Impact of Menstrual Cycle-Based Resistance Training on Neuromuscular Performance in Female Athletes (MENSES)

Universite de La Reunion

Status: Enrolling

Conditions: Women Health; Periodized Training; Oral Contraceptive Pill; Female Athlete; Resistance Training; Hormones; Menstrual Cycle; Muscle Strenght; Neuromuscular Function

Treatments: Other: Resistance periodized training program (N-PF); Other: Resistance peioridized training program (N-PL); Other: Continuous resistance training program (C)

Study type: Interventional

Funder types: Other

Identifiers

NCT06679491

AU1941 - 24.00913.000257 (Other Identifier)

ULaReunion

Details and patient eligibility

About

The goal of this clinical trial is to assess the impact of menstrual cycle-based resistance training on neuromuscular function in female athletes.

The primary questions it aims to answer are :

• Does varying resistance training intensity according to menstrual phases improve maximal knee extensor strength?
• How do different training protocols affect voluntary activation, rate of force development, muscle stiffness, and vertical jump height?

Researchers will compare natural menstrual cycle groups with an oral contraceptive control group to determine if menstrual phase-specific training influences neuromuscular adaptations.

Participants will:

• Undergo 2 weekly resistance training sessions over 13 weeks with intensity adjustments based on menstrual phase
• Complete periodic neuromuscular assessments across three menstrual phases: early follicular, late follicular, and mid-luteal before and after resistance training intervention

Full description

This study investigates the neuromuscular effects of menstrual cycle-based resistance training by comparing three distinct training protocols among female athletes with natural menstrual cycles and a control group of athletes using oral contraceptives. Hormonal fluctuations across the menstrual phases can impact muscle performance, recovery, and neuromuscular function. This trial aims to align training intensity with menstrual cycle phases to enhance neuromuscular adaptations.

Study Design and Population

The trial is a controlled, randomized, open-label design involving 60 recreationally active female athletes aged 18 and above. Participants are allocated into four groups:

N-PF: Natural menstrual cycle with increased training intensity during the follicular phase.

N-PL: Natural menstrual cycle with increased training intensity during the luteal phase.

N-C: Natural menstrual cycle with continuous training intensity across all phases.

OCP-C: Oral contraceptive users with continuous training intensity. Each participant completes a 13-week resistance training program tailored to her group's specific phase-aligned training protocol, with two sessions per week. To assess the neuromuscular impact, we perform pre- and post-intervention evaluations across three key menstrual phases: early follicular, late follicular, and mid-luteal.

Neuromuscular Assessments Primary outcomes include maximal knee extensor strength, assessed through isokinetic testing, and secondary measures cover neuromuscular activation, rate of force development (RFD), muscle stiffness, and vertical jump performance (CMJ). These assessments are conducted during each of the three menstrual phases pre- and post-intervention to capture phase-specific neuromuscular adaptations. Blood sampling for hormonal verification (estradiol and progesterone levels) accompanies each phase-specific testing session.

Methodology and Rationale The training intensity and volume are adjusted based on the participant's menstrual phase to leverage hormonal benefits, with estrogen levels typically promoting muscular strength in the follicular phase and progesterone affecting endurance in the luteal phase. We hypothesize that phase-specific training may yield greater improvements in strength, muscle stiffness, and overall neuromuscular efficiency.

This study's findings are expected to provide novel insights into optimizing training loads for female athletes according to hormonal cycles, with implications for improving performance, reducing injury risk, and advancing individualized training and rehabilitation protocols.

Enrollment: 60 estimated patients

Sex: Female

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Female athletes with natural menstrual cycles (eumenorrheic): Participants must have regular menstrual cycles lasting between 21 and 35 days, with at least 9 cycles per year.
• Women using a low-dose monophasic estrogen-progestin oral contraceptive.
• Age 18 or older: Participants must be legal adults.
• Body Mass Index (BMI) between 18 and 30 kg/m².
• No medical contraindications to high-level physical training or exercise.
• Physically active: Engages in at least 3 hours of physical activity per week.
• Informed consent: Provides written, informed consent to participate in the study.
• Affiliation with a social security system (if applicable by local regulations).

Exclusion criteria

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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60 participants in 4 patient groups

N-PF (Natural Cycle - Follicular Phase-Intensified Training)

Experimental group

Description:

Female athletes with natural menstrual cycles who follow a resistance training program with increased intensity during the follicular phase and reduced intensity during the luteal phase. This arm aims to evaluate the impact of follicular-phase-focused training on neuromuscular performance, leveraging the potential effects of elevated estrogen levels during this phase. Intervention: Resistance Training Program: 13 weeks, 2 sessions per week, with higher intensity training scheduled during the follicular phase (early and late) and reduced intensity during the luteal phase.

Treatment:

Other: Resistance periodized training program (N-PF)

N-PL (Natural Cycle - Luteal Phase-Intensified Training)

Experimental group

Description:

Description: Female athletes with natural menstrual cycles who undergo a resistance training program with increased intensity during the luteal phase and reduced intensity during the follicular phase. This approach assesses the impact of training when progesterone levels are elevated. Intervention: Resistance Training Program: 13 weeks, 2 sessions per week, with higher intensity training during the luteal phase (early and late) and reduced intensity during the follicular phase.

Treatment:

Other: Resistance peioridized training program (N-PL)

N-C (Natural Cycle - Continuous Training)

Experimental group

Description:

Description: Female athletes with natural menstrual cycles who participate in a continuous intensity training program across all phases of the menstrual cycle. This group provides a comparison to determine the effects of a non-phase-specific training protocol on neuromuscular function. Intervention: Resistance Training Program: 13 weeks, 2 sessions per week, maintaining a consistent training intensity across both follicular and luteal phases.

Treatment:

Other: Continuous resistance training program (C)

OCP-C (Oral Contraceptive - Continuous Training, Control Group)

Active Comparator group

Description:

Description: Female athletes using oral contraceptives, following a continuous intensity training program regardless of menstrual phase. This group serves as a control, providing insight into the neuromuscular effects of training under the hormonal conditions set by oral contraceptive use. Intervention: Resistance Training Program: 13 weeks, 2 sessions per week, with continuous intensity across all training sessions due to the stable hormonal environment induced by oral contraceptives.

Treatment:

Other: Continuous resistance training program (C)