ArticleBMJ open sport & exercise medicine2021
Patterns of endogenous and exogenous ovarian hormone modulation on recovery metrics across the menstrual cycle.
Article in BMJ open sport & exercise medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 4 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Wearable-Derived Heart Rate Variability Across the Menstrual Cycle, Hormonal Contraceptive Use, and Reproductive Life Stages in Females: A Living Systematic Review.Sports medicine (Auckland, N.Z.) · 2026Pooled it
- Nutritional Strategies for Optimizing Health, Sports Performance, and Recovery for Female Athletes and Other Physically Active Women: A Systematic Review.Nutrition reviews · 2025Pooled it
- The effects of oral contraceptives on resting autonomic function and the autonomic response to physiological stressors: a systematic review.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2023Pooled it
- Heart Rate Variability-An Index of the Efficacy of Complementary Therapies in Irritable Bowel Syndrome: A Systematic Review.Nutrients · 2022Pooled it
- Influence of oestradiol on exercise induced muscular damage and heart rate variability in a non-trained healthy population.Experimental physiology · 2026Article
- Monitoring Menstrual Health in Footballers: Considerations for Tracking Menstrual and Hormonal Contraceptive Cycles in the Field to Support Performance.Sports medicine (Auckland, N.Z.) · 2026Review
- Review
- The menstrual cycle through the lens of a wearable device: insights into physiology, sleep, and cycle variability.NPJ digital medicine · 2026Article
- Decoding menstrual health across the lifespan: a scoping review of digital health tools in research.medRxiv : the preprint server for health sciences · 2026Article
- Decoding menstrual health across the lifespan: a scoping review of digital health tools in research.npj women's health · 2026Article
- The Influence of Menstrual Cycle Phase on the Physiological and Perceptual Responses to Low-Intensity Continuous and High-Intensity Interval Sessions in Endurance Trained Women: The FENDURA Project.European journal of sport science · 2026Article
- Menstrual Cycle Symptoms, But Not Oestrogen or Progesterone Concentrations, Are Associated With Sleep in Female Athletes.European journal of sport science · 2025Article
- Heart Rate Variability Measurements Across the Menstrual Cycle and Oral Contraceptive Phases in Two Olympian Female Swimmers: A Case Report.Sports (Basel, Switzerland) · 2025Article
- The impact of menstrual cycle phase and symptoms on sleep, recovery, and stress in elite female basketball athletes: a longitudinal study.Frontiers in physiology · 2025Article
- Article
- A Novel method for quantifying fluctuations in wearable derived daily cardiovascular parameters across the menstrual cycle.NPJ digital medicine · 2024Article
- Effects of Hormonal Contraception and the Menstrual Cycle on Fatigability and Recovery From an Anaerobic Exercise Test.Journal of strength and conditioning research · 2024Article
- Effects of the Menstrual Cycle and Hormonal Contraceptive Use on Metabolic Outcomes, Strength Performance, and Recovery: A Narrative Review.Metabolites · 2024Review
- A Multimodal Exertional Test for concussion: a pilot study in healthy athletes.Frontiers in neurology · 2024Article
- International society of sports nutrition position stand: nutritional concerns of the female athlete.Journal of the International Society of Sports Nutrition · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAs the number of female athletes competing rises globally, training methodologies should reflect sex differences across critical metrics of adaptation to training. Surrogate markers of the autonomic nervous system (ANS) used for monitoring training load are heart rate variability (HRV) and resting heart rate (RHR). The aim was to investigate ovarian hormone effects on standard recovery metrics (HRV, RHR, respiratory rate (RR) and sleep duration) across a large population of female athletes.
methodsA retrospective study analysed 362 852 days of data representing 13 535 menstrual cycles (MC) from 4594 respondents (natural MC n=3870, BC n=455, progestin-only n=269) for relationships and/or differences between endogenous and exogenous ovarian hormones on ANS.
resultsHRV and return to baseline (recovery) decreased as resting HR and RR increased (p<0.001) from the early follicular to the late luteal phase of the MC. Patterning was paradoxical across phases for users of combined hormonal contraception (BC) as compared with the patterning of the MC. HRV and recovery start elevated and drop off quickly during the withdrawal bleed, rising through the active pill weeks (p<0.001). Progestin-only users had similar patterning as the MC. The relationship between normalised recovery and previous day strain is modulated by birth control type. BC exhibited steeper declines in recovery with additional strain-normalised recovery decreases by an additional 0.0055±0.00135 (p<0.001) per unit of strain; with no significant difference between MC and progestin-only (p=0.19).
conclusionThe patterning of ANS modulation from ovarian hormones is significantly different between naturally cycling women and those on BC, with the patterning dependent on the type of contraception used.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.