ReviewFrontiers in sports and active living2026
Biomarkers of exercise-induced muscle damage and inflammation across menstrual cycle phases: a critical review.
Review in Frontiers in sports and active living, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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4 authors.
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Abstract
Background: Menstrual cycle fluctuations in estradiol and progesterone may influence post-exercise biomarkers of muscle damage, inflammation, and recovery, but interpretation is limited by heterogeneous protocols, inconsistent phase verification, and poorly aligned sampling. Objective: To critically synthesize evidence on whether menstrual cycle phase modulates exercise-induced muscle damage, inflammatory, immune-cell, or recovery-related biomarker responses in naturally menstruating women not using hormonal contraception. Methods: PubMed, Scopus, and Web of Science were searched to June 21, 2026. Eligible studies assessed biomarkers or recovery outcomes after acute exercise or sport-related exposure across at least two menstrual cycle phases. Phase verification, exercise models, biomarker selection, sampling schedules, and methodological quality were synthesized narratively. Results: Eighteen studies were included. Exercise stimulus and sampling time were more consistent determinants of biomarker responses than menstrual phase labels alone. CK and IL-6 showed clear exercise-related, time-dependent responses, whereas phase-related differences were inconsistent across exercise models, endocrine contrasts, and verification methods. Emerging outcomes, including hepcidin, hs-CRP, oxidative-stress markers, immune-cell subsets, salivary IL-6, DOMS, and neuromuscular recovery, broadened the field but remained too heterogeneous for conclusions. Incomplete endocrine verification, non-equivalent phase definitions, small samples, and mismatched sampling limited interpretation. Conclusion: Current evidence does not support a uniform menstrual phase effect on biomarkers of exercise-induced muscle damage or inflammation. Menstrual status should be treated as a biologically relevant design and interpretation variable, not as a deterministic explanation for biomarker variation. Future studies require cycle-aware designs combining prospective tracking, ovulation confirmation, estradiol and progesterone assessment, standardized exercise stimuli, biomarker-specific sampling, and repeated-measures analyses.
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