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Menstrual Changes in Body Composition of Female Athletes

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The aim of the study was to determine whether the tendencies and scope of changes in body mass, body composition and body girths across the menstrual cycle were similar or different in women of different body build. Anthropometric examinations were carried out in a group of 40 naturally regularly menstruated females practicing team sports (aged 19–21, B-v 169.3+/–6.4 cm, body mass 59.6+/–7.0 kg), in the follicular, ovulatory and luteal phases of the menstrual cycle. The phases were determined on the basis of data from two consecutive menstrual cycles taking into account the cycle’s length. To establish the type of body build, Body Mass Index, hydration status and skin fold thickness were measured. For a statistical analysis, a multiple comparisons with multiple confidence intervals were applied. The increase in body mass between the follicular and the luteal phases was observed in all groups of women, the biggest gain was recorded in slim women, who in the luteal phase weighted 0.8 kg more. The amount of fat mass increased significantly across the menstrual cycle only in more hydrated (by about 0.66 kg) and slim women (by about 0.54 kg). Significant changes between consecutive phases of the menstrual cycle in waist and hip girths, and suprailiac skinfold thickness in some groups of women also indicate influence of fatness and hydration status and slenderness. In view of the presented results, the body build seems important for an analysis of the pattern of each component’s changes across the menstrual cycle, especially for female athletes. Certain changes can be seen only in some groups of women, therefore somatic features can be considered as a predictor of the intensity of changes.
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A. J. Stachoń: Menstrual Changes in Athletes, Coll. Antropol. 40 (2016) 2: 111–122
The hormonal changes during the menstrual cycle pre-
pare the woman’s body for pregnancy. Since sex hormones
affect not only the woman’s sex organs but her entire body,
the periodical changes concern various body functions and
components. It is assumed that the luteal phase of the
menstrual cycle involves increases in body mass and body
hydration1–3. The anthropometric measurements of skin-
folds were recommended after or before menstrual bleed-
ing, due to the possible increase in the uid content of
fat-free mass4. Some authors, however, did not notice sig-
ni cant changes in the hydration and adiposity levels
across the menstrual cycle5–7. Taking into account that the
intensity of changes of some body components during the
menstrual cycle varies not only between different popula-
tions but also among women from the same population,
the author of the present study decided to investigate the
impact of body bui ld’s ty pe on the patter n of bo dy composi-
tion changeability during the menstrual cycle. The valu-
Coll. Antropol. 40 (2016) 2: 111–122
Original scienti c paper
Menstrual Changes in Body Composition of
Menstrual Changes in Body Composition of
Female Athletes
Female Athletes
Aleksandra Jadwiga Stachoń
Aleksandra Jadwiga Stachoń
University of Physical Education in Wrocław, Department of Physical Anthropology, Wrocław, Poland
A B S T R A C T
ABSTRACT
The aim of the study was to determine whether the tendencies and scope of changes in body mass, body composition
and body girths across the menstrual cycle were similar or different in women of different body build. Anthropometric
examinations were carried out in a group of 40 naturally regularly menstruated females practicing team sports (aged
19–21, B-v 169.3+/–6.4 cm, body mass 59.6+/–7.0 kg), in the follicular, ovulatory and luteal phases of the menstrual cycle.
The phases were determined on the basis of data from two consecutive menstrual cycles taking into account the cycle’s
length. To establish the type of body build, Body Mass Index, hydration status and skinfold thickness were measured. For
a statistical analysis, a multiple comparisons with multiple con dence intervals were applied. The increase in body mass
between the follicular and the luteal phases was observed in all groups of women, the biggest gain was recorded in slim
women, who in the luteal phase weighted 0.8 kg more. The amount of fat mass increased signi cantly across the men-
strual cycle only in more hydrated (by about 0.66 kg) and slim women (by about 0.54 kg). Signi cant changes between
consecutive phases of the menstrual cycle in waist and hip girths, and suprailiac skinfold thickness in some groups of
women also indicate in uence of fatness and hydration status and slenderness. In view of the presented results, the body
build seems important for an analysis of the pattern of each component’s changes across the menstrual cycle, especially
for female athletes. Certain changes can be seen only in some groups of women, therefore somatic features can be consid-
ered as a predictor of the intensity of changes.
Key words: body components, body mass, body fat, fatness, hydration, body uids, body water, BMI, menstrual cycle,
female athletes
Introduction
Introduction
able element of presented study constitutes the highly
signi cant – in the biological and evolutional sense – ovu-
latory phase, which allowed for a more comprehensive im-
age of body composition variability during the menstrual
cycle, when comparing to previous studies5,7–9. The dif -
culty in comparing different scienti c results was caused
by lack of consistency in the methodology used to deter-
mine menstrual phase10. In this study, we follow the com-
mon approach to menstrual cycle phase11,12. Apart from
the follicular and luteal phases, we determined the ovula-
tory phase as the period of two days before and two days
after ovulation, when the level of luteinzing hormone is
expected to increase12.
The scope and directions of changes in certain body
components during the menstrual cycle are important in
view of development in women’s health and sport sciences.
It is arg ued that b ody composition changes accompa nying
Received for publication January 1, 2016
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A. J. Stachoń: Menstrual Changes in Athletes, Coll. Antropol. 40 (2016) 2: 111–122
changes in the hormonal pro le may affect women’s phys-
ical tness and motor performance3,13,14. This, in turn, is
important for training planning and, ultimately, for sports
performance of female athletes. The changes in body hy-
dration or adiposity during the menstrual cycle can be of
great signi cance in medicine, for example, in recommen-
dations of proper drug dosage or treatment prescription.
In fact, the differences in the metabolic effectiveness of
some drugs have been found with regard to particular
phases of the patient’s menstrual cycle15.
