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Menstrual CycleNCT05697263

The Impact of the Menstrual Cycle on Physical Exercise and Performance

A study testing Periodization of training in people with Menstrual Cycle and Exercise, run by Karolinska Institutet at 1 site in Sweden.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The menstrual cycle implies a basic difference in the biology of women and men but the effect of the hormonal variation on training protocols and physical performance is still not fully understood. Read more about this study

Who is it for?
Ages 18 to 35 years, women onlyHealthy volunteers can take part
Conditions the study is for
Menstrual Cycle, Exercise, Women's Health
What is being tested?
Periodization of training
Could I receive a placebo?
No, everyone receives an active treatment
How many people
111 participants
Where
1 siteSweden
Study dates
1 Aug 2023to Jul 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 35 years
  • Women only
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Women exercising at least 3-4 times a week on a high level
  • Regular menstrual cycle with 26-32 cycle days.
  • Fully healthy and be able to follow the training program.

Who cannot join

  • Hormonal contraceptive users,
  • Users of regular medication
  • Chronic disease
  • Past or present neurological disorder
  • Recent musculoskeletal injury

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Angelica L Hirschberg, Med dr contact

+46702559924

angelica.hirschberg.linden@ki.se

Cecilia Fridén, Med dr contact

+46707415122

cecilia.friden@ki.se

Sweden1 site, 1 recruiting
  • Angelica Lindén Hirschberg

    Stockholm, 17176

    Angelica L Hirschberg, Professor, angelica.linden-hirschberg@regionstockholm.se

    Cecilia Fridén, Ass Prof, 0046707415122, cecilia.friden@ki.se

    Recruiting

Other trials in Sweden

About this study

The menstrual cycle implies a basic difference in the biology of women and men but the effect of the hormonal variation on training protocols and physical performance is still not fully understood. Despite no existing evidence, the advice to periodize exercise according to the menstrual cycle has been widely spread among elite athletes, coaches, and sports federations. The advice is based on underpowered studies with considerable methodological weaknesses regarding determination of cycle phase, inclusion of athletes and lack of adequate control groups.

The purpose of this randomized, controlled study is to evaluate the effect of exercise periodization on aerobic fitness during different phases of the menstrual cycle. Further, the effect will be related to premenstrual symptoms, body composition and skeletal muscle morphology, sex hormone receptors, metabolic enzymes, and markers of muscle protein synthesis. This study will be well controlled and follow methodology recommendations for menstrual cycle research in sports and exercise.

Read more

Female athletes of fertile age will be randomized to different training regimens during three menstrual cycles (12 weeks):

Group A: Training three times a week throughout the menstrual cycle. Group B: Follicular phase-based training five times a week during the follicular phase and thereafter once a week during the luteal phase.

Group C: Luteal phase-based training five times a week during the luteal phase and once a week in the follicular phase.

The exercise will consist of high intensity intermittent spinning classes. Assessment of aerobic fitness and power will be performed at baseline, and again after three completed menstrual cycles. On the same day, body composition will be examined by DXA and blood samples will be collected for analysis of hormones and binding proteins. To confirm menstrual cycle phase, blood samples will be collected for hormone determination, and urinary stick will be used for detection of ovulation. Subjective ratings of menstrual cycle related symptoms will be performed every day. In a subgroup of women, muscle biopsies will be collected from m vastus lateralis at baseline and at the end of the study. This study will contribute to improved knowledge about exercise periodization in relation to the menstrual cycle. Well-grounded data is crucial to give evidence-based recommendations to female athletes when planning their training protocol to optimize training results and performance.

Being tested
Periodization of training
Keywords
Menstrual Cycle, Exercise, Women's Health, Athletic Performance
Medical subject headings
Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Periodization of trainingOther

    Participants in the three arms will exercise the same dose and number of sessions distributed in three different ways.

Study groups in NCT05697263
Study groupRoleWhat they receive
Follicle phase based trainingExperimentalFollicular phase-based training five times a week during the follicular phase (the first two weeks of the menstrual cycle) and thereafter once a week for the rest of the cycle.
Receives: Other: Periodization of training
Luteal phase based trainingExperimentalLuteal phase-based training five times a week during the luteal phase (from ovulation to next menstruation) and once a week in the follicular phase.
Receives: Other: Periodization of training
Regular trainingExperimentalRegular training three times a week throughout the menstrual cycle (control group).
Receives: Other: Periodization of training

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in aerobic performance

    Cosmeds K5 Wearable Metabolic System will be used for breath-by-breath gas exchange measurements. Change in VO2peak from baseline to end of study will be evaluated.

