UNLABELLED: The literature has extensively investigated potential factors influencing women's performance, including the menstrual cycle and the circadian rhythm. However, review articles exploring the combined influence of both factors remain lacking in the literature. The study aimed to systematically review the literature on the relationship between the circadian rhythm and menstrual cycle on physical performance in women. The review followed the PRISMA guidelines. The search was performed on the Web of Science, PubMed, Scopus, SPORTDiscus, and Google Scholar databases. Of the 1205 records identified, four articles met the inclusion criteria. From four articles, two studies found a significant interaction between the time of day and phase of the menstrual cycle with physical performance. The isometric strength increased in the afternoon in the mid-luteal phase (versus the morning in the mid-luteal phase, p < 0.05), and the maximum cycling power was higher in the afternoon in the mid-follicular phase (versus the morning in the mid-follicular phase, p < 0.01). Our findings suggest that the time of day and the menstrual cycle phase affect physical performance, with the daytime potentially having a more significant influence. However, the results should be interpreted cautiously due to the limited studies and diverse methodologies used to monitor the menstrual cycle phase. This review reinforces the need for further investigation to understand better the combined effects of the circadian rhythm and menstrual cycle on women's physical performance. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=380965, identifier CRD42022380965.

Department of Physical Activities and Health Sciences Faculty of Sports Studies Masaryk University Brno Czechia

Department of Sport Performance and Exercise Testing Faculty of Sports Studies Masaryk University Brno Czechia

See more in PubMed

Adan A., Archer S. N., Paz Hidalgo M., Di Milia L., Natale V., Randler C. (2012). Circadian typology: a comprehensive review. Chronobiology Int. 29 (9), 1153–1175. 10.3109/07420528.2012.719971 PubMed DOI

Aloui K., Abedelmalek S., Chtourou H., Wong D. P., Boussetta N., Souissi N. (2017). Effects of time-of-day on oxidative stress, cardiovascular parameters, biochemical markers, and hormonal response following level-1 yo-yo intermittent Recovery test. Physiol. Int. 104 (1), 77–90. 10.1556/2060.104.2017.1.6 PubMed DOI

Astrand P. O. (1968). Physical performance as a function of age. JAMA 205 (11), 729–733. 10.1001/jama.205.11.729 PubMed DOI

Ayala V., Martínez-Bebia M., Latorre J. A., Gimenez-Blasi N., Jimenez-Casquet M. J., Conde-Pipo J., et al. (2021). Influence of circadian rhythms on sports performance. Chronobiology Int. 38 (11), 1522–1536. 10.1080/07420528.2021.1933003 PubMed DOI

Bambaeichi E., Reilly T., Cable N. T., Giacomoni M. (2004). The isolated and combined effects of menstrual cycle phase and time-of-day on muscle strength of eumenorrheic females. Chronobiology Int. 21 (4–5), 645–660. 10.1081/cbi-120039206 PubMed DOI

Bellastella G., De Bellis A., Maiorino M. I., Paglionico V. A., Esposito K., Bellastella A. (2019). Endocrine rhythms and sport: it is time to take time into account. J. Endocrinol. Investigation 42 (10), 1137–1147. 10.1007/s40618-019-01038-1 PubMed DOI

Birch K., Reilly T. (2002). The diurnal rhythm in isometric muscular performance differs with eumenorrheic menstrual cycle phase. Chronobiology Int. 19 (4), 731–742. 10.1081/cbi-120006083 PubMed DOI

Blagrove R. C., Bruinvels G., Pedlar C. R. (2020). Variations in strength-related measures during the menstrual cycle in eumenorrheic women: a systematic review and meta-analysis. J. Sci. Med. Sport 23 (12), 1220–1227. 10.1016/j.jsams.2020.04.022 PubMed DOI

Bruggisser F., Knaier R., Roth R., Wang W., Qian J., Scheer F. A. J. L. (2023). Best time of day for strength and endurance training to improve Health and performance? A systematic review with meta-analysis. Sports Med. - Open 9 (1), 34. 10.1186/s40798-023-00577-5 PubMed DOI PMC

Carmichael M. A., Thomson R. L., Moran L. J., Wycherley T. P. (2021). The impact of menstrual cycle phase on athletes’ performance: a narrative review. Int. J. Environ. Res. Public Health 18 (4), 1667. 10.3390/ijerph18041667 PubMed DOI PMC

Colenso-Semple L. M., D’Souza A. C., Elliott-Sale K. J., Phillips S. M. (2023). Current evidence shows No influence of women’s menstrual cycle phase on acute strength performance or adaptations to resistance exercise training. Front. Sports Act. Living 5, 1054542. 10.3389/fspor.2023.1054542 PubMed DOI PMC

Cook C. J., Kilduff L. P., Crewther B. T. (2018). Basal and stress-induced salivary testosterone variation across the menstrual cycle and linkage to motivation and muscle power. Scand. J. Med. Sci. Sports 28 (4), 1345–1353. 10.1111/sms.13041 PubMed DOI

Downs S. H., Black N. (1998). The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of Health care interventions. J. Epidemiol. Community Health 52 (6), 377–384. 10.1136/jech.52.6.377 PubMed DOI PMC

