The Effect of Dıfferent Phases of The Menstrual Cycle on Some Performance Parameters ın Female Athletes

Öz

The aim of this study is to examine the effects of different phases of the menstrual cycle (MC) on certain performance parameters in female athletes. The study included 12 active female athletes aged 18–25 years (age: 21.58±1.44 years; height: 161.16±7.44 cm; body weight: 56.15±8.05 kg; body mass index [BMI]: 21.62±2.54 kg/m²; years of athletic experience: 10.83±2.12 years; training age: 10.66±2.05 years; competition age: 10.00±2.13 years; menarche age: 14.00±1.34 years). Tests assessing balance, vertical jump, anaerobic power, flexibility, strength, agility, speed, visual reaction (VR), and auditory reaction (AR) were conducted across the early follicular, ovulation, and luteal phases of the MC. The Borg Scale was used to assess perceived exertion (RPE) immediately after each measurement, and the Visual Analog Scale (VAS) was employed the following day to evaluate delayed onset muscle soreness (DOMS). Differences among variables were analyzed using repeated-measures ANOVA. Statistically significant differences were found between phases in vertical jump, speed, strength, flexibility, agility, total visual reaction time (VRT), mean visual reaction time (VRT), and RPE (p<0.05). However, no statistically significant differences were observed in body weight, BMI, balance, anaerobic power, AR, or DOMS parameters across phases (p>0.05). The findings suggest that performance variations in specific phases may be attributed to perceived exertion, the nocebo effect, hormonal fluctuations, various physiological responses, and mood changes. Notably, strength performance was observed to increase during the ovulation phase, while vertical jump, 30-meter sprint, flexibility, and agility performance were positively influenced during the luteal phase. Conversely, the early follicular phase was found to have negative effects on all performance parameters examined in this study.

Anahtar Kelimeler

• Athletic Performance
• Female Athletes
• Menstrual Cycle
• Sports

Kadın Sporcularda Menstrual Siklusun Farklı Fazlarının Bazı Performans Parametreleri Üzerine Etkisi

Öz

Bu çalışmanın amacı, kadın sporcularda menstrual siklusun (MS) farklı fazlarının, bazı performans parametreleri üzerindeki etkisinin incelenmesidir. Çalışmaya 18-25 yaşları arasında aktif spor yapan 12 kadın sporcu (yaş: 21,58±1,44 yıl; boy uzunluğu: 161,16±7,44 cm; vücut ağırlığı: 56,15±8,05 kg; beden kitle indeksi: 21,62±2,54 kg/m²; sporcu yaşı: 10,83±2,12 yıl; antrenman yaşı: 10,66±2,05 yıl; müsabaka yaşı:10,00±2,13 yıl; menarş yaşı:14,00±1,34 yıl) dâhil edildi. MS’nin erken foliküler faz (EFF), ovulasyon faz (OF) ve luteal faz (LF) arasında, denge, dikey sıçrama, anaerobik güç, esneklik, kuvvet, çeviklik, sürat, görsel reaksiyon (GR) ve işitsel reaksiyon (İR) testleri uygulandı. Her yapılan ölçüm sonrasında algılanan zorluk derecesini (AZD) değerlendirmek için Borg Skalası, ölçümden sonraki gün ise gecikmiş kas ağrısını belirlemek için Görsel Analog Skala (GAS) kullanıldı. Değişkenler arası farklılık repeated-measures ANOVA ile analiz edildi. Fazlar arasında dikey sıçrama, sürat, kuvvet, esneklik, çeviklik, görsel reaksiyon toplam (GRT), görsel reaksiyon ortalama süresi (GRO) ve AZD’de istatistiksel olarak anlamlı farklılık saptandı (p<0,05). Fazlar arası vücut ağırlığı, BKİ, denge, anaerobik güç, İR ve GAS parametrelerinde istatistiksel olarak anlamlı farklılık olmadığı saptandı (p>0,05). Elde edilen bulgulara göre, sporcuların belirli fazlarda performanslarının artmasının veya azalmasının, algılanan zorluk derecesi, nosebo etkisi, hormonal dalgalanmalar, çeşitli fizyolojik tepkiler ve duygu durum değişikliklerinden kaynaklandığı düşünülmektedir. Özellikle, OF’da kuvvet performansının arttığı, LF’de ise dikey sıçrama, 30 m sürat, esneklik ve çeviklik performansının olumlu yönde etkilendiği gözlemlendi. Buna karşılık, EFF’nin çalışmanın tüm performans parametreleri üzerinde olumsuz etkiler oluşturduğu tespit edildi.

