Why We Must Stop Assuming and Estimating Menstrual Cycle Phases in Laboratory and Field-Based Sport Related Research

Abstract

The increased growth, popularity, and media interest in women's sport has led to calls for greater prioritisation of female-specific research and innovation. In response, science and medicine researchers have increased the volume of sport-related studies investigating female-specific matters, such as the menstrual cycle. Whilst the accelerated rate of published studies with female participants is welcome, the emerging trend of using assumed or estimated menstrual cycle phases to characterise ovarian hormone profiles is a significant concern. Replacing direct measurements of key characteristics of the menstrual cycle (e.g. the surge in luteinising hormone prior to ovulation via urine detection and sufficient luteal phase progesterone via blood or saliva sampling) with assumptions or estimates (i.e. no measurements) is proposed to be a pragmatic and convenient way of generating data, particularly in field-based research (i.e. elite athlete environments), where time, resources, and athlete availability are sometimes constrained. Using assumed or estimated phases, however, amounts to guessing the occurrence and timing of ovarian hormone fluctuations and risks potentially significant implications for female athlete health, training, performance, injury, etc., as well as resource deployment. The positive intentions of researchers and scientific journals in this space are not in question. The aim of this Current Opinion is to explain why using assumed or estimated menstrual cycle phases is an approach that has little scientific basis and lacks the rigour and appropriate methodological quality to produce valid and reliable data. In doing so, we provide evidence-based responses to common speculation points and offer recommendations for future research.

Fig. 1

The ovarian hormone profile of a eumenorrheic cycle (A), luteal phase deficient cycle (B), anovulatory cycle (C), and ovulatory and anovulatory oligomenorrheic cycles (D and E). Panels B–E are adapted from Allaway et al. [17] with permission

Fig. 2

Conceptual illustration highlighting the misalignment between assumed versus actual ovarian hormone profiles. The upwards arrow denotes anticipated ovulation. MC menstrual cycle