    Measured: Change from baseline aerobic performance at the end of Cycle 4 (each cycle is around 28 days)

Secondary outcomes (11)
  1. Change in muscle strength

    A standardized isokinetic device (Biodex®, Corp, Shirley, NY, USA) will be used for measurements of maximal muscle torque (Nm) in the leg extensor muscles at 90 and 120 gr/sec (11). Change in muscle strength from baseline to end of study will be compared between groups.

    Measured: Change from baseline muscle strength at the end of Cycle 4 (each cycle is around 28 days)

  2. Change in one-leg sit-to-stand test

    Assessment of functional muscle strength in the lower extremities.

    Measured: Change from baseline test at the end of Cycle 4 (each cycle is around 28 days)

  3. Change in one-leg hop test for distance

    Assessment of functional muscle strength in the lower extremities.

    Measured: Change from baseline test at the end of Cycle 4 (each cycle is around 28 days)

  4. Change in body composition

    Differences in body fat (%) will be determined by DXA (Lunar equipment).

    Measured: Change from baseline body composition at the end of Cycle 4 (each cycle is around 28 days)

  5. Change in body composition

    Differences in muscle mass (g), will be determined by DXA (Lunar equipment).

    Measured: Change from baseline body composition at the end of Cycle 4 (each cycle is around 28 days)

  6. Premenstrual symptoms

    Prospective ratings of premenstrual symptoms will be performed with the Cyclicity Diagnoser

    Measured: Every day during the study period

  7. Change in metabolic serum markers

    Blood samples for analysis of IGF-1.

    Measured: Change from baseline metabolic serum markers at the end of Cycle 4 (each cycle is around 28 days)

  8. Change in mucle morphology

    Muscle biopsy in mm vastus lateralis

    Measured: Change from baseline muscle morphology at the end of Cycle 4 (each cycle is around 28 days)

  9. Change in muscle tissue steroid hormones

    Muscle biopsy in mm vastus lateralis

    Measured: Change from baseline muscle tissue steroid hormones at the end of Cycle 4 (each cycle is around 28 days)

  10. Change in muscle protein synthesis

    Muscle biopsy in mm vastus lateralis

    Measured: Change from baseline muscle protein synthesis at the end of Cycle 4 (each cycle is around 28 days)

  11. Dysmenorrhea

    Questionnaire

    Measured: Through study completion, an average of 4 month

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Jan 2023
  2. Study start1 Aug 2023
  3. Primary completionJul 2027 (estimated)
  4. Study completionJul 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Basic science
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
111 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05697263
Sponsor's protocol ID
2021-01650
Status last verified
Aug 2026
First submitted
20 Nov 2022
Last updated
13 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes

Publications

  • von Rosen P, Ekenros L, Solli GS, Sandbakk O, Holmberg HC, Hirschberg AL, Friden C. Offered Support and Knowledge about the Menstrual Cycle in the Athletic Community: A Cross-Sectional Study of 1086 Female Athletes. Int J Environ Res Public Health. 2022 Sep 21;19(19):11932. doi: 10.3390/ijerph191911932.

    PubMed 36231231
  • Ekenros L, von Rosen P, Solli GS, Sandbakk O, Holmberg HC, Hirschberg AL, Friden C. Perceived impact of the menstrual cycle and hormonal contraceptives on physical exercise and performance in 1,086 athletes from 57 sports. Front Physiol. 2022 Aug 30;13:954760. doi: 10.3389/fphys.2022.954760. eCollection 2022.

    PubMed 36111164
  • Ekenros L, Backstrom T, Hirschberg AL, Friden C. Changes in premenstrual symptoms in women starting or discontinuing use of oral contraceptives. Gynecol Endocrinol. 2019 May;35(5):422-426. doi: 10.1080/09513590.2018.1534097. Epub 2019 Jan 22.

