Evidence mapPaperPMID 41978194Full record

ReviewNutrients2026

Menstrual Cycle and Hormonal Contraceptives in Female Athletes: Should Symptoms and Nutrition Matter More than Cycle Phase? A Narrative Review.

Valentina Natalucci, Gioi Spinello, Tatiana Moro, Gaspare Pavei, Gennaro Boccia, Antonio La Torre, Matteo Bonato

Abstract readReview
In one paragraph

Review in Nutrients, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Valentina NatalucciDepartment of Experimental and Clinical Medicine, Università Politecnica delle Marche, 60126 Ancona, Italy.ORCID 0000-0002-0582-1575
Gioi SpinelloDepartment of Biomedical Sciences, University of Padova, 35131 Padova, Italy.ORCID 0009-0002-3134-6066
Tatiana MoroDepartment of Biomedical Sciences, University of Padova, 35131 Padova, Italy.ORCID 0000-0002-1404-1511
Gaspare PaveiDepartment of Pathophysiology and Transplantation, University of Milan, 20133 Milan, Italy.ORCID 0000-0002-0109-4964
Gennaro BocciaItalian Athletics Federation (FIDAL), 00191 Rome, Italy.ORCID 0000-0001-8706-4098
Antonio La TorreItalian Athletics Federation (FIDAL), 00191 Rome, Italy.ORCID 0000-0002-4987-2024
Matteo BonatoDepartment of Biomedical Sciences for Health, University of Milan, 20122 Milan, Italy.ORCID 0000-0002-5589-7957

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUnderstanding how endogenous hormonal fluctuations and exogenous hormonal modulation influence exercise-related outcomes in women is essential for developing individualized and evidence-informed training and nutritional strategies. This narrative review summarizes the endocrine physiology of the eumenorrheic menstrual cycle and hormonal contraceptive (HC) use and critically examines their implications for athletic performance, neuromuscular function, injury risk, and metabolic regulation in physically active women.

methodsA non-systematic literature search was conducted in PubMed, Scopus, and Web of Science for articles published up to January 2026. Search terms combined menstrual cycle-related, hormonal contraceptive, performance, and metabolic/nutritional keywords, and relevant studies were selected based on their relevance to the scope of this narrative review.

resultsEstradiol and progesterone fluctuations may modulate substrate utilization, connective tissue properties, central fatigue regulation, and symptom expression; however, evidence indicates that performance-related effects across menstrual phases are generally small and inconsistent, reflecting both the modest magnitude of physiological effects and the methodological heterogeneity in menstrual cycle phase classification and verification across studies. Similarly, although HC use suppresses endogenous hormonal variability, current findings do not support consistent benefits for performance, injury prevention, or metabolic outcomes, and responses remain heterogeneous. From a nutritional perspective, the endocrine context may contribute to modest changes in energy expenditure, insulin sensitivity, appetite regulation, inflammation, and recovery-related processes. Importantly, symptom burden-including pain, fatigue, sleep disturbances, gastrointestinal discomfort, and fluid retention-emerges as a practical driver of day-to-day training tolerance.

conclusionsWe propose an integrative framework in which sex hormones define a physiological context rather than deterministic performance regulators, while nutrition acts as a key modifiable factor influencing metabolic responses, symptom severity, and performance consistency.

Indexed as

AthletesAthletic PerformanceContraceptive Agents, HormonalContraceptives, Oral, HormonalMenstrual CycleNutritional StatusEnergy MetabolismFemaleHumansContraceptive Agents, HormonalContraceptives, Oral, Hormonalathletic performancefemale athleteshormonal contraceptivesinjury riskmenstrual cyclemetabolismneuromuscular functionnutritionsymptom monitoring

Identifiers

PMID41978194
PMCPMC13074237

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.