Exercise and hormones in women: why your cycle shapes your training
Most training plans were developed on men. What research can honestly say today about the cycle, performance, injuries and recovery, and why your own pattern matters more than any phase chart.
A woman's body is not a small male body with background noise. It follows a rhythm. The question is not whether you can ignore that rhythm, but whether you learn to read it.
Why was I so strong last week and so empty today?
You may know the feeling. On Tuesday your interval session went as if you had wings. Ten days later, same route, same pace, and your legs feel like wet sand.
You slept well. You ate normally. You can't find a reason. So you look for it in yourself. Not enough discipline. Not enough grit. Maybe just not fit enough.
And nobody around you asks which day of your cycle you are on. Your training plan doesn't ask either. It counts in weeks, not in cycles.
An endurance athlete in her early thirties, ambitious and well organised, came to my practice with a sentence I hear often.
Her blood tests were unremarkable, her training plan well thought out. What was missing was a second timeline. Together we tracked three cycles: cycle day, energy, sleep, how training felt. When we laid them on top of each other, a pattern emerged. The hard days almost always fell in the last few days before her period and on the first day of bleeding.
She then moved hard sessions away from those days where possible, and stopped counting the slumps as failures. She reported that her training weeks felt more predictable and less frustrating to her.
I cannot claim causality, but I document the temporal association. A single case is not proof, and other factors may have played a role.
The lesson: Sometimes the missing piece of the puzzle is not a new measure, but a new way of looking.
A performance slump on a certain cycle day is not a character trait. It is information. When you write it down, a vague “I'm just bad sometimes” turns into a map you can plan with.
And now you know why the question “What's wrong with me?” is often the wrong one. The better one is: “When exactly does this happen, and does it repeat?”
What happens hormonally during the cycle
Imagine your cycle as two tides lying on top of each other. Oestrogen rises in the first half, drops shortly after ovulation and rises moderately again in the second half. Progesterone stays flat in the first half and then dominates the second half.
Neither hormone is purely a reproductive hormone. Both talk to muscles, blood vessels, ligaments, the brain, the temperature centre and metabolism. That is the basis for the idea that the cycle could influence training.
Early follicular phase
Bleeding. Oestrogen and progesterone are low. Many women experience cramps, fatigue and iron loss. In studies, performance here is on average minimally lower.
Late follicular phase
Oestrogen rises markedly. Many women feel energetic. A slightly increased ligament laxity around ovulation is under discussion.
Early and mid luteal phase
Progesterone dominates. Body temperature rises slightly, and breathing may change. Some women find exertion more demanding here.
Late luteal phase
Both hormones fall. Many women notice water retention, sleep problems and mood swings. Subjectively, often the most difficult time.
This description applies to a natural cycle with ovulation. With the combined pill, a hormonal IUD or with irregular cycles, the hormonal picture looks different. Calendar apps only estimate the phases. They do not show whether ovulation actually took place.
The KPNI perspective: four systems are listening
From the perspective of Clinical Psychoneuroimmunology, the cycle is not an isolated hormonal event. It is a pacemaker to which several systems can respond at the same time.
Hormonal system
Oestrogen and progesterone bind to receptors in muscle, tendons and ligaments. This can influence collagen metabolism, water retention and temperature regulation.
Nervous system
Progesterone breakdown products dock onto GABA receptors in the brain, the brake of the nervous system. This can change sleep, mood and the perception of effort.
Immune system
Around bleeding, local inflammatory processes take place, driven among other things by prostaglandins. This may explain cramps and can influence how recovered you feel.
Metabolism
Blood loss costs iron. Iron is a building block of haemoglobin and of enzymes in the mitochondria, meaning it is needed for oxygen transport and energy production in the cell.
Mechanistically, all of this is plausible. The exciting question is how much of it actually ends up in measurable performance. And this is exactly where it gets more interesting than many social media posts suggest.
