Effects of the menstrual cycle on exercise performance

This article reviews the potential effects of the female steroid hormone fluctuations during the menstrual cycle on exercise performance. The measurement of estrogen and progesterone concentration to verify menstrual cycle phase is a major consideration in this review. However, even when hormone concentrations are measured, the combination of differences in timing of testing, the high inter- and intra-individual variability in estrogen and progesterone concentration, the pulsatile nature of their secretion and their interaction, may easily obscure possible effects of the menstrual cycle on exercise performance. When focusing on studies using hormone verification and electrical stimulation to ensure maximal neural activation, the current literature suggests that fluctuations in female reproductive hormones throughout the menstrual cycle do not affect muscle contractile characteristics. Most research also reports no changes over the menstrual cycle for the many determinants of maximal oxygen consumption (VO2max), such as lactate response to exercise, bodyweight, plasma volume, haemoglobin concentration, heart rate and ventilation. Therefore, it is not surprising that the current literature indicates that VO2max is not affected by the menstrual cycle. These findings suggest that regularly menstruating female athletes, competing in strength-specific sports and intense anaerobic/aerobic sports, do not need to adjust for menstrual cycle phase to maximise performance. For prolonged exercise performance, however, the menstrual cycle may have an effect. Even though most research suggests that oxygen consumption, heart rate and rating of perceived exertion responses to sub-maximal steady-state exercise are not affected by the menstrual cycle, several studies report a higher cardiovascular strain during moderate exercise in the mid-luteal phase. Nevertheless, time to exhaustion at sub-maximal exercise intensities shows no change over the menstrual cycle. The significance of this finding should be questioned due to the low reproducibility of the time to exhaustion test. During prolonged exercise in hot conditions, a decrease in exercise time to exhaustion is shown during the mid-luteal phase, when body temperature is elevated. Thus, the mid-luteal phase has a potential negative effect on prolonged exercise performance through elevated body temperature and potentially increased cardiovascular strain. Practical implications for female endurance athletes may be the adjustment of competition schedules to their menstrual cycle, especially in hot, humid conditions. The small scope of the current research and its methodological limitations warrant further investigation of the effect of the menstrual cycle on prolonged exercise performance.     

Effects of different types of respiratory muscle training on exercise performance in runners

To compare two different types of respiratory muscle training on exercise performance, a protocol was devised consisting of a combination of a 4-week, 12-session resistive respiratory muscle training (RRMT) followed by a 4-week, 12-session voluntary isocapnic hyperpnea training (VIHT) and conducted in experienced runners (4 men, 4 women). Measurements before and 5 days after training included: pulmonary function (spirometry), maximal inspiratory and expiratory mouth pressures, respiratory endurance time, maximal oxygen uptake (V(o2)max), running time to voluntary exhaustion at 80% V(o2)max, blood lactate concentration, and minute ventilation. There were no statistically significant differences in pulmonary functions and V(o2)max post-RRMT and post-VIHT compared to pre-RMT. Following RRMT the inspiratory muscle strength had improved by 23.8 +/- 30% and 18.7 +/- 21.4% at rest and immediately after the running test, respectively. RRMT did not increase the time intense voluntary isocapnic ventilation could be maintained during rest while VIHT increased it (237 +/- 207.8%). The duration of the endurance run was extended 17.7 +/- 6.5% after RRMT and 45.5 +/- 14.3% after VIHT.     

Effects of sodium citrate ingestion before exercise on endurance performance in well trained college runners

OBJECTIVE: To test the hypothesis that sodium citrate administered two hours before exercise improves performance in a 5 km running time trial. METHODS: A total of 17 male well trained college runners (mean (SD) O(2)MAX 61.3 (4.9) ml/kg/min) performed a 5 km treadmill run with and without sodium citrate ingestion in a random, double blind, crossover design. In the citrate trial, subjects consumed 1 litre of solution containing 0.5 g of sodium citrate/kg body mass two hours before the run. In the placebo trial, the same amount of flavoured mineral water was consumed. RESULTS: The time required to complete the run was faster in the citrate trial than the placebo trial (1153.2 (74.1) and 1183.8 (91.4) seconds respectively; p = 0.01). Lower packed cell volume and haemoglobin levels were found in venous blood samples taken before and after the run in the citrate compared with the placebo trial. Lactate concentration in the blood sample taken after the run was higher in the citrate than the placebo trial (11.9 (3.0) v 9.8 (2.8) mmol/l; p<0.001), and glucose concentration was lower (8.3 (1.9) v 8.8 (1.7) mmol/l; p = 0.02). CONCLUSION: The ingestion of 0.5 g of sodium citrate/kg body mass shortly before a 5 km running time trial improves performance in well trained college runners.     