The aim of the present study was to demonstrate
whether the tendencies and scope of changes in body mass,
body composition and bo dy girt hs in fem ale athlet es acr oss
the menstrual cycle were similar or different between
women of different body build. Female athletes constitute
a category of women especially interested in their body
composition and in searching for factors connected with
the experienced changes. Therefore, the results should be
of interest to young women, who in view of their occupa-
tion or practiced sport , struggle with chang es in t heir body
mass and hydration level during the menstrual cycle. They
are not aware, or not always accept the fact, that these
changes are the natural consequence of maintaining fer-
tility, and that pharmacological interventions aimed to
affect changes in body composition may lead to impaired
fertility.
Materials and Methods
Materials and Methods
Participants and procedure
Participants and procedure
Body composition and anthropometric measurements
across the menstrual cycle supported by personal inter-
view were carried out in a sample of 40 young (19–21 years
old) and naturally menstruated (without hormonal supple-
mentation or therapy) female athletes practicing team
sports (soccer, volleyball, basketball, handball). The re-
cruited athletes at the time of the study were not at the
competitive stage of their training cycle. They attended
training sessions two or three times a week (4.0 +/– 0.5
hours per week). Their training experience ranged be-
tween 4–7 years.
The women who were quali ed for the study declared
good health and regular menstrual cycles. Irregular men-
ses, sometimes very long or very short menstrual cycles,
use of hormonal contraception and therapies, slimming
diets and dietary supplements were considered as exclu-
sion criteria, which was the main factor of restricted
sample size. Earlier studies had revealed that levels of
certain body components (body water and body fat, in par-
ticular) were affected by the use of hormonal contracep-
tives as well as hormone replacement therapy16–18.
The average body height of examined women was
169.3+/–6.4 cm, and average body mass in the follicular
phase was 59.6+/–7.0 kg. All subjects had a normal BMI
(mean 21.6+/–1.8 kg/m2) in accordance with WHO crite-
ria19. The length of the menstrual cycle during the study
was 25–35 days, which is accepted as the correct length
of the cycle20,21.
The measurements of the subjects’ body mass, body
girths, skinfold thickness and body composition were
taken every week, at least three times during the men-
strual cycle (in the follicular phase – F, ovulatory phase
– O and luteal phase – L). The phases of menstrual cycles
were determined on the basis of self-reported onset of men-
ses. The ovulatory phase corresponds to the estimated day
of ovulation including two preceding days and two subse-
quent days12. The days of the cycle on which the measure-
ments were carried out were chosen individually for each
woman, after having taken into account their menstrua-
tion cycle’s length and dates of previous menstrual cycles.
The length of each phase of the menstrual cycle was ad-
opted following the published data on this issue11,12. As-
suming that the length of the luteal phase is relatively
constant (14 days), we established the time of ovulation
retrospectively by subtracting 14 days from the date of the
last menstruation11. During the experiment each woman
experienced menstrual bleeding twice, and a retrospective
check-up of the dates chosen for measurements was done.
Anthropometric measurements and body
Anthropometric measurements and body
composition assessment
composition assessment
The measurements were carried out using the equip-
ment of GPM Anthropological Instruments (Siber Hegner
Mach inery, Ltd, Switz erla nd). Body height was measur ed
with a Martin-type anthropometer to the nearest 1.0 mm.
Body mass was measured using an electronic weighing
scale to the nearest 0.1 kg; body girths with an anthropo-
metric tape to the nearest 1.0 mm. The thickness of skin-
folds (triceps, suprailiac, abdominal) was measured with a
Holtain skinfold caliper to the nearest 0.2 mm. One expe-
rienced investigator took a complete set of measurements
three times and the mean value of the three measures was
used for analyses. The assessment of measurement’s reli-
ability was conducted according to the recommendation of
Ulijaszek and Kerr22. The intraobserver technical error of
measurement (TEM) was between 0.4 mm and 1.0 mm for
skinfold thickness and between 1.0 mm and 10.0 mm for
circumference mea surements.
The anthropometric measurements were then used to
calculate the subjects’ proportions: BMI, WHR and SFI
– Subcutaneous Fatness Index (Equation 1).
SFI = (sum of triceps, suprailiac and abdomen
skinfolds [mm] / body height [cm]) * 100.
On the basis of BMI median value, the body build type
(BMI lower than 21.7 kg/m2 v. BMI equal or higher than
21.7 kg/m2) was determined for each participant; the SFI
was used to determine the level of subcutaneous fatness
in the examined women (less fatty, SFI<23.2 v. more fatty,
SFI 23.2).
Body composition was estimated by means of a bioelec-
trical impedance analysis, with the use of BIA Akern® 101
Sport Edition analyzer in standard conditions. The con-
tent of fat mass, free fat mass and total body water was
calculated with the use of Akern® Bodygram 1.3.1. soft-
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ware package. On the basis of percentage of total body
water (TBW) the subjects were divided into two body hy-
dration types: less hydrated (TBW<54.7%) v. more hy-
drated (TBW 54.7%). The measurements were taken at
the same time of the day (morning) to ensure the study’s
reliability. Body mass and body girths were measured in
one’s underwear.
Statistical analyses and ethics
Statistical analyses and ethics
During the statistical analysis the mean values of in-
creases/decreases of each studied characteristic between
two consecutive menstrual phases were calculated and
compared using Student’s t-test for repeated measures.
The level of statistical signi cance was set at p0.05. Also
multiple comparisons with multiple con dence intervals
were applied with the con dence level at 95% (Student’s
t-test with the Bonferroni correction). These calculations
allowed identi cation of two groups of similar (homoge-
nous) means: Group A with higher increases and Group B
with lower increases. The statistical analysis was made
with the StatSoft® Statistica 9.0 and R software (GPL, The
R Foundation for Statistical Computing; Version 1.9.0).