Anahtar Kelimeler

• Kadın Sporcular
• Menstrual Siklus
• Spor
• Sportif Performans

Kaynakça

1. Abdelmoty, H. I., Youssef, M. A., Abdallah, S., Abdel-Malak, K., Hashish, N. M., … et al. (2015). Menstrual patterns and disorders among secondary school adolescents in Egypt. A cross-sectional survey. BMC Women's Health, 15, 70. https://doi.org/10.1186/s12905-015-0228-8
2. Acar, K., Mor, A., Mor, H., Karakaş, F., & Karakoğlu, T. (2024). Yüzücülerde dayanıklık antrenmanının sıvı dengesi ve performans parametrelerine etkisi. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 13(1), 400-408. https://doi.org/10.37989/gumussagbil.1321602
3. Akdoğan, B. (2014). Menstrual döngünün koşu ekonomisine etkisi: Kalorik değerlendirme [Yüksek lisans tezi, Hacettepe Üniversitesi]. Sağlık Bilimleri Enstitüsü.Ankara
4. Albersnagel, F. A. (1988). Velten and music mood induction procedures: A comparison with accessibility of thought associations. Behavioral Research and Therapy, 26(1), 79-96. https://doi.org/10.1016/0005-7967(88)90035-6
5. Alpar, R. (2022). Spor, sağlık ve eğitim bilimlerinden örneklerle uygulamalı istatistik ve geçerlilik-güvenirlik. Detay Yayıncılık.
6. Ansdell, P., Brownstein, C. G., Škarabot, J., Hicks, K. M., Simoes, D. C., Thomas, K., ... et al. (2019). Menstrual cycle-associated modulations in neuromuscular function and fatigability of the knee extensors in eumenorrheic women. Journal of Applied Physiology, 126(6), 1701-1712.
7. Armour, M., Parry, K. A., Steel, K., & Smith, C. A. (2020). Australian female athlete perceptions of the challenges associated with training and competing when menstrual symptoms are present. International Journal of Sports Science & Coaching, 15(3), 316-323.
8. Arnoczky, S. P. (2007). Volume XII of the encyclopaedia of sports medicine: An IOC medical commission publication. IOC.

9. Arslan, E. (2023). Kadın sporcularda menstrüel siklus faz değişimlerinin sportif hareketlerdeki hata puanlarına etkisi [Yüksek lisans tezi, Süleyman Demirel Üniversitesi]. Beden Eğitimi ve Spor Anabilim Dalı.
10. Avcı, E. E., Şenocak, E., Akgün, İ., Timurtaş, E., Demirbüken, İ., … et al. (2021). Menstrual döngü boyunca tahmin edilen östrojen değişikliklerinin plantar basınç dağılımı ve denge kontrolü üzerindeki etkisi. Journal of Health Sciences and Management, 1(2), 75-81.
11. Aydin, A., Araz, A., & Asan, A. (2011). Görsel analog ölçegi ve duygu kafesi: kültürümüze uyarlama çalismasi. Turk Psikoloji Yazilari, 14(27), 1.
12. Bale, P., & Davies, J. (1983). Effects of menstruation and contraceptive pill on the performance of physical education students. British Journal of Sports Medicine, 17(1), 46-50. https://doi.org/10.1136/bjsm.17.1.46.
13. Borg, G. (1998). Borg's perceived exertion and pain scales. Human kinetics.
14. Borg, G. A. (1982). Psychophysical bases of perceived exertion. Medicine and Science in Sports and Exercise, 14(5), 377-381.
