all requirements and were retained for analyses. IAT did not show significant differences throughout the menstrual cycle (p = 0.633). Fatigue (p = 0.444), Stress (p = 0.868), Sleep (p = 0.398), DOMS (delayed onset muscle soreness; p = 0.725), and Hooper Index (p = 0.403) did not show significant differences either. RPE was also comparable across the cycle (p = 0.846). Our results failed to demonstrate that hormonal variation during the menstrual cycle influenced psychological and physical markers of performance.

Female basketball game performance is influenced by menstrual cycle phase, age, perceived demands and game-related contextual factors

This study evaluated the influence of physical and perceived game demands, menstrual cycle phase, perceived recovery, individual and game-related contextual factors on competitive performance in professional, female basketball players.11 professional female players (age: 20.6 ± 2.7 years) were monitored for game-related statistics (Performance Index Rating, PIR; rebounds, REB; effective field goal %, eFG%; turnovers, TO), objective (PlayerLoad per minute, PL·min-1) and subjective (RPE) game loads, pre-game perceived recovery (Total Quality Recovery, TQRpre), menstrual phase (follicular; luteal) and game-related contextual factors (game location; game outcome; score differential; opponent level) during 12 official games. Separate linear mixed models were used to evaluate the influence of RPE, PL·min-1, TQRpre, menstrual phase, contextual factors, and individual characteristics (age; playing position) on game-related statistics.Higher PIR and eFG% were found for older players and those who reported higher RPE (all p < 0.05). Higher age also led to less TO (p = 0.042). eFG% was higher when players reported higher TQRpre ;(p = 0.010). Better shooting (eFG%) and rebounding (REB) performances were found during the follicular menstrual phase (p < 0.05). More REB were collected in won games (p = 0.002).This study suggests that the co-influences of perceptual, menstrual-related, individual and game-related contextual factors should be considered to optimise female basketball players' performance.

Elite female football players' perception of the impact of their menstrual cycle stages on their football performance. A semi-structured interview-based study

OBJECTIVES

This study assesses how female footballers perceive how their menstrual cycle impacts their physical and psychological performance, informing future research and intervention.

METHODS

Semi-structured interviews, developed using piloting and peer review took place with fifteen elite female footballers from two English WSL clubs (age: 25.2 [18-33]). Data was audio recorded, transcribed verbatim, and analysed thematically using NVivo.

RESULTS

All players (100%) perceive their menstrual cycle to negatively impact performance. Analysing 27,438 words of data revealed five themes: A) symptoms, B) preparation, C) performance, D) recovery, and E) management. Over half (53%) of players experienced decreased appetite and sleep quality prior to performance during menstruation. Competitive performance was perceived to be most negatively impacted during menses (54 references) following by the pre-menstrual stage (23 references). During menstruation, the most impacted physical performance indicators were power (93%) and fatigue (87%). Psychologically, confidence, focus, and reaction to criticism were commonly affected (66.7%). Players reported missing training (13.3%) and matches (13.3%) due to severity of impact. Recovery was affected during the pre-menstrual (26.7%) and menstrual (66.7) stages. Players self-manage symptoms using over the counter (66.7%) and prescription (26.7%) medication, some prophylactically prior to competition (46.7%).

CONCLUSIONS

This first attempt to ascertain player perception in football exposes a clear negative impact on performance. The complex interplay of biopsychosocial and logistical factors, lack of awareness and education highlight the need for further research. Intervention is necessary and immediate initiation would be prudent, starting with simple measures such as basic self-management advice, education, and provision of sanitary products.

Normalising the conversation: a qualitative analysis of player and stakeholder perceptions of menstrual health support within elite female soccer

PURPOSE

This qualitative study explores player and stakeholder perceptions of menstrual health support in elite female soccer.

METHODS

Semi-structured interviews were conducted with 47 participants including players (n = 12), parents (n = 9), coaches (n = 9), sport scientists (n = 7), nutritionists (n = 5) and medical staff (n = 5).

RESULTS

Via thematic analysis, data demonstrate that elite female soccer players experience a range of physical and psychological symptoms primarily at the onset of and during menses (as also perceived by stakeholders), with most participants perceiving these symptoms to impact performance. Nonetheless, menstrual health support is perceived as minimal and although players have their menstrual status tracked, they report little understanding as to why or how this information is used. This confusion was also present among stakeholders, often as a result of uncertainty about the evidence supporting the need for menstrual health support. The perceived lack of support may also be reflective of a culture where conversations about the menstrual cycle are not normalised. Overall, this may result in failure to identify and treat menstrual irregularities despite non-coaching staff members perceiving them to be common amongst players.

CONCLUSION

These data support the need for individualised support based on the lived experiences of individual players and support staff. Furthermore, our research identifies the need for organisational, stakeholder, and player centred education programmes (led by experts in female athlete health) that create an environment where players receive personalised menstrual health support.