TABLE 1
TABLE 1
CHANGES IN BODY MASS, BODY MASS INDEX AND BODY COMPONENTS BETWEEN THREE PH ASES OF THE MENSTRUAL CYCLE
IN WOMEN W ITH DIFFERENT SUBCUTANEOUS ADIPOSITY
Parameters
Body build type
Less fatty (SFI < 23.2) More fatty (SFI 23.2)
F – L F – P P – L
Groups of
menstrual
phases
F – L F – P P – L
Groups of
menstrual
phases
BODY MASS BODY MASS
Average difference 0.64 * 0.21 0.42 * L A 0.58 * 0.06 0.53 * L A
Con dence interval 0.18 1.09 –0.19 0.62 – 0.03 0.89 P AB 0.25 0.92 –0.33 0.44 0.13 0.93 P B
p-value 0.001 0.19 0.03 F B <0.001 0.71 0.002 F B
BMI BMI
Average difference 0.22 * 0.08 0.14 * L A 0.22 * 0.02 0.19 * L A
Con dence interval 0.07 0.38 –0.07 0.24 – 0.03 0.31 P AB 0.08 0.35 – 0.13 0.18 0.03 0.35 P B
p-value <0.001 0.15 0.04 F B <0.001 0.66 0.004 F B
FAT M ASS FAT M ASS
Average difference 0.49 0.06 0.43 L A 0.07 0.08 0.02 L A
Con dence interval –0.37 1.35 –0.47 0.59 –0.50 1.36 P A –0.59 0.73 –0.36 0.53 –0.69 0.66 P A
p-value 0.15 0.77 0.24 F A 0.78 0.62 0.95 F A
FAT FREE MASS FAT FREE MASS
Average difference 0.16 0.16 –0.005 L A 0.52 –0.03 0.54 L A
Con dence interval –0.64 0.96 –0.47 0.80 – 0.89 0.88 P A 0.14 1.17 –0.46 0.40 –0.33 1.42 P A
p-value 0.60 0.50 0.99 F A 0.05 0.85 0.12 F A
TOTAL BODY WATER TOTAL BODY WATER
Average difference 0.13 0.13 0.00 L A 0.38 * –0.02 0.40 L A
Con dence interval –0.45 0.71 –0.34 0.60 –0.65 0.65 P A –0.11 0.86 –0.34 0.30 –0.23 1.02 P A
p-value 0.56 0.47 1.00 F A 0.05 0.87 0.11 F A
EX TRACELLU LAR WATE R EX TRACELLU LAR WATE R
Average difference 0.32 * 0.13 0.18 L A 0.23 * –0.06 0.29 L A
Con dence interval –0.07 0.70 –0.20 0.46 –0.20 0.48 P A –0.06 0.52 –0.33 0.21 –0.09 0.67 P A
p-value 0.04 0.31 0.16 F A 0.05 0.56 0.06 F A
INTRACELLULAR WATER INTRACELLULAR WATER
Average difference 0.19 –0.005 –0.18 L A 0.14 0.04 0.10 L A
Con dence interval –0.57 0.19 –0.29 0.28 – 0.63 0.26 P A 0.18 0.46 –0.24 0.31 –0.33 0.54 P A
p-value 0.19 0.96 0.28 F A 0.25 0.74 0.53 F A
F – follicular phase, P – periovulatory phase, L – luteal phase, average difference – mean value of differences between particular phases of
the menstrual cycle, body build type de ned on the basis of median value of SFI (MeSFI=23.2), groups of menstrual phases (on the basis of
Bonferroni correction): A – higher value of analyzed feature, B – lower value of analyzed feature, *p<0.05.
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The gures were drawn using Microsoft® Of ce Excel
2003.
The study was approved by the appropriate University
Committee for the Ethics and conducted according to the
Declaration of Helsinki on Ethical Principles for Medical
Research Involving Human Subjects. Informed, written
consent was obtained prior to the enrollment of each vol-
unteer. The study was conducted within the framework of
Young Scientists Research in Poland being funded by the
Ministry of Science and Higher Education in Poland.
Results
Results
Changes in body mass and Body Mass Index
Changes in body mass and Body Mass Index
across the menstrual cycle
across the menstrual cycle
The analysis of changes in body mass across the men-
strual cycle revealed a signi cant increase between the
follicular phase and the luteal one (F-L) in all groups of
women, regardless of their body build type (Table 1–3).