15. Brown, N., Knight, C. J., & Forrest, L. J. (2021). Elite female athletes’ experiences and perceptions of the menstrual cycle on training and sport performance. Scandinavian Journal Of Medicine & Science İn Sports, 31(1), 52-69.
16. Bruce, J., & Russell, G. F. (1962). Premenstrual tension: A study of weight changes and balances of water, sodium, and potassium. Lancet, 2(7250), 267-271. https://doi.org/10.1016/s0140-6736(62)90173-3.
17. Bull, J. R., Rowland, S. P., Scherwitzl, E. B., Scherwitzl, R., Danielsson, K. G., & Harper, J. (2019). Real-world menstrual cycle characteristics of more than 600,000 menstrual cycles. NPJ Digital Medicine, 2(1), 83.
18. Cable, N. T., & Elliott, K. J. (2004). The influence of reproductive hormones on muscle strength. Biological Rhythm Research, 35(3), 235-244. https://doi.org/10.1080/09291010412331335788.
19. Cabre, H. E., Joniak, K. E., Ladan, A. N., Moore, S. R., Blue, M. N. M., Pietrosimone, B. G., … et al. (2024). Effects of hormonal contraception and the menstrual cycle on maximal strength and power performance. Medicine and Science in Sports and Exercise, 56(12), 2385–2393. https://doi.org/10.1249/MSS.0000000000003524.
20. Campa, F., Micheli, M. L., Pompignoli, M., Cannataro, R., Gulisano, M., Toselli, S., … et al. (2021). The influence of menstrual cycle on bioimpedance vector patterns, performance, and flexibility in elite soccer players. International Journal of Sports Physiology and Performance, 17(1), 58-66. https://doi.org/10.1123/ijspp.2021-0135.
21. Carmichael, M. A., Thomson, R. L., Moran, L. J., & Wycherley, T. P. (2021). The impact of menstrual cycle phase on athletes' performance: A narrative review. International Journal of Environmental Research and Public Health, 18(4), 1667. https://doi.org/10.3390/ijerph18041667.
22. Chaffin, M. E., Berg, K. E., Meendering, J. R., Llewellyn, T. L., French, J. A., & Davis, J. E. (2011). Interleukin-6 and delayed onset muscle soreness do not vary during the menstrual cycle. Research Quarterly for Exercise and Sport, 82(4), 693-701. https://doi.org/10.1080/02701367.2011.10599806.
23. Chrousos, G. P., Torpy, D. J., & Gold, P. W. (1998). Interactions between the hypothalamic-pituitary-adrenal axis and the female reproductive system: Clinical implications. Annals of Internal Medicine, 129(3), 229-240. https://doi.org/10.7326/0003-4819-129-3-199808010-00012.
24. Constantini, N. W., Dubnov, G., & Lebrun, C. M. (2005). The menstrual cycle and sport performance. Clinics in Sports Medicine, 24(2), e51-e82.. https://doi.org/10.1016/j.csm.2005.01.003.
25. Cook, C. J., Kilduff, L. P., & Crewther, B. T. (2018). Basal and stress-induced salivary testosterone variation across the menstrual cycle and linkage to motivation and muscle power. Scandinavian Journal of Medicine & Science in Sports, 28(4), 1345-1353. https://doi.org/10.1111/sms.13041.
26. Czajkowska, M., Drosdzol-Cop, A., Naworska, B., Galazka, I., Gogola, C., Rutkowska, M., … et al. (2020). The impact of competitive sports on menstrual cycle and menstrual disorders, including premenstrual syndrome, premenstrual dysphoric disorder and hormonal imbalances. Ginekologia Polska, 91(9), 503-512. https://doi.org/10.5603/GP.2020.0097.
27. Çavlıca, B., Yücel, S. B, Darçın, N., Mirzai, İ. T, & Erbüyün, K. (2009). Profesyonel kadın voleybolcularda ağrı duyumunun menstrüel döngü ile ilişkisi. Ağrı Dergisi, 21(1), 29-35.
