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Women perform better when on their period, study finds
Previous research has shown that women seem to be at greater risk of sport-related injury during the luteal phase
Female athletes react quicker and make fewer errors when they are on their period, despite believing their performance would be worse, new research has found.
The study, conducted by UCL and the Institute of Sport, Exercise & Health (ISEH) and published in Neuropsychologia, is the first to assess sport-related cognition during the menstrual cycle.
The findings act as a proof-of-principle that specific types of cognition fluctuate throughout the menstrual cycle, which could have implications for injury and other aspects of women’s health.
Previous research has shown that women seem to be at greater risk of sport-related injury during the luteal phase, which is the time between ovulation and menstruation. This is possibly related to the significant hormonal changes that occur throughout the menstrual cycle, but precisely how these changes are linked to an increased likelihood of injury are unknown at present.
In this study, researchers collected reaction time and error data from 241 participants who completed a battery of cognitive tests 14 days apart. Participants also completed a mood scale and a symptom questionnaire twice. Period tracking apps were used to estimate which phase of their cycle the participants were in when they took the tests.
The tests were designed to mimic mental processes that are typical in team sports. In one test, participants were shown smiling or winking faces and asked to press the space bar only when they saw a smiley face, to test inhibition, attention, reaction time and accuracy. In another, they were asked to identify mirror images in a 3D rotation task, which assesses spatial cognition. A task that asked them to click when two moving balls collide on screen measured spatial timing.
Though participants reported feeling worse during menstruation and perceived that this negatively impacted their performance, their reaction times were faster and they made fewer errors.
The study found their timing was on average 10 milliseconds (12 per cent) more accurate in the moving balls task, and they pressed the space bar at the wrong time 25 per cent less in the inhibition task.
Participants’ reaction times were slower during the luteal phase. They were on average 10-20 milliseconds slower compared to being in any other phase. However, they did not make more errors in this phase.
Dr Flaminia Ronca, first author of the study from UCL Division of Surgery and Interventional Science and ISEH, said: “Research suggests that female athletes are more likely to sustain certain types of sports injuries during the luteal phase and the assumption has been that this is due to biomechanical changes as a result of hormonal variation. But I wasn’t convinced that physical changes alone could explain this association.
“Given that progesterone has an inhibitory effect on the cerebral cortex and oestrogen stimulates it, making us react slower or faster, we wondered if injuries could be a result of a change in athletes’ timing of movements throughout the cycle.
“What is surprising is that the participant’s performance was better when they were on their period, which challenges what women, and perhaps society more generally, assume about their abilities at this particular time of the month.”
She added: “I hope that this will provide the basis for positive conversations between coaches and athletes about perceptions and performance: how we feel doesn’t always reflect how we perform.”
To put the findings in context, the authors say the fluctuation in timing could be the difference between an injury or not.
Previous studies have shown that a variation of just 10 milliseconds can mean the difference between a concussion and a lesser injury. In the colliding balls task, participants’ timing was on average 12 milliseconds slower during the luteal phase compared to every other phase, a difference of 16 per cent.
Dr Megan Lowery, an author of the study from UCL Surgery & Interventional Science and ISEH, said: “There’s lots of anecdotal evidence from women that they might feel clumsy just before ovulation, for example, which is supported by our findings here. My hope is that if women understand how their brains and bodies change during the month, it will help them to adapt.
“Though there’s a lot more research needed in this area, these findings are an important first step towards understanding how women’s cognition affects their athletic performance at different points during their cycle, which will hopefully facilitate positive conversations between coaches and athletes around performance and wellbeing.”
Professor Paul Burgess, senior author of the study from UCL’s Institute of Cognitive Neuroscience, added: “This study emerged from listening carefully to female soccer players and their coaches.
“We created bespoke cognitive tests to try to mimic the demands made upon the brain at the points in the game where they were telling us that injuries and problems of timing occur at certain times of the menstrual cycle.
“As suggested by what the soccer players had told us, the data suggested that women who menstruate – whether they are athletes or not – do tend to vary in their performance at certain stages of the cycle. As a neuroscientist, I am amazed that we don’t already know more about this, and hope that our study will help motivate increasing interest in this vital aspect of sports medicine.”
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The winners were announced at a virtual event this afternoon attended by shortlisted companies, along with sponsors and judges.
The event welcomed guests from the UK, Europe, Asia, Africa and North America.
Thank you to all 174 entries, as well as the sponsors for making the event possible.
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Pregnant women’s expectations about postpartum sleep may predict sleep quality after birth, outweighing prior sleep and psychiatric history, a study suggests.
The findings suggest attitudes and beliefs about sleep during pregnancy could be a modifiable risk factor for postpartum sleep concerns.
They also indicate that, among women expecting the poorest sleep, higher postpartum anxiety may further worsen sleep quality.