This increment mainly resulted from the changes between
the ovulatory and luteal phases (O-L; Table 1–3). No sig-
ni cant changes in body mass were noted between the
TABLE 2
TABLE 2
CHANGES IN BODY MASS, BODY MASS INDEX AND BODY COMPONENTS BETWEEN THREE PH ASES OF THE MENSTRUAL CYCLE
IN WOMEN W ITH DIFFERENT BODY HY DRATION STATUS
Parameters
Body build type
Less hydrated (TBW < 54.7%) More hydrated (TBW 54.7%)
F – L F – O P – L
Groups of
menstrual
phases
F – L F – P P – L
Groups of
menstrual
phases
BODY MASS BODY MASS
Average difference 0.54 * 0.14 0.40 * L A 0.68 * 0.12 0.56 * L A
Con dence interval 0.18 0.91 – 0.23 0.53 – 0.02 0.83 P AB 0.25 1.10 –0.29 0.54 0.11 1.0 P B
p-value <0.001 0.33 0.02 F B <0.001 0.46 0.003 F B
BMI BMI
Average difference 0.18 * 0.06 0.12 L A 0.26 * 0.04 0.22 * L A
Con dence interval 0.05 0.31 –0.09 0.22 –0.04 0.27 P AB 0.10 0.42 –0.11 0.20 0.05 0.38 P B
p-value 0.001 0.26 0.06 F B <0.001 0.45 0.002 F B
FAT M ASS FAT M ASS
Average difference –0.10 –0.03 –0.07 L A 0.66 * 0,18 0.48 L A
Con dence interval –0.95 0.75 –0.47 0.41 –0.96 0.72 P A 0.04 1.28 –0.35 0.70 –0.23 1.20 P AB
p-value 0.76 0.86 0.84 F A 0.01 0.39 0.09 F B
FAT FREE MASS FAT FREE M ASS
Average difference 0.65 * 0.18 0.47 L A 0.02 –0.04 0.07 L A
Con dence interval –0.15 1.45 –0.26 0.62 –0.53 1.47 P A –0.60 0.65 0.67 0.58 –0.70 0.84 P A
p-value 0.04 0.29 0.23 F A 0.92 0.85 0.81 F A
TOTAL BODY WATER TOTA L BODY WATER
Average difference 0.48 * 0.13 0.34 L A 0.03 –0.02 0.05 L A
Con dence interval –0.11 1.06 –0.19 0.45 –0.37 1.06 P A –0.43 0.49 – 0.48 0.44 – 0.51 0.61 P A
p-value 0.04 0.30 0.22 F A 0.86 0.91 0.82 F A
EX TRACELLU LAR WATE R EXT RACE LLULAR WAT ER
Average difference 0.40 * 0.07 0.34 * L A 0.14 0.00 0.14 L A
Con dence interval 0.05 0.76 –0.19 0.33 –0.04 0.71 P AB –0.17 0.45 –0.35 0.35 –0.20 0.48 P A
p-value 0.007 0.48 0.03 F B 0.24 1.00 0.29 F A
INTRACELLULAR WATER INTRACELLULAR WATER
Average difference 0.06 0.06 0.01 L A 0.12 –0.02 –0.09 L A
Con dence interval –0.31 0.44 –0.21 0.32 0.47 0.49 P A –0.46 0.23 –0.31 0.26 –0.49 0.31 P A
p-value 0.65 0.59 0.96 F A 0.38 0.82 0.56 F A
F – follicular phase, P – periovulatory phase, L – luteal phase, average difference – mean value of differences between particular phases of
the menstrual cycle, body build type de ned on the basis of median value of TBW (MeTBW=54.7%), groups of menstrual phases (on the basis
of Bonferroni correction): A – higher value of analyzed feature, B – lower value of analyzed feature, *p<0.05.
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A. J. Stachoń: Menstrual Changes in Athletes, Coll. Antropol. 40 (2016) 2: 111–122
follicular and ovulatory phases (F-O), with the exception
of slim women who gain in weight regularly during the
whole cycle (Table 3). The maximum body mass increases
during the whole cycle amounted to about 2 kg in indi-
vidual cases but in several women the changes were small-
er than 0.25 kg (Figure 1). Few cases of decreased body
mass in individual women took place mainly in the rst
part of the menstrual cycle (between phases F and O), but
were also rarely observed in the second part of the cycle
(between O and L) (Figure 1). The comparison of changes
between women with different subcutaneous adiposity
levels showed that both less fatty and fattier women dis-
played the same tendencies of body mass changes during
the menstrual cycle (Table 1). It should be noted, however,
that the less fatty women had lower total gains in body
mass in the cycle (F-L). The level of body hydration did not
differentiate the direction of changes in body mass be-
tween subsequent phases, but women with more hydrated
bodies showed higher increases in body mass in the whole
menstrual cycle (F-O; Table 2). Signi cant changes in
body mass gains were found between women with higher
and those with lower BMI values. Slim women had twice
TABLE 3
TABLE 3
CHANGES IN BODY MASS, BODY MASS INDEX AND BODY COMPONENTS BETWEEN THREE PH ASES OF THE MENSTRUAL CYCLE
IN WOMEN W ITH DIFFERENT BODY SLEN DERNESS
Parameters
Body build type
BMI < 21.7 kg/m2BMI 21.7 kg/m2
F – L F – P P – L
Groups of
menstrual
phases
F – L F – P P – L
Groups of
menstrual
phases
BODY MASS BODY MASS
Average difference 0.80 * 0.37 * 0.43 * L A 0.40 * –0.13 0.53 * L A
Con dence interval 0.43 1.17 –0.05 0.81 –0.008 0.87 P AB 0.02 0.78 –0.40 0.14 0.11 0.96 P B
p-value <0.001 0.04 0.02 F B 0.01 0.21 0.004 F B
BMI BMI
Average difference 0.30 * 0.14 * 0.17 * L A 0.13 * –0.04 0.16 * L A
Con dence interval 0.17 0.44 –0.03 0.31 0.001 0.333 P B –0.01 0.26 –0.14 0.07 0.01 0.32 P B
p-value < 0.001 0.04 0.02 F B 0.02 0.35 0.01 F AB
FAT M ASS FAT M ASS
Average difference 0.53 * 0.10 0.43 * L A 0.01 0.04 0.04 L A
Con dence interval 0.03 1.03 –0.35 0.55 –0.08 0.93 P AB 0.99 1.00 – 0.49 0.58 –1.11 1.04 P A
p-value 0.01 0.56 0.04 F B 0.99 0.84 0.93 F A
FAT FREE MASS FAT FREE M ASS
Average difference 0.29 0.29 0.00 L A 0.39 0.17 0.57 L A
Con dence interval –0.15 0.72 –0.17 0.74 –0.60 0.60 P A –0.60 1.39 –0.78 0.43 –0.57 1,7 P A
p-value 0.10 0.11 1.00 F A 0.31 0.45 0.20 F A
TOTAL BODY WATER TOTA L BODY WATER
Average difference 0.22 0.21 0.01 L A 0.29 –0.12 0.41 L A
Con dence interval –0.09 0.53 –0.13 0.55 –0.43 0.44 P A –0.44 1.02 – 0.56 0.33 –0.42 1.23 P A
p-value 0.08 0.12 0.95 F A 0.30 0.49 0.21 F A
EX TRACELLU LAR WATE R EXT RACE LLULAR WAT ER
Average difference 0.27 * 0.07 0.20 L A 0.28 0.00 0.28 L A
Con dence interval 0.01 0.52 – 0.23 0.36 – 0.08 0.48 P AB –0.15 0.71 –0.32 0.32 –0.16 0.72 P A
p-value 0.01 0.55 0.07 F B 0.10 1.00 0.11 F A
INTRACELLULAR WATER INTRACELLULAR WATER
Average difference –0.05 0.14 0.19 L A 0.00 –0.13 0.13 L A
Con dence interval –0.30 0.21 –0.11 0.39 – 0.51 0.13 P A –0.46 0.46 –0.41 0.16 –0.41 0.67 P A
p-value 0.63 0.14 0.13 F A 1.00 0.25 0.54 F A
F – follicular phase, P – periovulatory phase, L – luteal phase, average difference – mean value of differences between particular phases of
the menstrual cycle, body build type de ned on the basis of median value of BMI (MeBMI=21.7 kg/m2), groups of menstrual phases (on the
basis of Bonferroni correction): A – higher value of analyzed feature, B – lower value of analyzed feature, *p<0.05.