Influence of the menstrual cycle phase and menstrual symptoms on maximal anaerobic performance

PURPOSE: This study was designed to analyze the effect of the menstrual cycle phase on maximal anaerobic performance during short-term anaerobic tests. METHODS: Seven eumenorrheic women (NOC) and 10 women using monophasic oral contraceptives (OC) performed three anaerobic tests (force-velocity, multi-jump, and squatting jump tests) during menstruation (M: between days 1 and 4), the midfollicular phase (F: between days 7 and 9), and the midluteal phase (L: between days 19 and 21) of the ovarian cycle. Follicular and luteal phases were confirmed by serum progesterone levels. The order of testing sessions was randomly assigned and a 15-min standardized warm-up preceded each testing session. Rectal temperatures were taken before (Trec(b)) and after (Trec(a)) warm-up. RESULTS: No significant differences were observed among M, F, and L in Trec(b), Trec(a) maximal cycling power (Pmax(c)), maximal jumping power (Pmax(j)), or maximal height of jump (h(j)) in either NOC or OC. Ten of the women suffered premenstrual or menstrual symptoms (MS); the other seven did not report any premenstrual or menstrual discomfort (NMS). Presence or absence of symptoms was not correlated with oral contraceptive use. No significant differences were observed among the three stages of the menstrual cycle in Pmax(c), Pmax(j), or h(j) in NMS. In MS, only Pmax(j) decreased by 8% in M compared with that in F (P < 0.05). CONCLUSIONS: Although there were no significant differences in maximal anaerobic performance during different menstrual cycle phases, results of this study suggest that the presence or absence of premenstrual or menstrual syndrome symptoms may have an effect, possibly through an action on the stretch-shortening cycle of tendons and ligaments.     

Effects of unaccustomed and accustomed exercise on the immune response in runners

PURPOSE: To test the hypothesis that long-term immunological response may be different after accustomed concentric and unaccustomed eccentric exercise in endurance-trained men. METHODS: Fourteen highly endurance-trained male runners performed two bouts of high-intensity exercise with at least 2-wk intervals between bouts. Concentric exercise consisted of a 60-min level run with a targeted heart rate of 80% VO2 peak. Eccentric exercise was conducted lying on a specially designed exercise rack, eliciting eccentric action of the musculus quadriceps femoris. Blood samples were taken before and 1, 6, 24, 72, and 144 h after exercise to determine creatine kinase (CK), C-reactive protein (CRP), and interleukin-6 (IL-6). Lymphocyte subset distribution was assessed using flow cytometry. RESULTS: We found a significant (P < 0.05) increase of CD4 (eccentric: 17%; concentric: 20%), CD3+/CD4+ (16 vs 19%), CD25+ (45 vs 29%), CD25+/CD4+ (27 vs 50%), HLA-DR+ (20 vs 15%), HLA-DR+/CD4+ (16 vs 67%), and CD19+/CD45+ (52 vs 103%) positive lymphocytes 1 h after both exercise bouts. However, eccentric exercise resulted in a significantly higher and longer (6 h) increase of CD25+/CD4+ and HLA-DR+/CD8+ lymphocytes and a peak increase of CK at 72 h. IL-6 and CRP increased only after concentric exercise within the first 24 h. Both exercises resulted in a decrease of monocyte activation (LFA-1: CD18+/CD11a+) after 6 h, with an increase for the eccentric exercise part after 24 h (P < 0.05). CONCLUSION: Accustomed concentric exercise mainly induced an acute-phase response, with increased CRP, IL-6, and activation of CD4 lymphocyte subsets. Unaccustomed eccentric exercise provided a delayed increase in CK and activation of monocytes and CD4+ and CD8+ subsets. Therefore, the immunological reaction depends not only on the type of contraction but also on the adaptation to the exercise.     