28. Çelik, A., & Uskun, E. (2021). Yaşam kalitesini bozan bir sorunsal: Premenstrüel sendrom. Smyrna Tıp Dergisi, 8, 57-68.
29. Çoban, B., & Karlı, K. (2023). Premenstrual sendromun iştah ve besin tercihi üzerine etkileri. Kastamonu Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 2(2), 19-28. https://doi.org/10.59778/sbfdergisi.1312932.
30. Çolakoğlu, T., Er, F., İpekoğlu, G., Karacan, S., Çolakoğlu, F., & Zorba, E. (2014). Elit oryantring sporcularının fiziksel, fizyolojik ve bazı performans parametrelerinin incelenmesi. Pegem Akademi Yayıncılık.
31. Daneshjoo, A., Mokhtar, A. H, Rahnama, N., & Yusof, A. (2013). Effects of the 11+ and Harmoknee warm-up programs on physical performance measures in professional soccer players. Journal of Sports Science & Medicine, 12(3), 489-496.
32. Dougherty, D. M, Bjork, J. M, Moeller, F. G, & Swann, A. C. (1997). The influence of menstrual-cycle phase on the relationship between testosterone and aggression. Physiology & Behavior, 62(2), 431-435. https://doi.org/10.1016/s0031-9384(97)88991-3.
33. Esin, K., Köksal, E., Güldemir, H. H., & Garipağaoğlu, M. (2016). Menstrual döngünün vücut bileşimine etkisi. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi, 7(2), 23-27.
34. Findlay, R. J., Macrae, E. H, Whyte, I. Y., Easton, C., & Forrest, L.J (2020). How the menstrual cycle and menstruation affect sporting performance: Experiences and perceptions of elite female rugby players. British Journal of Sports Medicine, 54(18), 1108-1113. https://doi.org/10.1136/bjsports-2019-101486 Fox, E. B. (2012). Beden eğitimi ve sporun fizyolojik temelleri, Spor Yayınevi.
35. Fox, E. L., Bowers, R. W., & Foss, M. L. (1988). The physiological basis of physical education and athletics, SaundersCo. Publishing, Philadelphia, 28-30.
36. Fruzzetti, F., Lazzarini, V., Ricci, C., Quirici, B., Gambacciani, M., Paoletti, A. M., … et al. (2007). Effect of an oral contraceptive containing 30 microg ethinylestradiol plus 3 mg drospirenone on body composition of young women affected by premenstrual syndrome with symptoms of water retention. Contraception, 76(3), 190–194. https://doi.org/10.1016/j.contraception.2007.05.080.
37. Gençdoğan, B. (2006). Premenstruel sendrom için yeni bir ölçek. Türkiye'de Psikiyatri Dergisi, 8(2), 81-87. Giersch, G. E., Morrissey, M. C., Katch, R. K., Colburn, A. T., Sims, S. T., Stachenfeld, N. S., … et al. (2020). Menstrual cycle and thermoregulation during exercise in the heat: A systematic review and meta-analysis. Journal of Science and Medicine in Sport, 23(12), 1134-1140.https://doi.org/10.1016/j.jsams.2020.05.014.
38. Golub, L. J., Menduke, H., & Conly, S. S., Jr. (1965). Weight changes in college women during the menstrual cycle. American Journal of Obstetrics and Gynecology, 91, 89–94. https://doi.org/10.1016/0002-9378(65)90591-0.
39. Gordon, D., Hughes, F., Young, K., Scruton, A., Keiller, D., Caddy, O., … et al. (2013). The effects of menstrual cycle phase on the development of peak torque under isokinetic conditions. Isokinetics and Exercise Science, 21(4), 285-291. https://doi.org/10.3233/IES-130499
40. Göker, A., Artunc-Ulkumen, B., Aktenk, F., & Ikiz, N. (2015). Premenstrual syndrome in Turkish medical students and their quality of life. Journal of Obstetrics and Gynaecology: The Journal of The Institute of Obstetrics and Gynaecology, 35(3), 275–278. https://doi.org/10.3109/01443615.2014.948820
41. Griffin, L. Y., Agel, J., Albohm, M. J., Arendt, E. A., Dick, R. W., Garrett, W. E., … et al.. (2000). Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies. The Journal of the American Academy of Orthopaedic Surgeons, 8(3), 141–150. https://doi.org/10.5435/00124635-200005000-00001