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as high increases in body mass between the follicular
phase and the luteal one than the women with higher BMI
(Table 3). Moreover, increases in body mass between phas-
es F and O in slim women were statistically signi cant
and were only slightly lower than increases between phas-
es O and L in this group of women (Table 3).
In all groups of women, signi cantly higher BMI val-
ues were noted in the luteal phase. The greatest BMI
changes were found in slim women (Table 3) and more
hydrated women (Table 2); the smallest ones in women
with higher BMI (Table 3) and less hydrated women (Ta-
ble 2).
Changes in body composition across the
Changes in body composition across the
menstrual cycle
menstrual cycle
Fat mass increased signi cantly between phases F and
L only in more hydrated women (Table 2) and in slim
women (Table 3). The amount of subcutaneous fat did not
affect signi cantly the changes in total fat mass between
subsequent phases (Table 1). No changes in the amount of
fat free mass across the menstrual cycle were found (Table
2).
There were no signi cant differences in terms of total
body water content, with the exception of less hydrated
women who had higher volumes of total body water in
luteal phase (Table 2). The amount of extracellular water
changed signi cantly between the follicular phase and the
luteal one in almost all studied groups of women, and was
greater in the second half of the cycle (Tables 1–3). The
increases between phases F and L were signi cant both
in less fatty and more fatty women (Table 1). In women
with more hydrated bodies the content of extracellular
water was almost unchanged in the consecutive phases of
the cycle, whereas in less hydrated women a signi cantly
higher level of extracellular uid was found in the luteal
phase (Table 2). A higher level of extracellular uid in the
luteal phase was also noted in slim women (Table 3); how-
ever, the increases were smaller than in the group of
women with less hydrated bodies. In individual cases the
amount of extracellular water rose by about 1.5 kg (Figure
2). In some women a decrease of about 1.0 kg was noted in
the level of extracellular hydration in the follicular and
luteal phases of the menstrual cycle (Figure 2). No sig-
ni cant differences in the amount of intracellular water
were found between three consecutive phases of the men-
strual cycle (Tables 1–3).
Changes in body girths during the menstrual cycle
Changes in body girths during the menstrual cycle
The analysis of multiple comparisons did not result in
an identi cation of phases with signi cantly different
mean lengths of waist girths in any of the studied groups
-1,5 -1,0 -0,5 0,0 0,5 1,0 1,5 2,0 2,5
Body mass changes [kg]
I part of menstrual cycle
II part of menstrual cycle
-1,5 -1,0 -0,5 0,0 0,5 1,0 1,5 2,0
Extracellular water changes [kg]
I part of menstrual cycle
II part of menstrual cycle
Fig. 1. Body mass changes in individual women under study;
negative values »–« signify a decrease in body mass; »I part of
menstrual cycle” means the differences between the measurements
in follicular and ovulatory phases; »II part of menstrual cycle«
means the differences between the measurements in ovulatory and
luteal phases.
Fig. 2. Extracellular water changes in individual women under
study; negative values »– « signify a decrease in extracellular body
volume; »I part of menstrual cycle« means the differences between
the measurements in follicular and ovulatory phases; »II part of
menstrual cycle« means the differences between the measurements
in ovulatory and luteal phases.
117
A. J. Stachoń: Menstrual Changes in Athletes, Coll. Antropol. 40 (2016) 2: 111–122
of women (Tables 4–6). However, a tendency towards lon-
ger waist girth in the rst phase of the menstrual cycle
was observed. An increase in the hip girth – above 1cm
– was noted in the rst half of the menstrual cycle (F-O)
in less fatty women and slim ones (Tables 4, 6). A statisti-
cally signi cant change was also found in women with
more hydrated bodies (Table 5) and in less fatty women
(Table 4). In the second half of the menstrual cycle (O-L),
the hip girth remained the same or decreased insigni -
cantly (Tables 4–6).