Effects of acute exercise on plasma erythropoietin levels in trained runners

PURPOSE: The purpose of this study was to investigate further the influence of exercise on erythropoietin. METHODS: We observed the effects of high intensity running on plasma erythropoietin concentration in competitive distance runners. A repeated measures design was used to compare the responses of intermittent high intensity (HIGH) exercise to continuous moderate intensity (MOD) exercise and rest (REST). The HIGH treatment consisted of 60 min of exercise alternating 5 min of running at approximately 90% of VO2max with 5 min of brisk walking. The MOD treatment consisted of a continuous 60-min run on the treadmill at 60% of VO2max. Blood samples were collected immediately before the exercise (PRE), immediately following the exercise (POST), and 4 (heart rate (4HR), 12 (12HR), 24 (24HR), and 48 (48HR)) h following the exercise. The variables examined included plasma erythropoietin concentration ([EPO]), hemoglobin (Hb) concentration ([Hb]), hematocrit (Hct), red blood cell count (RBC), and mean corpuscular volume (MCV). RESULTS: ANOVA revealed the expected treatment-by-time interaction for Hct and [Hb] suggesting a hemodilution at 24 and 48 h postexercise for the MOD and HIGH treatments. However, no significant treatment-by-time interactions were observed for [EPO], RBC, or MCV. CONCLUSION: These results indicate that intermittent high intensity exercise does not have a significant effect on [EPO] in trained distance runners.     

Cortisol levels during prolonged exercise: the influence of menstrual phase and menstrual status.

The purpose of this study was to determine the influence of menstrual phase and menstrual status on the cortisol response during 90 minutes of treadmill running at 60% VO2max. Eight eumenhorrheic athletes were tested in the early follicular (EF) (day 3-5), late follicular (LF) (day 13-15) and mid-luteal (ML) (day 22-24) phases. Six amenorrheic athletes were tested on two separate occasions. The resting cortisol levels were similar in each menstrual phase and overall a decreasing pattern of cortisol response to exercise was observed in all menstrual phases (P greater than .05). The amenorrheic athletes had a significantly greater (P less than .01) pattern of cortisol response than was observed in eumenorrheic athletes. The net increment in cortisol levels during exercise were distinctly greater (P less than .01) in amenorrheic than eumenorrheic athletes (amenorrheic: 413.8 +/- 113.1, eumenorrheic: EF: -482.8 +/- 88.3, LF: -311.8 +/- 102.1, ML: -386.3 +/- 146.2 nmol.l-1). In conclusion the cortisol levels are independent of menstrual phase. Also a larger cortisol increment is observed in amenorrheic athletes in response to prolonged submaximal exercise. The elevated cortisol levels in amenorrheics at rest and throughout exercise provides further evidence that disturbances in the hypothalamic-pituitary-adrenal function are associated with exercise-induced amenorrhea, although the site(s) of physiological disturbance have not been identified.     

Trabecular bone density and menstrual function in women runners

Osteoporosis results in decreased bone mineral mass and reduced trabecular bone density. Although its etiology remains unknown, studies have revealed differential changes in the bone mineral densities of postmenopausal women, anorexic women, and amenorrheic female athletes. Correlations have also been made between estrogen deficiency and osteoporosis in both premenopausal and postmenopausal women. In order to examine the possibility of osteopenia, a group of 36 female runners between the ages of 15 and 44 years were evaluated for bone mineral density, menstrual function, and dietary habits. Serum calcium, phosphorus, and parathyroid hormone (PTH) levels were also determined for each participant, as were complete blood counts. Using dual photon absorptiometry, all participants underwent a 20 minute scan of the lumbar spine with specificity to the L1-14 vertebrae. The 36 subjects included 19 oligomenorrheic and 17 eumenorrheic women. Results of bone density analyses revealed that the oligomenorrheic runners had significantly lower calibrated bone mineral density (CBMD) than their eumenorrheic counterparts (P less than or equal to 0.01). Likewise, the PTH levels of the oligomenorrheic runners were also significantly lower (P less than or equal to 0.01). Analysis of dietary logs revealed no significant differences between the dietary habits, the calcium intake, or the caloric intake of the two groups. The data from this study indicate that there is a relationship between reduced serum PTH levels and the oligomenorrheic state. The loss of the protective effect of estrogen in the oligomenorrheic runners possibly contributed to their reduced bone mineral densities and could be a contributing factor in osteopenia.     

