Table_1_The Effects of Menstrual Cycle Phase on Elite Athlete Performance: A Critical and Systematic Review.XLSX

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.

研究背景：在精英运动员群体中，训练个体化策略被广泛推荐用于优化竞技表现。既往研究已证实，激素波动会对女性运动员的多项竞技表现参数产生影响。尽管将月经周期（Menstrual Cycle，MC）阶段作为个性化训练策略的考量参数实属必要，但仍需针对精英运动员群体中此类影响的系统性证据展开评估。
研究目的：系统梳理已发表的、探究精英女性运动员月经周期（MC）阶段与竞技表现之间关联的文献。本研究的核心目标是明确现有研究是否已达成共识，从而能够基于证据提出适配月经周期阶段的个性化训练建议。
研究方法：本系统综述遵循《系统综述与Meta分析首选报告条目》（Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA）规范。检索了3个主要的学术文献数据库，检索时限为建库至2020年11月3日。纳入的研究需聚焦于精英运动员至少一个月经周期阶段内的生理或心理参数变化的影响。
研究结果：本次检索共得到780条结果，另手动补充了既往参考文献库中的26篇文献。最终对662篇论文进行了全文审阅，其中218项研究符合纳入标准。在这些研究中，仅7项（占比1%）精准探究了至少一个月经周期阶段内的竞技或身体参数变化的影响。这7项研究共纳入314名精英女性受试者，平均年龄为20.58±1.91岁。其中3项研究采用访谈、问卷或报告前瞻性分析的方法；4项研究开展了多项竞技表现测试或纳入了身体指标测量，但仅2项研究在训练期间或比赛赛前/比赛期间完成了测试。7项研究中，5项通过血液、唾液或尿液采样开展了激素检测；剩余2项则依赖运动员的月经日记记录。现有证据表明，月经周期与部分竞技表现相关结局之间存在可变关联，例如耐力或力量耐力、韧带刚度、决策技能、心理状态或竞技意识。
研究结论：精英女性运动员的多项运动表现相关参数会在月经周期内发生变化，但具体涉及的参数、影响的程度与方向目前尚无定论。当前亟需开展纵向前瞻性研究，系统性监测赛场竞技表现参数，从而能够为精英女性运动员制定基于月经周期的个性化训练建议。