The WHR index was lower between the follicular phase
and the luteal phase in all groups of women with different
body build types (Tables 4–6); however, the changes were
statistically non-signi cant. Furthermore, the WHR
changes in individual women varied, and in some women
TABLE 4
TABLE 4
CHANGES IN SELECTED BODY GIRTHS, WAIST-TO-HIP RATIO AND SELECTED SK INFORLDS BETWEEN THREE PHASES OF THE
MENSTRUAL CYCLE IN WOMEN WITH DIFFERENT SUBCUTA NEOUS ADIPOSIT Y
Parameters
Body build type
Less fatty (SF I <23.2) More fatty (SFI 23.2)
F – L F – P P – L
Groups of
menstrual
phases
F – L F – P P – L
Groups of
menstrual
phases
WAIST GIRTH WAIST GIRTH
Average difference 3.9 6.3 * –3.3 L A 0.3 0.0 0.0 L A
Con dence interval –5.0 12.8 –0.6 13.2 –13.8 7.1 P A –6.3 6.8 –10.6 10.6 9.3 9.3 P A
p-value 0.26 0.03 0.41 F A 0.91 1.00 1.00 F A
HIP GIRTH HIP GIRTH
Average difference 10. 8 * 14.7 * –3.3 L AB 5.0 2.5 1.4 L A
Con dence interval –1.4 23.0 3 .0 26.4 –14.7 8.1 P A 7.5 17.5 11.2 16.2 8.4 11.1 P A
p-value 0.03 0.004 0.45 F B 0.30 0.64 0.71 F A
WHR WHR
Average difference –0.004 –0.005 –0,001 L A –0.003 –0.002 –0.001 L A
Con dence interval –0.016 0.007 –0.015 0.005 –0.008 0.006 P A 0.013 0.007 –0.012 0.009 –0.011 0.009 P A
p-value 0.34 0.23 0.74 F A 0.43 0.69 0.78 F A
ARM GIRTH ARM GIRTH
Average difference 1.9 0.5 1.1 L A 2.5 1.3 1.7 L A
Con dence interval –2.4 6.3 –4.9 5.9 –3.4 5.7 P A –3. 5 8.5 –3.5 6.1 –4.5 7.9 P A
p-value 0.25 0.80 0.52 F A 0.28 0.47 0.48 F A
THIGH GIRTH THIGH GIRTH
Average difference –2.2 5.5 –7.5 * L B 1.0 –2.2 3.1 L A
Con dence interval –10.1 5.7 2.2 13.3 –14.7 – 0.3 P A –5.4 7.4 –10. 2 5.8 5.2 11.4 P A
p-value 0.46 0.07 0.01 F AB 0.68 0.47 0.34 F A
TRICEPS SKINFOLD TRICEPS SKINFOLD
Average difference 0.16 0.23 0.06 L A 0.28 0.38 0.17 L A
Con dence interval –0.75 1.08 –0.41 0.86 –0.90 0.77 P A –0.62 1.19 –0.27 1.03 –1.36 1.03 P A
p-value 0.64 0.35 0.84 F A 0.41 0.13 0.71 F A
ILIAC SKINFOLD ILIAC SKINFOLD
Average difference 0.14 0.68 0.54 L A 0.74 0.05 0.73 L A
Con dence interval –0.78 1.06 –0.31 1.67 –1.48 0.41 P A –1.22 2.70 –1.77 1.87 0.73 2.20 P A
p-value 0.69 0.09 0.15 F A 0.33 0.94 0.20 F A
ABDOMINAL SKINFOLD ABDOMINAL SKINFOLD
Average difference 0.97 1.03 0.05 L A 0.47 0.56 0.11 L A
Con dence interval –0.46 2.41 –0.51 2.56 –1.20 1.10 P A –1,20 2.13 –0.98 2.10 –2.17 1.95 P A
p-value 0.09 0.09 0.90 F A 0.47 0.35 0.89 F A
F – follicular phase, P – periovulatory phase, L – luteal phase, average difference – mean value of differences between particular phases of
the menstrual cycle, body build type de ned on the basis of median value of SFI (MeSFI=23.2), groups of menstrual phases (on the basis of
Bonferroni correction): A – higher value of analyzed feature, B – lower value of analyzed feature, *p<0.05.
118
A. J. Stachoń: Menstrual Changes in Athletes, Coll. Antropol. 40 (2016) 2: 111–122
the WHR decreased in the follicular phase and also in the
luteal one of the menstrual cycle.
No signi cant changes in arm girth and thigh girth
were found across the menstrual cycle in the studied wom-
en (Tables 4–6). The exception was the group of less fatty
women, who featured a longer thigh girth in the rst half
of the cycle and a shorter thigh girth in the second half,
thus resulting in the highest mean value of the thigh girth
in the ovulatory phase (Table 4).