Bone mineral content and menstrual regularity in female runners

The relationship between bone mineral content and menstrual regularity in 10 amenorrheic runners (0-3 menses during the past year), 12 runners with regular menstrual cycles (10-12 menses during the past year), and 15 non-athletic women with regular menstrual cycles was investigated. Comparisons of the two groups of runners indicated no significant differences in body fatness, average weekly running distance, or average daily intake of calcium (Ca), phosphorus (P), and Ca/P ratios. Mean bone mineral content for the three groups, measured by photon absorptiometry, was 0.508, 0.529, and 0.544 g X cm-2, respectively, at 3 cm distal radius, and 0.707, 0.700, and 0.707 g X cm-2, respectively, at one-third distal radius, indicating no significant differences among the groups (P less than 0.05). However, a significant relationship (r = 0.77) was noted between bone mineral content and body fatness only in the amenorrheic runners. Within the amenorrheic population, the five thinnest runners had significantly lower mean bone mineral content values at 3 cm distal radius (0.457 g X cm-2) than the five runners with higher relative body fatness (0.559 g X cm-2). We conclude, therefore, that amenorrhea, independent of body composition, was not related to reduced bone mineral content in female runners. However, the combination of excessive thinness and amenorrhea may, in fact, predispose female athletes to reduced bone mass.     

The impact of exercise modality and menstrual cycle phase on circulating cardiac troponin T

ObjectivesIt is unclear whether exercise modality (moderate-intensity continuous [MCE]; high-intensity interval [HIE]) and menstrual cycle phase (follicular [FP]; luteal [LP]), individually or in combination, mediate the commonly observed exercise-induced elevation in cardiac troponin T (cTnT). This study examines cTnT responses to MCE and HIE during both the FP and LP.DesignRandomised crossover study.MethodsSeventeen healthy, eumenorrheic women completed four trials including MCE (60% VO_2max steady-state cycling until 300 kJ) and work‐equivalent HIE (repeated 4-min cycling at 90% VO_2max interspersed with 3-min rest) during both the FP and LP. The FP and LP were verified based on ovarian hormones. Serum cTnT was assessed using a high-sensitivity assay before, immediately after, and 1 (1HR), 3 (3HR) and 4 (4HR) hours after exercise. cTnT values were corrected for plasma volume changes.ResultscTnT was significantly elevated (p < 0.05) post-exercise in both MCE (at 3HR and 4HR) and HIE (at 1HR, 3HR and 4HR). No statistically significant difference (p > 0.05) in peak post-exercise cTnT, which mostly occurred at 3HR, was seen among the four trials (median [range], ng l⁻¹: 5.2 [1.7–18.1] after MCE during FP; 4.8 [1.7–24.9] after MCE during LP, 8.2 [3.9–24.8] after HIE during FP and 6.9 [1.7–23.1] after HIE during LP).ConclusionsA single 300 kJ bout of both MCE or HIE resulted in a significant post-exercise increase in cTnT, with no differences in peak cTnT response between menstrual cycle phases or between exercise modes, but the cTnT elevation occurs slightly earlier after HIE.     

Effects of exercise training on the menstrual cycle: existence and mechanisms

This review evaluates the status of the evidence that exercise training affects the menstrual cycle beginning with evidence for the existence of delayed menarche, amenorrhea, and luteal suppression in athletes. A later age of menarche and a higher prevalence of amenorrhea and luteal suppression have been observed in athletes, but there is no experimental evidence that athletic training delays menarche, and alternative sociological and statistical explanations for delayed menarche have been offered. Cross-sectional studies of amenorrheic athletes have revealed abnormal reproductive hormone patterns, suggesting that the GnRH pulse generator in the hypothalamus is failing to initiate normal hypothalamic-pituitary-ovarian function. Longitudinal data show that the abrupt initiation of a high volume of aerobic training can disrupt the menstrual cycle in at least some women, but these women may be more susceptible to reproductive disruption than others, and some aspect of athletic training other than exercise (such as caloric deficiency) may be responsible for the observed disruption. Luteal suppression may be an intermediate condition between menstrual regularity and amenorrhea in athletes, or it may be the endpoint of a successful acclimation to exercise training. A potential endocrine mechanism of menstrual disruption in athletes involving the hypothalamic-pituitary-adrenal axis is discussed. Finally, promising future directions for research on this topic are described.     

The effect of amenorrhea on calcaneal bone density and total bone turnover in runners.