42. Guyton AC. (1977). Tıbbi fizyoloji. Güven Kitabevi Yayınları.
43. Günay, M., Yüce, A. (2008). Futbol antrenmanının bilimsel temelleri. Gazi Kitabevi.,
44. Halson, S. L., & Martin, D. T. (2013). Lying to win-placebos and sport science. International Journal of Sports Physiology and Performance, 8(6), 597–599. https://doi.org/10.1123/ijspp.8.6.597.
45. Hazır, T., Mahir, Ö. F., & Açıkada, C. (2010). Genç futbolcularda çeviklik ile vücut kompozisyonu ve anaerobik güç arasındaki ilişki. Spor Bilimleri Dergisi, 21(4), 146-153.
46. Hillier, S. E., Venables, M. C., & Craven, R. P. (2011). The effects of changes in estradiol and progesterone concentrations during the menstrual cycle on resting metabolic rate. Proceedings of the Nutrition Society, E125. https://doi.org/10.1017/S0029665111001765.
47. Igonin, P. H., Cognasse, F., Gonzalo, P., Philippot, P., Rogowski, I., Sabot, T., … et al. (2024). Monitoring of sprint and change of direction velocity, vertical jump height, and repeated sprint ability in sub-elite female football players throughout their menstrual cycle. Science & Medicine in Football, 1–9. https://doi.org/10.1080/24733938.2024.2328674.
48. Igonin, P. H., Rogowski, I., Boisseau, N., & Martin, C. (2022). Impact of the menstrual cycle phases on the movement patterns of sub-elite women soccer players during competitive matches. International Journal of Environmental Research and Public Health, 19(8), 4465. https://doi.org/10.3390/ijerph19084465.
49. Janse de Jonge, X. A. (2003). Effects of the menstrual cycle on exercise performance. Sports Medicine, 33(11), 833–851. https://doi.org/10.2165/00007256-200333110-00004.
50. Jones, B. P., L'Heveder, A., Bishop, C., Kasaven, L., Saso, S., Davies, S., … et al. (2024). Menstrual cycles and the impact upon performance in elite British track and field athletes: a longitudinal study. Frontiers in Sports and Active Living, 6, 1296189. https://doi.org/10.3389/fspor.2024.1296189.
51. Juillard, E., Douchet, T., Paizis, C., & Babault, N. (2024). Impact of the menstrual cycle on physical performance and subjective ratings in elite academy women soccer players. Sports, 12(1), 16. https://doi.org/10.3390/sports12010016.
52. Kanellakis, S., Skoufas, E., Simitsopoulou, E., Migdanis, A., Migdanis, I., Prelorentzou, T., … et al. (2023). Changes in body weight and body composition during the menstrual cycle. American Journal of Human Biology: The Official Journal of The Human Biology Council, 35(11), e23951. https://doi.org/10.1002/ajhb.23951.
53. Karacan, S., & Günay, M. (2003). Sporcularda menstruasyon ve premenstrual sendromun bazı temel motorik özelliklere ve fizyolojik parametrelere etkisi. Gazi Beden Eğitimi ve Spor Bilimleri Dergisi, 8(4), 49-57.
54. Karim, K. G. (2016). The effects of the menstrual cycle on agility [Master’s thesis, Cleveland State University], Department of Health and Human Performance.
55. Kin, A., Hazır, T., & Ergen, E. (1994). Step ve aerobik egzersizlerinde Borg skalasının güvenirliği ve geçerliliği. Spor Bilimleri Dergisi, 7(4), 4-12.