Changes in subcutaneous adiposity during the
Changes in subcutaneous adiposity during the
menstrual cycle
menstrual cycle
No signi cant changes in the triceps skinfold thickness
were noted between the consecutive phases of the men-
TABLE 5
TABLE 5
CHANGES IN SELECTED BODY GIRTHS, WAIST-TO-HIP RATIO AND SELECTED SK INFORLDS BETWEEN THREE PHASES OF THE
MENSTRUAL CYCLE IN WOMEN WITH DIFFERENT HY DRATION LEVELS
Parameters
Body build type
Less hydrated (TBW < 54.7%) More hydrated (TBW 54.7%)
F – L F – P P – L
Groups of
menstrual
phases
F – L F – P P – L
Groups of
menstrual
phases
WAIST GIRTH WAIST GIRTH
Average difference 1.4 2.6 –1.9 L A 2.8 3.7 –1.4 L A
Con dence interval –6.4 9.2 –0.8 13.3 –10.5 6.6 P A –5.2 10.8 –3.6 11.0 –12.6 9.8 P A
p-value 0.64 0.52 0.55 F A 0.37 0.20 0.74 F A
HIP GIRTH HIP GIRTH
Average difference 6.1 9.2 –2.2 L A 9.7 * 8.0 0.3 L A
Con dence interval 7.7 19.9 3.7 22.1 –11.8 7.4 P A –1.2 20.6 5.7 21.7 –11.4 1 2.0 P A
p-value 0.25 0.07 0.54 F A 0.03 0.14 0.95 F A
WHR WHR
Average difference –0.004 –0.003 –0.001 L A –0.004 –0.002 –0.002 L A
Con dence interval –0.011 0.004 –0.010 0.004 – 0.007 0.005 P A –0.014 0.006 –0.010 0.007 –0.009 0.006 P A
p-value 0.20 0.26 0.37 F A 0.29 0.55 0.57 F A
ARM GIRTH ARM GIRTH
Average difference 0.6 0.5 –0.3 L A 3.9 1.3 3.1 L A
Con dence interval –4.2 5.3 –4.5 5.5 –6.4 5.9 P A –1.6 9.4 –3.9 6.5 –1.3 7.4 P A
p-value 0.76 0.78 0.91 F A 0.07 0.51 0.08 F A
THIGH GIRTH THIGH GIRTH
Average difference 0.8 3.4 –2.2 L A –2.1 –0.1 –2.2 L A
Con dence interval –5 .8 7.4 –5.1 11.9 –10.7 6.2 P A –9.8 5.7 –7.9 7.7 –10.7 6.3 P A
p-value 0.74 0.30 0.49 F A 0.49 0.97 0.50 F A
TRICEPS SKINFOLD TRICEPS SKINFOLD
Average difference 0.18 0.05 0.14 L A 0.26 0.56 * –0.38 L A
Con dence interval 0.68 1.04 –0.58 0.67 –0.85 1.12 P A –0.70 1.22 –0.06 1.19 –1.40 0.64 P A
p-value 0.58 0.84 0.72 F A 0.48 0.03 0.34 F A
ILIAC SKINFOLD ILIAC SKINFOLD
Average difference 0.91 0.68 0.23 L A –0.07 0.05 –0.08 L A
Con dence interval –0.78 2.60 –0.95 2.30 –1.01 1.47 P A –1.28 1.14 –1.23 1.34 –1.39 1.24 P A
p-value 0.17 0.28 0.63 F A 0.88 0.91 0.88 F A
ABDOMINAL SKINFOLD ABDOMINAL SKINFOLD
Average difference 0.83 1.28 * 0.45 L A 0.62 0.31 0.31 L A
Con dence interval –1.09 2.74 –0.18 2 .74 –1,96 1,06 P A 0.39 1.63 –1.25 1.86 –1.43 2.05 P A
p-value 0.27 0.03 0.44 F A 0.12 0.61 0.64 F A
F – follicular phase, P – periovulatory phase, L – luteal phase, average difference – mean value of differences between particular phases of
the menstrual cycle, body build type de ned on the basis of median value of TBW (MeTBW=54.7%), groups of menstrual phases (on the basis
of Bonferroni correction): A – higher value of analyzed feature, B – lower value of analyzed feature, *p<0.05.
119
A. J. Stachoń: Menstrual Changes in Athletes, Coll. Antropol. 40 (2016) 2: 111–122
strual cycle in any of the studied groups of women (Tables
4–6). An increase in the thickness of the suprailiac skin-
fold was found between the follicular phase and the luteal
one in the group of women with lower BMI (F-L; Table 6).
The abdominal skinfold was found to be thicker between
the follicular phase and the ovulatory one in slim women
(Table 6) and in less hydrated ones (Table 5). The ten-
dency towards a thicker abdominal skinfold in the ovula-
tory phase was observed in all studied groups; however,
the results of multiple comparison tests did not allow for
an identi cation of menstrual cycle phases of signi cant-
ly different values of abdominal skinfold thickness and the
observed changes were smaller than the measuring error
(Tables 4–6).
TABLE 6
TABLE 6
CHANGES IN SELECTED BODY GIRTHS, WAIST-TO-HIP RATIO AND SELECTED SK INFORLDS BETWEEN THREE PHASES OF THE
MENSTRUAL CYCLE IN WOMEN WITH DIFFERENT BODY SLENDERNESS
Parameters
Body build type
BMI < 21.7 kg/m2BMI 21.7 kg/m2
F – L F – P P – L
Groups of
menstrual
phases
F – L F – P P – L
Groups of
menstrual
phases
WAIST GIRTH WAIST GIRTH
Average difference 2.5 4.2 –1.8 L A 1.6 1.9 –1.6 L A
Con dence interval –3.3 8.3 –1.8 10.3 –10.2 6.7 P A –8.8 12.0 –10.0 13.3 –13.4 10.3 P A
p-value 0.27 0.08 0.59 F A 0.69 0.67 0.73 F A
HIP GIRTH HIP GIRTH
Average difference 8.2 10.5 * –2.2 L A 7.5 6.5 0.6 L A
Con dence interval –4.1 20.6 –0.2 21.2 –12.2 7.7 P A –5.0 20.0 –9.4 22.4 –11.0 12.2 P A
p-value 0.09 0.02 0.56 F A 0.12 0.29 0.89 F A
WHR WHR
Average difference –0.003 –0.003 –0.000 L A –0.004 –0.003 –0.002 L A
Con dence interval –0.014 0.007 –0.012 0.006 –0.009 0.009 P A 0.015 0.007 –0.015 0.009 –0.009 0.005 P A
p-value 0.42 0.36 0.99 F A 0.32 0.50 0.44 F A
ARM GIRTH ARM GIRTH
Average difference 3.0 1.8 1.2 L A 1.2 0.0 1.6 L A
Con dence interval –1.8 7.8 –2.8 6.3 –3.4 5.9 P A –4.4 6.9 –5.6 5.6 –5.0 8.1 P A
p-value 0.12 0.32 0.48 F A 0.55 1.00 0.53 F A
THIGH GIRTH THIGH GIRTH
Average difference 0.6 2.1 –1.5 L A –2.1 1.2 –3.1 L A
Con dence interval –7.3 8.5 –5.4 9.6 –10.6 7.6 P A –7.7 3.5 –7.8 10.1 –10.2 4.0 P A
p-value 0.84 0.47 0.67 F A 0.32 0.73 0.25 F A
TRICEPS SKINFOLD TRICEPS SKINFOLD
Average difference 0.26 0.34 0.09 L A 0.18 0.26 0.14 L A
Con dence interval –0.75 1.26 –0.26 0.95 –1.18 1.00 P A 0.55 0.92 –0.43 0.95 –1.03 0.75 P A
p-value 0.51 0.15 0.83 F A 0.51 0.32 0.68 F A
ILIAC SKINFOLD ILIAC SKINFOLD
Average difference 0.68 * 0.30 0.38 L A 0.15 0.44 –0.27 L A
Con dence interval –0.13 1.48 0.74 1.33 –0.66 1.42 P A –1.99 2.29 –1.45 2.34 –1.79 1.25 P A