To examine in athletes the effect of long-term amenorrhea on the skeleton, measurements of calcaneal density and whole body retention of 99mTc-imidodiphosphate were made in 42 women who could be allocated to one of 3 groups defined by their level of physical activity and by menstrual status. There was no difference in bone density between eumenorrheic normoactive females and either eumenorrheic or amenorrheic athletes. However, calcaneal density was significantly greater for each group than for previously measured sedentary controls. Total body bone turnover was greater in both eumenorrheic and amenorrheic athletes than in eumenorrheic normoactive women. Sustained, intense physical activity does not significantly increase calcaneal bone density over and above the increase associated with normal levels of activity. This is despite a significant increase in the rate of total body bone mineral turnover.     

Nutritional, physiological, and menstrual status of distance runners

Amenorrheic runners (AR; N = 8), regularly menstruating runners (RMR; N = 9), and regularly menstruating sedentary controls (RMSC; N = 7) were compared for plasma progesterone levels, plasma lipid levels, menstrual cycle characteristics, physical characteristics, and nutritional adequacy to determine whether exercise training was the major factor associated with menstrual cycle disturbances. Plasma progesterone levels were significantly lower in the AR group subjects than those found during either the follicular or luteal phases of the menstrual cycle for either the RMR or the RMSC subjects. The RMR subjects had a shorter luteal phase length relative to their cycle length than did the RMSC subjects. The AR subjects consumed significantly less fat, red meat, and total calories than did the RMR subjects, while the RMSC subjects consumed significantly less total calories than did the RMR subjects. Serum LDL-C was significantly higher in the AR subjects when compared to that of the RMR subjects, while serum HDL-C was significantly higher for both the AR and RMR subjects when compared to that obtained for the RMSC subjects. The nutritional inadequacy would appear to separate the AR from the RMR, and, thus, the exercise training performed by the athletes at the time of the present investigation alone does not appear to be the major factor associated with athletic amenorrhea.     

Effects of erythropoietin abuse on exercise performance

The present review provides a comprehensive overview on the erythropoietic and non-erythropoietic effects of rHuEpo on human sport performance, paying attention to quantifying numerically how rHuEpo affects exercise performance and describing physiological changes regarding the most important exercise variables. Much attention has been paid to treatment schedules, in particular, to assess the effects of microdoses of rHuEpo and the prolonged effects on sport performance following withdrawal. Moreover, the review takes into account non-erythropoietic ergogenic effects of rHuEpo, including cognitive benefits of rHuEpo. A significant increase in both Vo2max and maximal cycling power was evidenced in studies taken into account for this review. rHuEpo, administered at clinical dosage, may have significant effects on haematological values, maximal and submaximal physiological variables, whereas few reports show positive effects on exercise perfomance. However, the influence of micro-dose rHuEpo on endurance performance in athletes is still unclear and further studies are warranted.     

Effects of diltiazem and atenolol on exercise performance in man

The effects of diltiazem and atenolol on exercise performance were studied in 9 healthy and physically fit volunteers according to a double-blind cross-over design. All subjects performed, with an interval of 1 week, 3 exercise tests on a treadmill with stepwise increase of the workload until exhaustion. Two hours prior to each exercise test they received in a randomised order placebo, diltiazem 120 mg or atenolol 100 mg. Running time and VO2peak were not influenced by diltiazem, while running time was significantly reduced (-10%) after atenolol. The reduction of VO2peak (-9%) after atenolol did not reach statistical significance. Both diltiazem and atenolol significantly decreased heart rate at peak effort but the decrease was much more pronounced after atenolol (-52 b.min-1) than after diltiazem (-6 b.min-1). At submaximal level VO2 was not influenced by diltiazem, but significantly lowered (-6%) after atenolol. Submaximal heart rate was decreased and plasma lactate concentration was increased by both diltiazem and atenolol, but the effect of atenolol was more pronounced. The study shows that maximal work performance of young healthy subjects is not affected by diltiazem 120 mg, in contrast to atenolol 100 mg which decreases maximal work performance in the same subjects.     