    PubMed 30668208
  • Von Rosen P, Kottorp A, Friden C, Frohm A, Heijne A. Young, talented and injured: Injury perceptions, experiences and consequences in adolescent elite athletes. Eur J Sport Sci. 2018 Jun;18(5):731-740. doi: 10.1080/17461391.2018.1440009. Epub 2018 Mar 3.

    PubMed 29504456
  • von Rosen P, Heijne A, Frohm A, Friden C. Menstrual irregularity and use of oral contraceptives in female adolescent athletes in Swedish National Sports High Schools. Int J Adolesc Med Health. 2017 Nov 23;32(2):/j/ijamh.2020.32.issue-2/ijamh-2017-0113/ijamh-2017-0113.xml. doi: 10.1515/ijamh-2017-0113.

    PubMed 29168967
  • Ekenros L, Papoutsi Z, Friden C, Dahlman Wright K, Linden Hirschberg A. Expression of sex steroid hormone receptors in human skeletal muscle during the menstrual cycle. Acta Physiol (Oxf). 2017 Feb;219(2):486-493. doi: 10.1111/apha.12757. Epub 2016 Aug 9.

    PubMed 27438889
  • Ekenros L, Hirschberg AL, Heijne A, Friden C. Oral contraceptives do not affect muscle strength and hop performance in active women. Clin J Sport Med. 2013 May;23(3):202-7. doi: 10.1097/JSM.0b013e3182625a51.

    PubMed 22948447
  • Ekenros L, Hirschberg AL, Backstrom T, Friden C. Postural control in women with premenstrual symptoms during oral contraceptive treatment. Acta Obstet Gynecol Scand. 2011 Jan;90(1):97-102. doi: 10.1111/j.1600-0412.2010.01021.x. Epub 2010 Nov 26.

    PubMed 21275922
  • Friden C, Ramsey DK, Backstrom T, Benoit DL, Saartok T, Linden Hirschberg A. Altered postural control during the luteal phase in women with premenstrual symptoms. Neuroendocrinology. 2005;81(3):150-7. doi: 10.1159/000086592. Epub 2005 Jun 28.

    PubMed 15985762
  • Friden C, Hirschberg AL, Saartok T, Renstrom P. Knee joint kinaesthesia and neuromuscular coordination during three phases of the menstrual cycle in moderately active women. Knee Surg Sports Traumatol Arthrosc. 2006 Apr;14(4):383-9. doi: 10.1007/s00167-005-0663-4. Epub 2005 Jun 8.

    PubMed 15942744
  • Friden C, Hirschberg AL, Saartok T, Backstrom T, Leanderson J, Renstrom P. The influence of premenstrual symptoms on postural balance and kinesthesia during the menstrual cycle. Gynecol Endocrinol. 2003 Dec;17(6):433-9. doi: 10.1080/09513590312331290358.

    PubMed 14992161
  • Friden C, Hirschberg AL, Saartok T. Muscle strength and endurance do not significantly vary across 3 phases of the menstrual cycle in moderately active premenopausal women. Clin J Sport Med. 2003 Jul;13(4):238-41. doi: 10.1097/00042752-200307000-00007.

    PubMed 12855926
  • Hirschberg AL. Challenging Aspects of Research on the Influence of the Menstrual Cycle and Oral Contraceptives on Physical Performance. Sports Med. 2022 Jul;52(7):1453-1456. doi: 10.1007/s40279-021-01616-5. Epub 2022 Jan 22. No abstract available.

    PubMed 35064914
  • Ekenros L, von Rosen P, Norrbom J, Holmberg HC, Sundberg CJ, Friden C, Hirschberg AL. Impact of Menstrual cycle-based Periodized training on Aerobic performance, a Clinical Trial study protocol-the IMPACT study. Trials. 2024 Jan 29;25(1):93. doi: 10.1186/s13063-024-07921-4.

    PubMed 38287424

Questions about this trial

What is this clinical trial studying?

A study testing Periodization of training in people with Menstrual Cycle and Exercise, run by Karolinska Institutet at 1 site in Sweden.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 13 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Angelica L Hirschberg, Med dr (+46702559924, angelica.hirschberg.linden@ki.se), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in aerobic performance (time frame: Change from baseline aerobic performance at the end of Cycle 4 (each cycle is around 28 days)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05697263, which also lists 14 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Aug 2026.

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