Elliott-Sale K. J., Minahan C. L., Janse de Jonge X. A. K., Ackerman K. E., Sipilä S., Constantini N. W., et al. (2021). Methodological considerations for studies in sport and exercise science with women as participants: a working guide for standards of practice for research on women. Sports Med. 51 (5), 843–861. 10.1007/s40279-021-01435-8 PubMed DOI PMC

Giacomoni M., Guy F. (1999). Influence of menstrual cycle phase and oral contraceptive use on the time-of-day effect on maximal anaerobic power. Biol. Rhythm Res. 30 (5), 583–591. 10.1076/brhm.30.5.583.1407 DOI

Hammouda O., Chtourou H., Chaouachi A., Chahed H., Bellimem H., Karim C., et al. (2013). Time-of-Day effects on biochemical responses to soccer-specific endurance in elite Tunisian football players. J. Sports Sci. 31 (9), 963–971. 10.1080/02640414.2012.757345 PubMed DOI

Hawkins S. M., Matzuk M. M. (2008). The menstrual cycle: basic biology. Ann. N. Y. Acad. Sci. 1135, 10–18. 10.1196/annals.1429.018 PubMed DOI PMC

Lack L., Bailey M., Lovato N., Wright H. (2009). Chronotype differences in circadian rhythms of temperature, melatonin, and sleepiness as measured in a modified constant routine protocol. Nat. Sci. Sleep 1 (11), 1–8. 10.2147/nss.s6234 PubMed DOI PMC

McNulty K. L., Elliott-Sale K. J., Dolan E., Swinton P. A., Ansdell P., Goodall S., et al. (2020). The effects of menstrual cycle phase on exercise performance in eumenorrheic women: a systematic review and meta-analysis. Sports Med. Auckl. N.Z. 50 (10), 1813–1827. 10.1007/s40279-020-01319-3 PubMed DOI PMC

Meignié A., Duclos M., Carling C., Orhant E., Provost P., Toussaint J.-F., et al. (2021). The effects of menstrual cycle phase on elite athlete performance: a critical and systematic review. Front. Physiology 12, 654585. 10.3389/fphys.2021.654585 PubMed DOI PMC

Mirizio G. G., Soares Mendes Nunes R., Vargas D. A., Foster C., Vieira E. (2020). Time-of-Day effects on short-duration maximal exercise performance. Sci. Rep. 10, 9485. 10.1038/s41598-020-66342-w PubMed DOI PMC

Ouzzani M., Hammady H., Fedorowicz Z., Ahmed E. (2016). Rayyan-a Web and mobile app for systematic reviews. Syst. Rev. 5 (1), 210. 10.1186/s13643-016-0384-4 PubMed DOI PMC

Page M. J., McKenzie J. E., Bossuyt P. M., Boutron I., Hoffmann T. C., Mulrow C. D., et al. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372, n71. 10.1136/bmj.n71 PubMed DOI PMC

Paludo A. C., Paravlic A., Dvořáková K., Gimunová M. (2022). The effect of menstrual cycle on perceptual responses in athletes: a systematic review with meta-analysis. Front. Psychol. 13, 926854. 10.3389/fpsyg.2022.926854 PubMed DOI PMC

Postolache T. T., Gulati A., Okusaga O. O., Stiller J. W. (2020). “An introduction to circadian endocrine physiology: implications for exercise and sports performance,” in Endocrinology of physical activity and sport. Editors Hackney A. C., Constantini N. W. Third Edition (Totowa, NJ, USA: Humana Press; ), 363–390. 10.1007/978-3-030-33376-8 DOI

Romero-Parra N., Cupeiro R., Alfaro-Magallanes V. M., Rael B., Rubio-Arias J. Á., Peinado A. B., et al. (2021). Exercise-induced muscle damage during the menstrual cycle: a systematic review and meta-analysis. J. Strength Cond. Res. 35 (2), 549–561. 10.1519/JSC.0000000000003878 PubMed DOI

Smith M. J., Adams L. F., Schmidt P. J., Rubinow D. R., Wassermann E. M. (2002). Effects of ovarian hormones on human cortical excitability. Ann. Neurology 51 (5), 599–603. 10.1002/ana.10180 PubMed DOI

Thompson B., Almarjawi A., Sculley D., Jonge X. J. D. (2020). The effect of the menstrual cycle and oral contraceptives on acute responses and chronic adaptations to resistance training: a systematic review of the literature. Sports Med. Auckl. N.Z. 50 (1), 171–185. 10.1007/s40279-019-01219-1 PubMed DOI

Tounsi M., Jaafar H., Aloui A., Souissi N. (2018). Soccer-related performance in eumenorrheic Tunisian high-level soccer players: effects of menstrual cycle phase and moment of day. J. Sports Med. Phys. Fit. 58 (4), 497–502. 10.23736/S0022-4707.17.06958-4 PubMed DOI

Youngstedt S. D., Elliott J. A., Kripke D. F. (2019). Human circadian phase-response curves for exercise. J. Physiology 597 (8), 2253–2268. 10.1113/JP276943 PubMed DOI PMC