The fact that a hormone reaches a receptor in muscle does not mean you will lift less weight because of it. There are many layers between mechanism and performance. That is not a disappointment, but an invitation to look more closely.
And now you know why the cycle touches more than just the uterus.
What the research can honestly say: small average effects, large individual differences
You may have seen plans like: “Lift heavy in the follicular phase, only yoga in the luteal phase.” That sounds logical. The question is whether the data support it.
On average, the cycle changes performance only trivially
In 2020, a British research group led by McNulty and Elliott-Sale analysed all available studies on cycle phase and performance, whether strength or endurance. In the early follicular phase, meaning during bleeding, they found on average trivially reduced performance, with a pooled effect size of minus 0.06.
They rated the quality of the evidence as low. Their conclusion: general guidelines for training across the cycle cannot be derived from this. Instead, they recommend a personalised approach based on each woman's individual response.
For you, this means: the average is flat. Your personal curve doesn't have to be.
McNulty KL et al. The Effects of Menstrual Cycle Phase on Exercise Performance in Eumenorrheic Women. Sports Med. 2020;50(10):1813-1827. DOI: 10.1007/s40279-020-01319-3In 2023, a research group from McMaster University led by Colenso-Semple and Phillips went one step further. They re-examined the existing reviews on strength training themselves. Their assessment: it is premature to conclude that short-term hormonal fluctuations meaningfully influence acute strength performance or long-term muscle growth. Above all, they criticise that many studies verified the cycle phase inadequately.
A complementary review by the same group, led by D'Souza, came to a similar picture. Differences between the cycle phases are present, but rather subtle. Their meta-analysis also found no difference between phases in the ratio of fat to carbohydrate used as fuel.
Many studies did not actually know which phase their participants were in
In 2021, an international group of authors led by Elliott-Sale published a guide for sports studies involving women. It describes how most high-quality sports science data come from studies with men.
Among other things, they call for cycle phases to be confirmed through hormone measurements and evidence of ovulation, rather than estimated from the calendar. Many older studies do not meet this standard.
For you, this means: if someone sells you an exact phase plan as scientifically established, scepticism is appropriate.
Elliott-Sale KJ et al. Methodological Considerations for Studies in Sport and Exercise Science with Women as Participants. Sports Med. 2021;51(5):843-861. DOI: 10.1007/s40279-021-01435-8The good news: research is catching up. At the Karolinska Institutet, for example, the IMPACT study is under way. There, 120 trained women are to be randomly assigned to follicular-phase-focused, luteal-phase-focused or regular training, with hormone checks in the blood. The authors themselves write that evidence is still lacking on whether cycle-based periodisation offers any benefit at all.
“No large effect on average” does not mean “no effect for you”. A meta-analysis averages women whose cycle barely changes anything with women whose cycle changes a lot. Both can be true at the same time. That is exactly why the researchers themselves recommend the individual route.
And now you know why, instead of a rigid phase plan, I prefer to recommend an observation log.
The feeling is real: symptoms as a training factor
You may be thinking: “But I can feel it.” And you are right. Performance on a lab ergometer is one thing. How you feel, how you sleep and whether you are in pain is another.
Almost all women who exercise know cycle symptoms
A research group led by Bruinvels surveyed 6812 exercising women not using combined hormonal contraception via the sports app Strava. The most frequently reported symptoms were mood changes or anxiety at 90.6 percent, fatigue at 86.2 percent, abdominal cramps at 84.2 percent and breast tenderness at 83.1 percent.
The more numerous and frequent the symptoms, the more likely it was that training was skipped or modified and competitions were missed.
For you, this means: symptoms are not imagination. They are a measurable factor in your availability to train.
Bruinvels G et al. Prevalence and frequency of menstrual cycle symptoms are associated with availability to train and compete. Br J Sports Med. 2021;55(8):438-443. DOI: 10.1136/bjsports-2020-102792The picture is similar among elite athletes. In a five-year survey of 128 British track and field athletes, 76.8 percent described their cycle as affecting their performance negatively. Of those who named a time point, 40 percent placed the slump in the late luteal phase and 35 percent in the early follicular phase. That fits my patient's story remarkably well.
