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Ventilation differences in the menstrual cycle: A systematic review and meta-analysis.
Catherine A Rattley1, Paul Ansdell2, Louise Burgess1
1Department of Rehabilitation and Sport Sciences, Faculty of Health and Social Science, Bournemouth University, Bournemouth, UK.
Respiratory Physiology & Neurobiology
|July 2, 2025
Summary
Minute ventilation (V̇E) is lower in the follicular phase than the luteal phase during rest and submaximal exercise. Progesterone changes explain some V̇E differences during exercise, but hormonal influence is minimal at maximal intensities.
Area of Science:
- Exercise Physiology
- Reproductive Endocrinology
- Respiratory Physiology
Background:
- Minute ventilation (V̇E) may fluctuate across the menstrual cycle due to sex hormone variations.
- These hormonal changes might influence V̇E in an exercise intensity-dependent manner.
Purpose of the Study:
- To systematically review and meta-analyze differences in V̇E, respiratory frequency (RF), and tidal volume (VT) between the follicular and luteal phases.
- To assess these differences at rest, during submaximal exercise (≤90% V̇O2max), and at maximal exercise (100% V̇O2max).
Main Methods:
- Systematic review and meta-analysis adhering to PRISMA guidelines.
- Included healthy, eumenorrheic females not using hormonal contraceptives.
- Searches conducted in Cochrane, PubMed, and EBSCO; quality assessed using modified Downs and Black checklist.
- Meta-analyses and meta-regressions used to analyze V̇E, RF, and VT, with intensity, duration, and progesterone change as moderators.
Main Results:
- 35 studies (743 participants, 64 datasets) were included.
- V̇E was significantly lower in the follicular phase than the luteal phase at rest (p<0.001) and during submaximal exercise (p<0.001).
- Progesterone change significantly predicted V̇E during submaximal exercise (p=0.02), but not at rest (p=0.07). Minimal effects on RF and VT were observed.
Conclusions:
- The menstrual cycle significantly impacts V̇E, with lower values during the follicular phase.
- Progesterone partially explains V̇E variations during exercise, but not at rest.
- Hormonal influence on V̇E is minimal at maximal exercise intensities, suggesting physiological factors dominate.
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