Menstrual Cycle Effects on Performance Parameters in Female Football Players: A Systematic Review

The aim of this systematic review was to investigate the influence of menstrual cycle (MC) phases on performance-determining parameters in female football players.

A systematic search was conducted in PubMed and SPORTDiscus (last updated January 2026) following PRISMA guidelines. Studies were eligible if they included eumenorrheic female football players and assessed at least one quantitative performance outcome across 2 or more defined MC phases. Outcomes were categorized into aerobic performance (eg, total running distance, Yo-Yo tests), sprint and high-intensity running, and agility and power-related parameters (eg, jumps, change in direction). Methodological quality and MC phase verification were assessed using a modified version of an existing quality tool. Outcomes were synthesized using a structured, domain-based comparison across MC phases. This review was not registered.

Fifteen prospective observational studies (total n = 210) met inclusion criteria. Evidence for MC phase effects on performance was inconsistent. Five studies reported reduced aerobic and/or sprint performance in the early follicular phase compared with the late follicular or mid-luteal phases, while 10 studies found no differences. No consistent effect of MC phase was observed on agility and power-related outcomes. Methodological limitations across studies included small sample sizes, inconsistent MC phase verification, and variability in performance tests.

Current evidence suggests that aerobic and sprint performance may be slightly impaired during the early follicular phase in female football players, but findings remain inconclusive. Standardized protocols and hormonal confirmation of MC phases are needed to clarify the impact of hormonal fluctuations on sport-specific performance.