Recovery could also depend on the phase. A small Spanish-Portuguese crossover study with 20 amateur female football players found greater neuromuscular fatigue and higher levels of the inflammatory messenger interleukin-6 in saliva after intense small-sided games in the mid luteal phase. However, the phases were only estimated by calendar. That is an indication, not proof.
The average of all women doesn't train. You do.
And now you know why your perception is a measurement you are allowed to take seriously.
Injury risk: the ACL, ligaments and the cycle
In sports with jumps and changes of direction, women tear their anterior cruciate ligament considerably more often than men. Hewett and colleagues speak of a three to six times higher risk in their work. Whether hormones play a role in this has occupied sports medicine for decades.
Indications of a time window, but weak evidence
In 2007, a systematic review by Hewett, Zazulak and Myer found indications in all seven included studies of more ACL injuries in the first half of the cycle, before ovulation.
Ten years later, Herzberg and colleagues analysed 21 studies with a total of 68,758 participants. Four out of five studies in women not using hormonal contraception showed the luteal phase as the phase with the weakest association with ACL injuries. Ligaments were measurably looser around ovulation than in the follicular phase. However, the authors rated the overall strength of the evidence as low.
For you, this means: an association is plausible, but not established firmly enough that you would need to avoid certain days.
Herzberg SD et al. The Effect of Menstrual Cycle and Contraceptives on ACL Injuries and Laxity: A Systematic Review and Meta-analysis. Orthop J Sports Med. 2017;5(7):2325967117718781. DOI: 10.1177/2325967117718781The most sensible consequence of these data is not to skip exercise on certain cycle days. It is to take landing technique, hip and thigh strength and coordination seriously all year round. If you feel less stable in jumping sports around ovulation, you are free to land more cleanly on purpose and take fewer risks there.
And now you know why injury prevention in women is not a calendar issue, but a training issue.
The pill and performance: does contraception make a difference?
Many female athletes use hormonal contraception. In a Danish survey of 186 elite female athletes, it was 57 percent. 60 percent of pill users reported having already shifted their cycle by taking the pill continuously, for example around competitions.
A probably trivial difference
In 2020, Elliott-Sale and colleagues compared women on the pill with women with a natural cycle across 42 studies with 590 participants.
The pill may on average be associated with slightly lower performance, but in the authors' assessment the effect was most likely trivial and varied widely between studies. Across the pill cycle itself, performance remained constant.
For you, this means: the decision for or against the pill cannot sensibly be based on athletic performance. It belongs in a gynaecological consultation.
Elliott-Sale KJ et al. The Effects of Oral Contraceptives on Exercise Performance in Women: A Systematic Review and Meta-analysis. Sports Med. 2020;50(10):1785-1812. DOI: 10.1007/s40279-020-01317-5I find one observation from the same Danish survey important: even with hormonal contraception, athletes continued to report period pain. Contraception may, however, somewhat reduce emotional symptoms. And 13 percent of all athletes said that cycle or pill symptoms sometimes or always kept them from their planned training.
And now you know why tracking symptoms remains worthwhile even on the pill.
The bigger picture: energy, iron and the cycle as a vital sign
This is the part that matters most to me in my practice. Often the cycle phase is not the problem, but something that throws the whole cycle out of rhythm.
When your period stops, that is not good form
Some athletes find it convenient when bleeding becomes less frequent with a lot of training. I see it differently. A regular cycle is something like a vital sign. It shows that your body has enough energy to afford reproduction, bone building and repair alongside training.
Relative Energy Deficiency in Sport
In 2023, the International Olympic Committee, under the lead of Mountjoy, updated its consensus on REDs. It describes a syndrome that develops when energy intake is too low relative to training expenditure.