A systematic review of match-play characteristics in women's soccer

This review aimed to (1) systematically review the scientific literature evaluating the match-play characteristics of women's soccer, (2) determine the methods adopted to quantify match-play characteristics of women's soccer, and (3) present the physical, technical and tactical characteristics of women's soccer match-play across age-groups, playing standards and playing positions. A systematic search of electronic databases was conducted in May 2021; keywords relating to the population, soccer and match-play characteristics were used. Studies which quantified physical, technical or tactical performance of women's soccer players during match-play were included. Excluded studies included adapted match-play formats and training studies. Sixty-nine studies met the eligibility criteria. Studies predominantly quantified match-play characteristics of senior international (n = 27) and domestic (n = 30) women's soccer match-play, with only seven studies reporting youth match-play characteristics. Physical (n = 47), technical (n = 26) and tactical characteristics (n = 2) were reported as whole-match (n = 65), half-match (n = 21), segmental (n = 17) or peak (n = 8) characteristics. Beyond age-groups, playing standard, and playing position, fourteen studies quantified the impact of contextual factors, such as environment or match outcome, on match-play characteristics. Distance was the most commonly reported variable (n = 43), as outfield women's soccer players covered a total distance of 5480-11160 m during match-play. This systematic review highlights that physical match-performance increases between age-groups and playing standards, and differs between playing positions. However, further research is warranted to understand potential differences in technical and tactical match-performance. Coaches and practitioners can use the evidence presented within this review to inform population-specific practices, however, they should be mindful of important methodological limitations within the literature (e.g. inconsistent velocity and acceleration/deceleration thresholds). Future research should attempt to integrate physical, technical and tactical characteristics as opposed to quantifying characteristics in isolation, to gain a deeper and more holistic insight into match-performance.

Impact of the Menstrual Cycle Phases on the Movement Patterns of Sub-Elite Women Soccer Players during Competitive Matches

The purpose of this study was to evaluate the influence of the menstrual cycle phases on the movement patterns of sub-elite women soccer players during competitive matches over three consecutive seasons. Individual movement data were analyzed and compared in eight players from the second French League at the early follicular (EF), late follicular (LF) and mid-luteal (ML) phases of their menstrual cycle, determined by the calendar method. The movement patterns, expressed as meters per minute, were recorded during competitive matches using devices placed on the player’s ankle. Our results showed significantly lower distances covered at moderate and high velocity in the EF phase than in the LF and ML phases (Cohen’s d effect size = 1.03 and 0.79, respectively). The total distance covered during matches and the number of sprints also were reduced during EF compared with LF (d = 0.78 and 0.7, respectively). Overall, the total distance and distance covered at low velocity were significantly lower during the second half-time of the matches (d = 1.51), but no menstrual cycle phase × game period interaction was noted. In conclusion, our study suggests that EF may impact the movement pattern of sub-elite women soccer players during competitive matches, without any modulation of this effect by the playing time. Despite the low sample size, these results can be useful for coaches and support staff to modulate training loads and player rotation during soccer games.

In-Season Body Composition Effects in Professional Women Soccer Players

This study aimed to analyze anthropometric and body composition effects in professional soccer women players across the early and mid-competitive 2019/20 season. Seventeen players (age, height, body mass, and body mass index of 22.7 ± 6.3 years, 167.5 ± 5.6 cm, 60.7 ± 6.6 kg and 21.6 ± 0.2 kg/m2) from a Portuguese BPI League team participated in this study. The participants completed ≥80% of 57 training sessions and 13 matches. They were assessed at three points (before the start of the season (A1), after two months (A2), and after four months (A3)) using the following variables: body fat mass (BFM), soft lean mass (SLM), fat-free mass (FFM), intracellular water (ICW), extracellular water (ECW), total body water (TBW), and phase angle (PhA, 50 Khz), through InBody S10. Nutritional intake was determined through a questionnaire. Repeated measures ANCOVA and effect sizes (ES) were used with p < 0.05. The main results occurred between A1 and A2 for BFM (-21.7%, ES = 1.58), SLM (3.7%, ES = 1.24), FFM (4%, ES = 1.34), ICW (4.2%, ES = 1.41), TBW (3.7%, ES = 1.04). Furthermore, there were significant results between A1 and A3 for FFM (4.8%, ES = 1.51), ICW (5%, ES = 1.68), and PhA (10.4%, ES = 6.64). The results showed that the water parameters improved over time, which led to healthy hydration statuses. The training load structure provided sufficient stimulus for appropriate physical fitness development, without causing negative disturbances in the water compartments.

