In women, exercise performance might be reduced by a trivial amount during the early follicular phase of the menstrual cycle when compared with other phases. However, large between-study variance was identified, indicating that research design, participant characteristics and choice of outcome measure might influence any group-level effect.

Practically, the current evidence does not warrant general guidance on modulating exercise across the menstrual cycle. As such, we recommend that a personalised approach should be taken based on each individual's response to exercise performance across the menstrual cycle.

The quality of evidence for this review was mostly classified as “low” quality, which can be attributed to a range of methodological issues. Future studies need to improve methodological quality and limit confounders to facilitate a deeper understanding of the effects of the menstrual cycle on exercise performance.