The consequences can affect health and performance, in women and men alike. Newly emphasised are the role of low carbohydrate availability and the interplay with mental health.
For you, this means: if training goes up and eating stays the same or goes down, your cycle may be the first system to go quiet.
Mountjoy M et al. 2023 International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs). Br J Sports Med. 2023;57(17):1073-1097. DOI: 10.1136/bjsports-2023-106994The Danish survey shows how widespread this is. 51 percent of elite female athletes not using hormonal contraception had menstrual dysfunction. Among endurance athletes it was 69 percent, and a missing period was associated with a higher volume of endurance training.
Iron: the silent player in every period
With every period you lose iron. At the same time, intense training can slow down absorption. After exercise, the hormone hepcidin rises, a kind of bouncer that holds iron back in the gut and in the stores.
Training may strengthen the iron bouncer
An Australian research group led by Fensham analysed the raw data of numerous studies together. Exercise was associated with a 1.5 to 2.5-fold increase in hepcidin, peaking around three to six hours after training.
Most of the change was explained by the duration of exercise. In women, the rise was on average somewhat smaller, but the authors consider the data still too thin for comparisons between the sexes.
For you, this means: blood loss and long sessions may reinforce each other when it comes to iron.
Fensham NC et al. Factors Influencing the Hepcidin Response to Exercise: An Individual Participant Data Meta-analysis. Sports Med. 2023;53(10):1931-1949. DOI: 10.1007/s40279-023-01874-5Two papers show how common the problem is. A review led by Sim and Peeling puts iron deficiency in cohorts of female athletes at roughly 15 to 35 percent. In a Japanese study of university athletes, nobody had anaemia. Nevertheless, 22 of the 47 female athletes, or 47 percent, had a ferritin of 30 ng/ml or less. Half of the female athletes surveyed also reported a drop in performance during menstruation.
Established: iron deficiency without anaemia is common in female athletes, and a normal blood count does not rule out empty stores.
Clinical experience, without a study consensus behind it: in active women with exhaustion, I aim for a ferritin above 100. Laboratory reference limits are considerably lower. How a deficiency can be corrected, orally or by infusion, is decided individually based on the findings.
When the performance slumps around your period are especially deep, it is worth looking not only at your hormones. It is also worth looking at what leaves the body with the blood.
For me, this is where the moment of freedom in this topic lies. It is not about squeezing a few percent of performance out of one phase. It is about knowing your body so well that you no longer let it work against you. A body that is understood doesn't have to keep sounding the alarm.
And now you know why a stable cycle, enough energy and full iron stores are the foundation of every woman's training.
Overview: what is established and what remains open
| Question | What the data show today | Strength of evidence |
|---|---|---|
| Performance across phases | On average trivially lower in the early follicular phase | Low, many studies methodologically weak |
| Muscle growth across phases | No convincing difference shown | Low to moderate |
| Rigid cycle training plans | Benefit not yet shown, large studies under way | Very low |
| ACL risk | Indications pointing to the first half of the cycle and ovulation | Low |
| The pill and performance | Most likely a trivial difference | Low to moderate |
| Symptoms and missed training | Very common, clear association | Good, large surveys |
| Energy deficiency and menstrual dysfunction | Well-described association | IOC consensus |
| Iron deficiency in female athletes | Common, often without anaemia | Good |
What you can do starting today
You don't need a new training plan. You need a second timeline and a few clear warning signs.
Track three cycles
Note cycle day, energy from one to ten, sleep, symptoms and how training felt every day. Then lay the cycles on top of each other and look for repetitions.
Plan flexibly, not rigidly
If a pattern is confirmed, move hard sessions away from your personally difficult days where possible. Build in buffers instead of strictly ruling out phases.
Have the basics checked
Have a doctor test your ferritin, blood count and, if needed, further hormones. Make sure you eat enough on hard days, especially carbohydrates.