The Effects of Menstrual Cycle Phase on Elite Athlete Performance: A Critical and Systematic Review

Background: In elite athletes, training individualization is widely recommended to optimize competitive performance. Previous studies have evidenced the impact of hormonal fluctuations on different performance parameters among female athletes. While consideration of menstrual cycle (MC) phases as a parameter in training individualization strategies is necessary, systematic evidence identifying such impacts in elite athletes should be evaluated. Objective: Systematically review publications that have investigated the link between MC phases and performance in elite female athletes. The overarching aim is to identify whether a consensus across studies exists enabling evidence-based recommendations for training individualization depending on menstrual cycle phases. Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three major scientific publication databases were searched from inception until November 3, 2020. Studies included focused on the influence of physiological or psychological parameters throughout at least one phase of the menstrual cycle of elite athletes. Results: A total of 780 search results were yielded and 26 references from a past bibliography were added manually. About 662 papers were reviewed of which 218 studies were assessed for eligibility. Of these, only seven (1%) precisely investigated the influence of a performance or physical parameter during at least one menstrual cycle phase. These seven studies included a total of 314 elite female participants (20.58 ± 1.91 years). Three used interviews, questionnaires or prospective analyses of reports. Four conducted several performance tests or included physical measures although only two performed tests during training or before/during competition. Among the seven studies, five performed hormonal testing through sampling of blood, saliva, or urine. The remaining relied on athletes' menstruation diaries. The current evidence suggests a variable association between menstrual cycle and a few performance-related outcomes, such as endurance or power resistance, ligament stiffness, decision making skills, psychology, or competitiveness. Conclusion: Different sports performance-related parameters are affected during the menstrual cycle among elite athletes, but the parameters themselves and the magnitude and the direction of the effects are inconclusive. Additional longitudinal and prospective studies to systematically monitor on-field performance parameters are urgently required in order to enable recommendations and training individualization in female elite athletes.

Physical Demands of Women's Soccer Matches: A Perspective Across the Developmental Spectrum

Female soccer players are exposed to specific physical demands during matches, which vary according to the standard of play. Existing studies have largely focused on quantifying the distances covered for professional and international level players. This approach is limited in scope regarding the broader aspects around physical demands and is detached from development pathway models. An understanding of the demands across all standards will provide valuable insights about appropriate player development and help ensure physical readiness for the demands of the sport. The aim of this perspective paper is to describe the physical demands experienced during women's soccer matches across the developmental spectrum. A combination of evidence from the literature and data from the author's research (JDV) is presented. Specifically highlighted are the trends for locomotor distances, acceleration and deceleration frequency, and metabolic power metrics for youth (≤U17), college (NCAA/U20), professional (domestic) and international standards of women's soccer. In addition, the changes in match demands between levels of play are used to help illustrate gaps that must be overcome in order to successfully achieve physical readiness to compete at higher levels. The evidence demonstrates the importance of training appropriate attributes to prepare female soccer players who are striving to play at progressively higher standards.

The Impact of Menstrual Cycle Phase on Athletes' Performance: A Narrative Review

The effect of the menstrual cycle on physical performance is being increasingly recognised as a key consideration for women's sport and a critical field for further research. This narrative review explores the findings of studies investigating the effects of menstrual cycle phase on perceived and objectively measured performance in an athletic population. Studies examining perceived performance consistently report that female athletes identify their performance to be relatively worse during the early follicular and late luteal phases. Studies examining objective performance (using anaerobic, aerobic or strength-related tests) do not report clear, consistent effects of the impact of menstrual cycle phase on physical performance. Overall sport performance can be influenced by both perceived and physical factors. Hence, to optimise performance and management of eumenorrheic female athletes, there is a need for further research to quantify the impact of menstrual cycle phase on perceived and physical performance outcomes and to identify factors affecting variability in objective performance outcomes between studies.

Effects of high-carbohydrate versus mixed-macronutrient meals on female soccer physiology and performance

PURPOSE

Athletes are often told to minimize intakes of fiber, fat, and protein in pre-competition meals to avoid gut distress, but this guidance is based on scant direct evidence. This study evaluated the physiological and perceptual effects of pre-competition mixed-macronutrient (MM) and high-carbohydrate (HCHO) meals in collegiate female soccer players.

METHODS

Fifteen players participated in this randomized, investigator-blinded, crossover study involving two ~ 1000-kcal meals (HCHO and MM) consumed 4 h prior to 70-min scrimmages. Assessments included global positioning system (GPS) tracking, heart rate (HR), perceived exertion (RPE), ratings of fatigue (ROF), gut symptoms, and perceptions of satiety, hunger, and fullness. Differences between conditions for HR, RPE, ROF, and gut symptoms were evaluated with Wilcoxon signed-rank tests. GPS data and hunger, satiety, and fullness scores were compared using within-subjects repeated measures ANOVAs.

RESULTS

No statistically significant differences were found between the conditions at any time point for HR, RPE, ROF, or gut symptoms. Significant time effects were found for two GPS variables (total distance covered and high-speed running), indicating that participants covered less distance during the second half of the scrimmages in comparison to the first half. However, there were no significant condition or condition × time interactions for GPS data. Finally, there were no condition or condition × time interactions for hunger, fullness, and satiety, though significant time effects were observed.

CONCLUSION

A MM meal consumed 4 h prior to 70 min of soccer competition does not increase gut symptoms and can be similarly ergogenic as a HCHO meal.