56. Kumar, S., Mufti, M., & Kisan, R. (2013). Variation of reaction time in different phases of menstrual cycle. Journal of Clinical and Diagnostic Research, 7(8), 1604–1605. https://doi.org/10.7860/JCDR/2013/6032.3236
57. Larsen, B., Morris, K., Quinn, K., Osborne, M., & Minahan, C. (2020). Practice does not make perfect: A brief view of athletes' knowledge on the menstrual cycle and oral contraceptives. Journal of Science and Medicine in Sport, 23(8), 690–694. https://doi.org/10.1016/j.jsams.2020.02.003.
58. Lebrun C. M. (1993). Effect of the different phases of the menstrual cycle and oral contraceptives on athletic performance. Sports Medicine, 16(6), 400–430. https://doi.org/10.2165/00007256-199316060-00005.
59. Lebrun, C. M., Joyce, S. M., & Constantini, N. W. (2013). Effects of female reproductive hormones on sports performance. In endocrinology of physical activity and sport. Humana Press.
60. McNulty, K. L., Elliott-Sale, K. J., Dolan, E., Swinton, P. A., Ansdell, P., Goodall, S., Thomas, K., & Hicks, K. M. (2020). The effects of menstrual cycle phase on exercise performance in eumenorrheic women: A systematic review and meta-analysis. Sports Medicine, 50(10), 1813–1827. https://doi.org/10.1007/s40279-020-01319-3.
61. Meignié, A., Duclos, M., Carling, C., Orhant, E., Provost, P., Toussaint, J. F., & Antero, J. (2021). The Effects of Menstrual Cycle Phase on Elite Athlete Performance: A Critical and Systematic Review. Frontiers in physiology, 12, 654585. https://doi.org/10.3389/fphys.2021.654585.
62. Mor, A., Karakaş, F., Mor, H., Yurtseven, R., Yılmaz, A. K., & Acar, K. (2022). Genç futbolcularda direnç bandı egzersizlerinin bazı performans parametrelerine etkisi. Spormetre Beden Eğitimi ve Spor Bilimleri Dergisi, 20(3), 128-142. https://doi.org/10.33689/spormetre.1095371.
63. Mor, A., Yurtseven, R., Mor, H., & Acar, K. (2021). 11-12 yaş grubu futbolcularda farklı ısınma protokollerinin bazı performans parametrelerine etkisi. Spormetre Beden Eğitimi ve Spor Bilimleri Dergisi, 19(4), 72-83. https://doi.org/10.33689/spormetre.907920.
64. Oğul, A., Ercan, S., Ergan, M., Parpucu, T. İ., & Çetin, C. (2021). The effect of menstrual cycle phase on multiple performance test parameters. Turkish Journal of Sports Medicine, 56(4), 159-165. https://doi.org/10.47447/tjsm.0552.
65. Ön., S., Diker, G., & Özkamçı, H. (2014). Adolesan voleybolcularda menstruasyonun anaerobik güce ve aktif sıçrama performansına etkisi. Sport Sciences, 9(2), 32-42. https://doi.org/10.12739/NWSA.2014.9.2.2B0099 Özdemir, R., & Küçükoğlu, S. (1993). Bayan sporcularda menstruasyonun sürat ve dayanıklılığa etkisi. Spor Bilimleri Dergisi, 4(4), 3-9. https://doi.org/10.17644/sbd.171640.
66. Özer-Kaya, D., &Toprak-Çelenay, Ş. (2016). Fluctuations of state anxiety, spinal structure, and postural stability across the menstrual cycle in active women. Turkish Journal of Medical Sciences, 46(5), 977-984. https://doi.org/10.3906/sag-1501-13.
67. Pawar, B. L., Kulkarni, M. A., Syeda, A., Somwanshi, N. D., & Chaudhari, S. P. (2006). Effect of premenstrual stress on cardiovascular system and central nervous system. Journal of Obstetrics and Gynecology of India, 56(2), 156-158.
68. Pereira, H. M., Larson, R. D., & Bemben, D. A. (2020). Menstrual cycle effects on exercise-ınduced fatigability. Frontiers in Physiology, 11, 517. https://doi.org/10.3389/fphys.2020.00517.
69. Pitchers, G., & Elliott-Sale, K. (2019). Considerations for coaches training female athletes. Professional Strength & Conditioning, 55, 19–30.