When you should see a doctor
- Your period stops for three months or longer, or becomes noticeably more irregular.
- Period pain regularly forces you to miss training or work.
- You are constantly exhausted, even though you sleep enough and have reduced your training.
- Your periods are very heavy or last unusually long.
- You have had a stress fracture or several bone problems without a clear accident.
Frequently asked questions about exercise, the cycle and hormones
Is cycle-based training worth it for women?
As a rigid scheme for all women, the evidence is currently too thin. The large meta-analysis by McNulty and colleagues, covering 78 studies, found only a trivial difference in performance, with slightly reduced performance in the early follicular phase.
The authors explicitly do not recommend a general phase plan, but a personalised approach. It can make sense to observe your own cycle and adapt your training to your personal patterns, not to a table from the internet.
In which cycle phase am I at my strongest?
That is hard to say for the average woman, and for you it can only be found through observation. In McNulty's network meta-analysis, the early follicular phase, meaning the days of bleeding, tended to come last.
But the effect was so small that in everyday life it may get lost in the noise of sleep, stress and nutrition. Some women feel strong just before ovulation, others in the middle of the second half of the cycle. Your own pattern over three to four cycles tells you more than any average curve.
Does injury risk vary across the cycle?
There are indications, but no firm answer. A systematic review by Hewett and colleagues found a higher occurrence of ACL tears in the first half of the cycle across seven studies.
A meta-analysis by Herzberg and colleagues covering 21 studies found increased ligament laxity around ovulation, but rated the overall strength of the evidence as low. For you, this means: jumping and landing technique, as well as hamstring and hip strength, make sense in every phase, not only on certain days.
Does the pill reduce athletic performance?
Probably only minimally. The meta-analysis by Elliott-Sale and colleagues, with 42 studies and 590 participants, found on average slightly lower performance in pill users compared with women with a natural cycle.
In the authors' assessment, the effect was most likely trivial and varied widely between studies. A general recommendation for or against the pill for performance reasons cannot be derived from this. The decision belongs in a gynaecological consultation, where other reasons count too.
Why do I feel so bad in training before my period?
You are not alone in this. In a longitudinal survey of 128 British track and field athletes, 76.8 percent reported that their cycle affects their performance negatively. Of those who named a time point, 40 percent placed it in the late luteal phase and 35 percent in the early follicular phase.
Possible contributors include water retention, changes in sleep, mood, pain and altered temperature regulation. The feeling is real, even though laboratory performance tests show only small differences on average.
How common are cycle symptoms in active women?
Very common. In a survey of 6812 exercising women recruited via the Strava app, 90.6 percent reported mood changes or anxiety, 86.2 percent fatigue, 84.2 percent abdominal cramps and 83.1 percent breast tenderness.
The more numerous and frequent the symptoms, the more likely training was skipped or modified. Symptoms are therefore not a side issue, but a genuine training factor.
What does iron deficiency have to do with the cycle and exercise?
A lot. With every period you lose iron, and intense training can additionally slow down iron absorption. An individual participant data meta-analysis found a 1.5 to 2.5-fold increase in the iron regulator hepcidin after exercise.
A review puts iron deficiency in cohorts of female athletes at roughly 15 to 35 percent. In a Japanese study, 47 percent of female athletes had a ferritin of 30 ng/ml or less, even though not a single one had anaemia. In my practice, I aim for a ferritin above 100 in active women.
What does it mean if my period stops because of heavy training?
It is a warning sign that should be checked by a doctor. A common cause in active women is low energy availability, meaning too little energy relative to what training uses.
The 2023 IOC consensus statement describes this picture as Relative Energy Deficiency in Sport, which can affect hormones, bones, the immune system, mental health and performance. In a Danish survey, 51 percent of elite female athletes not using hormonal contraception had menstrual dysfunction, and 69 percent of endurance athletes. A missing period is not a sign of good form.
Why is research on women and exercise so thin?