Running performance in middle-school runners

AIM: This study examined the relationship of 3-km run time to indices of aerobic and anaerobic ability in 9 male runners (13.4+/-0.6 years, mean+/-SD). METHODS: Anthropometric measurements were made, and an exercise test to determine running economy at 187 m x min(-1) and (.-)VO(2max) were assessed on a treadmill. On a separate day, 2 55-m sprints followed by a 3-km run were performed on a 200-m indoor track. Capillary blood samples were obtained from a finger tip immediately after the run to determine blood lactate level. Fractional utilization (%(.-)VO(2max) used during the 3-km run) was calculated. Correlations were used to examine the relationship between run time and the physiological measurements. RESULTS: Mean values for (.-)VO(2), HR and RER at maximal exercise were 61.7+/-4.4 ml x kg(-1)xmin(-1), 198.9+/-6.7 b x min(-1), and 1.16+/-0.04, respectively. The average time to run 3 km was 13.27+/-0.97 min (90.1+/-7.2% of (.-)VO(2max)). Post-run blood lactate level was 8.3+/-3.2 mmol x L(-1) and was significantly related (r=-0.73, p=0.02) to 3-km time. Fractional utilization tended to be related (r=-0.56, p=0.12) to time. CONCLUSIONS: In this age group the ability to run at a high percentage of (.-)VO(2max) and tolerate a high blood lactate appear to be important determinants of running performance in young male runners.     

Substrate oxidation and GH responses to exercise are independent of menstrual phase and status.

The purpose of this study was to determine the extent to which growth hormone (GH) and energy substrate utilization are influenced by basal sex steroid levels during prolonged submaximal exercise across menstrual phase and status. Also the 17 beta-estradiol (E2) and progesterone responses during prolonged exercise were compared according to menstrual phase and menstrual status. Six amenorrheic (AMc) athletes and seven eumenorrheic (EUc) athletes ran at 60% VO2max for 90 min and serial blood samples were taken at rest, every 10 min throughout exercise, and 5 and 15 min post-exercise. The EUc athletes were tested in the early follicular phase (EF) (days 3-5), the late follicular phase (LF) (days 14-16) and the mid-luteal phase (ML) (days 22-25). The incremental GH response to exercise, measured by area under the curve, was consistent with previous reposts and was not altered according to menstrual phase or status (EF-37.5 +/- 11.5, LF-61.9 +/- 11.5, ML-48.1 +/- 12.8 micrograms.1-1.90 min-1). Furthermore, carbohydrate and fat utilization during exercise were not influenced by basal sex steroid levels associated with menstrual phase or status. The incremental E2 response to exercise in AMc athletes was significantly smaller than seen in EUc athletes (AMc-208.1 +/- 44.0, EF-383.0 +/- 116.4, LF-204.7 +/- 84.1, ML-45.1 +/- 18.4 pmol.1(-1).90 min-1), although the pattern of release is similar between groups. In conclusion, GH levels and substrate utilization are independent of both menstrual phase and status; hence, menstrual phase has no negative ramifications on metabolism during exercise. Amenorrhea does not result in metabolic consequences during prolonged exercise by influencing substrate utilization.     

The menstrual cycle and exercise: performance, muscle glycogen, and substrate responses

Six eumenorrheic females (age = 26.3 +/- 2.4 yrs; X +/- SE) exercised until exhaustion (EE; 70% VO2max) at the midluteal (LP, 7-8 days after ovulation) and midfollicular (FP, days 7-8) phases of their menstrual cycles. Phases were confirmed by estradiol and progesterone concentrations. Each EE test was preceded by a depletion exercise bout (DE; 90 min, 60% VO2max and 4 x 1 min, 100% VO2max) and 3 days of rest/diet control. Muscle biopsies 1% (vastus lateralis) were taken post-DE, pre-EE, and post-EE and then analyzed for glycogen content. There was a strong tendency (P less than 0.07) for EE duration to be greater during LP (139.2 +/- 14.9 min) than FP (126 +/- 17.5 min). Glycogen repletion (pre-EE minus post-DE) following DE was greater (P = 0.05) during the LP than FP (88.2 +/- 4.7 vs 72.8 +/- 5.7 mumol/g w. w. muscle). However, EE glycogen utilization (pre-EE minus post-EE/EE time) did not differ between phases (LP = 0.41 +/- 0.08 mumol/g w. w. muscle/min vs FP = 0.33 +/- 0.11 mumol/g w. w. muscle/min; P = 0.17). The results suggest that exercise performance and muscle glycogen content are enhanced during the LP of the menstrual cycle. These findings imply athletic performance may be affected by the phases of the menstrual cycle.