70. Rigon, F., De Sanctis, V., Bernasconi, S., Bianchin, L., Bona, G., Bozzola, M., … et al. (2012). Menstrual pattern and menstrual disorders among adolescents: an update of the Italian data. Italian Journal of Pediatrics, 38, 1-8. https://doi.org/10.1186/1824-7288-38-38.
71. Sarwar, R., Niclos, B. B., & Rutherford, O. M. (1996). Changes in muscle strength, relaxation rate and fatiguability during the human menstrual cycle. The Journal of Physiology, 493(1), 267–272. https://doi.org/10.1113/jphysiol.1996.sp021381.
72. Sawai, A., Tochigi, Y., Kavaliova, N., Zaboronok, A., Warashina, Y., Mathis, B. J., … et al. (2018). MRI reveals menstrually-related muscle edema that negatively affects athletic agility in young women. PloS one, 13(1), e0191022. https://doi.org/10.1371/journal.pone.0191022.
73. Smith, M. J., Adams, L. F., Schmidt, P. J., Rubinow, D. R., & Wassermann, E. M. (2002). Effects of ovarian hormones on human cortical excitability. Annals of Neurology, 51(5), 599–603. https://doi.org/10.1002/ana.10180.
74. Solli, G. S., Sandbakk, S. B., Noordhof, D. A., Ihalainen, J. K., & Sandbakk, Ø. (2020). Changes in self-reported physical fitness, performance, and side effects across the phases of the menstrual cycle among competitive endurance athletes. International Journal of Sports Physiology and Performance, 15(9), 1324–1333. https://doi.org/10.1123/ijspp.2019-0616.
75. Sung, E., Han, A., Hinrichs, T., Vorgerd, M., Manchado, C., & Platen, P. (2014). Effects of follicular versus luteal phase-based strength training in young women. SpringerPlus, 3, 1-10. https://doi.org/10.1186/2193-1801-3-668.
76. Şahin, İ., & Süel, E. (2010). Güreşçilerde kısa süreli kilo kaybının esneklik üzerine etkisi. Beden Eğitimi ve Spor Bilimleri Dergisi, 7(4).
77. Şirin, A., & Kavlak, O. (2015). Kadın sağlığı. Nobel Kitabevleri.
78. Tenan, M. S., Hackney, A. C., & Griffin, L. (2016). Maximal force and tremor changes across the menstrual cycle. European Journal of Applied Physiology, 116(1), 153–160. https://doi.org/10.1007/s00421-015-3258-x.
79. Tenan, M. S., Peng, Y. L., Hackney, A. C., & Griffin, L. (2013). Menstrual cycle mediates vastus medialis and vastus medialis oblique muscle activity. Medicine And Science in Sports and Exercise, 45(11), 2151–2157. https://doi.org/10.1249/MSS.0b013e318299a69d.
80. Thompson, B., Janse de Jonge, X., & Han, A. (2019). Methodological recommendations for menstrual cycle research in sports and exercise. Medicine and Science in Sports And Exercise, 51(12), 2610-2617. , Webb, J. L., Millan, D. L., & Stolz, C. J. (1979). Gynecological survey of American female athletes competing at the Montreal Olympic Games. The Journal of Sports Medicine and Physical Fitness, 19(4), 405–412.
81. Yalçın, S., Bağış, Y. E., Yerlikaya, G., Beyleroğlu, M. (2023). Orta düzeyde aktif genç kadınlarda menstrual döngü fazlarının egzersiz performansı, vücut sıcaklığı ve yorgunluk düzeyleri üzerine etkisi. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 12(1), 201-210. https://doi.org/10.37989/gumussagbil.1224750.
82. Yamamoto, K., Okazaki, A., Sakamoto, Y., & Funatsu, M. (2009). The relationship between premenstrual symptoms, menstrual pain, irregular menstrual cycles, and psychosocial stress among Japanese college students. Journal of Physiological Anthropology, 28(3), 129–136. https://doi.org/10.2114/jpa2.28.129