For a long time, women were excluded from sports science studies, often with the argument that the cycle makes the data noisy. In addition, many studies only estimated the cycle phase by calendar instead of confirming it hormonally.
In 2021, Elliott-Sale and colleagues therefore published a methodological guide that calls for measures such as hormone testing and confirmation of ovulation. Many older claims about cycle-based training rest on studies that do not meet this standard.
How do I start tracking my cycle for training?
For three to four cycles, note three things every day: cycle day, your energy level on a scale from one to ten, and how your training felt. Add sleep, symptoms and any unusual stress.
Then lay the cycles on top of each other and look for recurring patterns. Only once a pattern repeats is it worth shifting training content. Recurring severe symptoms, very irregular cycles or a missing period should also be checked by a doctor.
Further reading on the ViveCura Blog
Iron deficiency in women and menstruation
Why every period draws on your stores.
Iron and exerciseIron deficiency in runners
Hepcidin, foot strike and empty stores.
NutritionFasting in women and the cycle
Why energy deficiency may disrupt the rhythm.
HormonesThe cycle and digestion
Prostaglandins, the gut and the days of your period.
ExerciseRecognising overtraining
The quiet warning signs of your body.
SleepSleep, hormones and recovery
Why the night may shape the training effect.
Sources
All studies were checked against PubMed, and figures are taken from the respective abstracts. Research on the cycle and training is young, and many individual studies are small and methodologically limited. Where the evidence is low, the text says so. The statement on the ferritin target range is based on clinical experience, not on a study consensus. This article does not replace a medical or gynaecological examination.
- McNulty KL, Elliott-Sale KJ, Dolan E, Swinton PA, Ansdell P, Goodall S, Thomas K, Hicks KM. The Effects of Menstrual Cycle Phase on Exercise Performance in Eumenorrheic Women: A Systematic Review and Meta-Analysis. Sports Med. 2020;50(10):1813-1827. DOI: 10.1007/s40279-020-01319-3 [Meta-analysis, network meta-analysis, k=78 studies]
- Elliott-Sale KJ, McNulty KL, Ansdell P, Goodall S, Hicks KM, Thomas K, Swinton PA, Dolan E. The Effects of Oral Contraceptives on Exercise Performance in Women: A Systematic Review and Meta-analysis. Sports Med. 2020;50(10):1785-1812. DOI: 10.1007/s40279-020-01317-5 [Meta-analysis, k=42 studies, n=590]
- Colenso-Semple LM, D'Souza AC, Elliott-Sale KJ, Phillips SM. 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. 2023;5:1054542. DOI: 10.3389/fspor.2023.1054542 [Review, umbrella review]
- D'Souza AC, Wageh M, Williams JS, Colenso-Semple LM, McCarthy DG, McKay AKA, Elliott-Sale KJ, Burke LM, Parise G, MacDonald MJ, Tarnopolsky MA, Phillips SM. Menstrual cycle hormones and oral contraceptives: a multimethod systems physiology-based review of their impact on key aspects of female physiology. J Appl Physiol (1985). 2023;135(6):1284-1299. DOI: 10.1152/japplphysiol.00346.2023 [Systematic review, with meta-analysis on substrate oxidation]
- Elliott-Sale KJ, Minahan CL, de Jonge XAKJ, Ackerman KE, Sipilä S, Constantini NW, Lebrun CM, Hackney AC. 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. 2021;51(5):843-861. DOI: 10.1007/s40279-021-01435-8 [Review, methodological guideline]
