The influence of sex hormones and the menstrual cycle on women's athletic performance: A literature review.

The cyclical nature of female sex hormones - primarily estradiol and progesterone - exerts a multidimensional influence on physiological processes relevant to sports performance. This narrative review summarizes the current understanding of how different phases of the menstrual cycle affect energy metabolism, cardiovascular dynamics, neuromuscular function, thermoregulation, and psychological responses in physically active women. Estrogen-dominant phases, especially the late follicular stage, are generally associated with enhanced aerobic capacity, improved vasodilation, mood stabilization, and more efficient motor control. Conversely, progesterone-dominant phases - most notably the mid-to-late luteal stage - are characterized by increased core temperature, fluid retention, fatigue, and greater reliance on carbohydrate metabolism. The review also evaluates the effects of hormonal contraceptives, particularly oral contraceptives, on athletic performance and training adaptations. While individual responses vary, hormonal fluctuations create predictable patterns of performance variability that can be leveraged through phase-aware training. Based on the reviewed literature, the paper suggests practical training strategies, including phase-specific adaptations, nutritional support, and attention to menstrual symptoms. The review further highlights methodological limitations in the literature, including small sample sizes, inconsistent hormone validation, and underrepresentation of elite athletes. A personalized understanding of menstrual physiology enables more effective planning of training loads and recovery strategies, benefiting both professional and recreationally active women.