The Symptoms Experienced by Naturally Menstruating Women and Oral Contraceptive Pill Users and Their Perceived Effects on Exercise Performance and Recovery Time Posttraining

Kelly L. McNulty*, Paul Ansdell, Stuart Goodall, Kevin Thomas, Kirsty J. Elliott-Sale, Glyn Howatson, Kirsty M. Hicks

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)
40 Downloads (Pure)


This study examined the type, frequency, and severity of symptoms experienced by naturally menstruating women and combined, monophasic, oral contraceptive pill users and their perceived effects on exercise performance and recovery time posttraining. Forty-two recreationally active women; 21 naturally menstruating and 21 combined, monophasic, oral contraceptive pill users participated in the study. Data were collected using two approaches: (a) an online 54-part retrospective survey and (b) a daily questionnaire. “Total number of symptoms,” “symptom index score,” “average symptom severity,” and “symptom index × severity score” were calculated from the retrospective data set. Real-time symptom data (i.e., “symptom frequency per phase” and “phase symptom frequency × severity score”) were calculated across predefined cycle phases from the daily questionnaire. The retrospective survey showed that symptoms were commonly reported by recreationally active women, but there were no differences in symptomology between the groups (p > .113). The daily questionnaire showed both groups experienced a greater frequency and severity of symptoms while bleeding (p ≤ .001), which was associated with perceived reductions in exercise performance (odds ratio = 1.04–1.07) and a perceived longer recovery time posttraining (odds ratio = 1.03–1.04). The results from this study show that cycle-related symptoms were commonly reported by a group of recreationally active women, with no difference in symptomology between naturally menstruating women and combined, monophasic, oral contraceptive pill users. The magnitude of symptoms was greater while bleeding, which was associated with a perceived reduction in exercise performance and a longer recovery time posttraining.
Original languageEnglish
Article numberwspaj.2023-0016
Number of pages13
JournalWomen in Sport and Physical Activity Journal
Issue number1
Early online date13 Jun 2023
Publication statusPublished - 1 Jan 2024

Cite this