- Ekenros L, von Rosen P, Norrbom J, Holmberg HC, Sundberg CJ, Fridén C, Hirschberg AL. Impact of Menstrual cycle-based Periodized training on Aerobic performance, a Clinical Trial study protocol: the IMPACT study. Trials. 2024;25(1):93. DOI: 10.1186/s13063-024-07921-4 [RCT, study protocol, planned n=120, no results yet]
- Bruinvels G, Goldsmith E, Blagrove R, Simpkin A, Lewis N, Morton K, Suppiah A, Rogers JP, Ackerman KE, Newell J, Pedlar C. Prevalence and frequency of menstrual cycle symptoms are associated with availability to train and compete: a study of 6812 exercising women recruited using the Strava exercise app. Br J Sports Med. 2021;55(8):438-443. DOI: 10.1136/bjsports-2020-102792 [Real-world, cross-sectional survey, n=6812]
- Jones BP, L'Heveder A, Bishop C, Kasaven L, Saso S, Davies S, Chakraverty R, Brown J, Pollock N. Menstrual cycles and the impact upon performance in elite British track and field athletes: a longitudinal study. Front Sports Act Living. 2024;6:1296189. DOI: 10.3389/fspor.2024.1296189 [Real-world, longitudinal survey over 5 years, n=128]
- Silva AF, Trybulski R, Trybek G, Moska W, Aidar FJ, González-Fernández FT. Impact of The Menstrual Cycle on Physical Recovery after Small-Sided Games: A Crossover Study in Women's Soccer Players. J Sports Sci Med. 2025;24(3):532-542. DOI: 10.52082/jssm.2025.532 [RCT, crossover, n=20, phases estimated by calendar only]
- Hewett TE, Zazulak BT, Myer GD. Effects of the menstrual cycle on anterior cruciate ligament injury risk: a systematic review. Am J Sports Med. 2007;35(4):659-68. DOI: 10.1177/0363546506295699 [Systematic review, k=7 studies]
- Herzberg SD, Motu'apuaka ML, Lambert W, Fu R, Brady J, Guise JM. The Effect of Menstrual Cycle and Contraceptives on ACL Injuries and Laxity: A Systematic Review and Meta-analysis. Orthop J Sports Med. 2017;5(7):2325967117718781. DOI: 10.1177/2325967117718781 [Meta-analysis, k=21 studies, n=68,758, low strength of evidence]
- Oxfeldt M, Dalgaard LB, Jørgensen AA, Hansen M. Hormonal Contraceptive Use, Menstrual Dysfunctions, and Self-Reported Side Effects in Elite Athletes in Denmark. Int J Sports Physiol Perform. 2020;15(10):1377-1384. DOI: 10.1123/ijspp.2019-0636 [Real-world, cross-sectional survey, n=186]
- Mountjoy M, Ackerman KE, Bailey DM, Burke LM, Constantini N, Hackney AC, Heikura IA, Melin A, Pensgaard AM, Stellingwerff T, Sundgot-Borgen JK, Torstveit MK, Jacobsen AU, Verhagen E, Budgett R, Engebretsen L, Erdener U. 2023 International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs). Br J Sports Med. 2023;57(17):1073-1097. DOI: 10.1136/bjsports-2023-106994 [Review, IOC consensus statement]
- Fensham NC, Govus AD, Peeling P, Burke LM, McKay AKA. Factors Influencing the Hepcidin Response to Exercise: An Individual Participant Data Meta-analysis. Sports Med. 2023;53(10):1931-1949. DOI: 10.1007/s40279-023-01874-5 [Meta-analysis, individual participant data]
- Sim M, Garvican-Lewis LA, Cox GR, Govus A, McKay AKA, Stellingwerff T, Peeling P. Iron considerations for the athlete: a narrative review. Eur J Appl Physiol. 2019;119(7):1463-1478. DOI: 10.1007/s00421-019-04157-y [Review, narrative]
- Nabeyama T, Suzuki Y, Saito H, Yamamoto K, Sakane M, Sasaki Y, Shindo H, Takita M, Kami M. Prevalence of iron-deficient but non-anemic university athletes in Japan: an observational cohort study. J Int Soc Sports Nutr. 2023;20(1):2284948. DOI: 10.1080/15502783.2023.2284948 [Real-world, observational study, n=126]