Sammy Dhaliwal, lead author is clinical health psychologist and research fellow in the department of obstetrics and gynaecology at the Perelman School of Medicine at the University of Pennsylvania.
Dhaliwal said: “Most pregnant women in our sample anticipated poor postpartum sleep before it occurred, and it was striking that those expectations predicted worse sleep outcomes even after accounting for factors such as prior sleep disorders, psychiatric history, and number of previous births.
“This suggests that attitudes and beliefs about sleep during pregnancy may represent a modifiable target for early intervention before postpartum sleep problems emerge.”
Sleep disturbance affects an estimated 60 to 80 per cent of postpartum women and is linked to a higher risk of depression and anxiety.
Researchers said it is often regarded as an expected part of life after childbirth rather than a health issue that may be addressed earlier.
The study enrolled 432 pregnant women at about 24 weeks of gestation, meaning around 24 weeks into pregnancy.
Participants completed measures of their expectations about postpartum sleep, current sleep quality using the Pittsburgh Sleep Quality Index, and mood using validated depression and anxiety scales.
Assessments were repeated at six, 12 and 24 weeks postpartum.
A subset of 49 women also wore wrist actigraphy devices at six to eight weeks postpartum.
Actigraphy uses a wearable device, similar to a watch, to estimate sleep and wake patterns based on movement.
The results showed that 70 per cent of pregnant women, or 301 of 432 participants, expected poor sleep in the postpartum period.
Researchers found that predicted sleep disruption during pregnancy was a significant predictor of postpartum sleep concerns.
Among first-time pregnant women without prior health concerns, those who expected greater sleep disturbance had significantly more disrupted sleep after birth, measured by both actigraphy and self-report.
Among women who expected the worst sleep quality, higher postpartum anxiety significantly worsened both measured sleep and self-reported sleep, independent of anxiety levels during pregnancy.
Dhaliwal said the findings point to two possible areas for intervention: addressing sleep-related beliefs during pregnancy and treating postpartum anxiety.
Dhaliwal said: “Postpartum sleep disruption is often treated only after problems develop, but our findings suggest there may be an opportunity to intervene earlier during pregnancy.
“Addressing sleep-related beliefs and postpartum anxiety during prenatal and postpartum care may help improve sleep and emotional well-being in new mothers.”
A weight loss jab may improve fertility outcomes in women with PMOS, early findings from an ongoing clinical trial suggest.
The proof-of-concept analysis found that injectable semaglutide may offer reproductive benefits while also addressing obesity and metabolic dysfunction.
It is the first report to examine how injectable semaglutide may improve reproductive outcomes in women with PMOS while also addressing obesity and metabolic dysfunction.
The work forms part of the ongoing RESTORE clinical trial.
Melanie Cree, professor at CU Anschutz and first author of the report, said: “Women with PMOS frequently face a frustrating choice between treatments that target reproductive symptoms and those that address metabolic health.
“Our early findings suggest injectable semaglutide may have the potential to improve both, offering a more comprehensive approach to care.
“This medication is incredibly promising when someone responds with 10 per cent weight loss.”
The trial is examining whether semaglutide can restore ovulation and improve reproductive health in adolescents and adults with polyendocrine metabolic ovarian syndrome, known as PMOS.
PMOS, formerly known as polycystic ovary syndrome or PCOS, is a hormone and metabolic condition linked to irregular periods, raised testosterone levels, infertility risk, obesity and increased cardiometabolic disease.
Cardiometabolic disease refers to conditions linked to the heart and metabolism, such as heart disease, high blood pressure and type 2 diabetes.
Existing treatments, including metformin and hormonal contraceptives, often do not fully address reproductive and metabolic complications at the same time.
The analysis focused on participants aged 12 to 35 who lost at least 10 per cent of their body weight during treatment.
Researchers said reproductive improvements appeared earlier than expected, prompting them to report preliminary findings while the wider study continues.
Cree is also a paediatric endocrinologist at Children’s Hospital Colorado.
Endocrinologists are doctors who specialise in hormones and hormone-related conditions.
Cree said: “What makes this work particularly important is that it focuses specifically on women with PMOS receiving injectable semaglutide.
“Although GLP-1 medications have transformed obesity treatment, there remains a significant need for rigorous data examining how these therapies affect fertility and reproductive function in this population.”
The RESTORE study is evaluating semaglutide treatment in girls and women with PMOS and obesity.
Its broader aim is to determine whether weight loss and metabolic improvements can restore ovulation and improve reproductive outcomes.
Ovulation is the release of an egg from the ovary, a key part of the menstrual cycle and fertility.
The authors said the findings are from an early proof-of-concept analysis and that larger, longer-term studies will be needed to confirm whether the reproductive benefits last.
The findings suggest injectable semaglutide may become a treatment option for women with PMOS seeking improvements in both metabolic and reproductive health, if future studies confirm the results.
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