p-value 0.04 0.46 0.35 F A 0.86 0.54 0.64 F A
ABDOMINAL SKINFOLD ABDOMINAL SKINFOLD
Average difference 1.06 1.35 * –0.29 L A 0.34 0.17 0.16 L A
Con dence interval 0.34 2.46 0.004 2,704 –1.58 1.00 P A –1.38 2.05 –1.48 1.86 –1.8 5 2.18 P A
p-value 0.06 0.02 0.56 F A 0.61 0.78 0.83 F A
F – follicular phase, P – periovulatory phase, L – luteal phase, average difference – mean value of differences between particular phases of
the menstrual cycle, body build type de ned on the basis of median value of BMI (MeBMI=21.7 kg/m2), groups of menstrual phases (on the
basis of Bonferroni correction): A – higher value of analyzed feature, B – lower value of analyzed feature, *p<0.05.
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A. J. Stachoń: Menstrual Changes in Athletes, Coll. Antropol. 40 (2016) 2: 111–122
Discussion
Discussion
Results of some previous studies indicated that women’s
body mass increased in the luteal phase of the menstrual
cycle by about 0.1–0.2 kg, and in some cases even by 0.5
kg
1,3,6,8,9
. Comparing to that, the female athletes in our
study, especially those characterized by slim body build
(lower BMI), presented more substantial increases of body
mass. Tasmektepligil et al. also observed that changes in
body mass were greater in sportswomen than in controls
3
.
The increase in body mass between the follicular phase
and the luteal one in the present study was noted in all
groups of women of different body build. It should be
stresse d, howe ver, t hat the absolute gain in body mass was
the biggest in slim women, who in the luteal phase weight-
ed 0. 8 kg more th an in t he foll icula r pha se. In women w ith
lower BMI the increase in body mass in the rst part of
the menstrual cycle was similar to the increase in the sec-
ond part of the cycle. The tendencies were, however, differ-
ent in women with different body build types: the increase
in body mass between the follicular phase and the ovula-
tory phase was far lower than in the second part of the
cycle. It must be stressed that in individual cases a body
mass loss was observed in the studied women in the con-
secutive phases of the menstrual cycle (F-O-L), despite
exclusion of a slimming diet factor and impact of treat-
ment. The factors affecting these individual cases might
not have been considered during the experiment (undiag-
nosed hormonal disorders). Some earlier studies failed to
reveal any signi cant changes in body mass during the
menstrual cycle, however, they did not take into account
different body build types of their subjects
5,7
.
Body mass changes during the menstrual cycle are
hormonally driven; however, their intensity, which varies
in different individuals, may depend on a variety of factors
such as increased consumption or limited physical activ-
ity23 –25. Several earlier studies reported increased appetite
and food intake during the luteal phase of the menstrual
cycle, and these changes were connected not only with
estrogen and progesterone levels but also with leptin and
insulin levels26,27. These results can be con rmed by the
noted heightened sleeping metabolic rate in the luteal
phase, which is commonly thought to re ect the cost of
tissue regeneration and energy storage28. The consequence
of body mass changes during the menstrual cycle is BMI
variability. A signi cantly higher BMI was observed in
the luteal phase in all groups of women under study. The
most signi cant changes of the BMI were found in slim
women and in more hydrated ones, and the least signi -
ca nt in women with higher B MI a nd in les s hyd rate d ones.
The body composition analysis made it possible to nd
those body components whose changes increase body mass
in the consecutive phases of the menstrual cycle. In the
present study a signi cant increase in lean body mass be-
tween the follicular and ovulatory phases was only found
in the group of less hydrated women, but not in the other
groups. It should be stressed that the amount of fat free
mass is calculated on the basis of intracellular water vol-
ume estimates. Gleihauf and Roe using BIA revealed
changes in fat free mass (by 0.1 kg lower in the follicular
phase)
8
. In the present study on female athletes the extra-
cellular water level was higher in the second part of the
cycle by about 0.4 kg in less hydrated women, and by about
0.3 kg in other groups of women with different body builds
types. Also Tomazo-Ravnik and Jakopič showed that body
hydration was the highest in the luteal phase
9
. Some ear-
lier studies, with the use of magnetic resonance imaging,
showed that the water content was the lowest between the
6th and the 15th day of the menstrual cycle
2
. These param-
eters then soared in the second part of the menstrual cycle
reaching the peak after the 25
th
day
2
. In the majority of
female athletes in the current study, no changes in body
hydration were noted in the rst phase of the menstrual
cycle. The amount of fat mass in women under study in-
creased signi cantly between the follicular and ovulatory
phases only in more hydrated women (by about 0.7 kg) and
in slim women (by about 0.5 kg). The amount of subcutane-
ous adiposity did not affect the changes in total fat mass
between subsequent phases. According to Wickham et al.,
the adiposity level decreases in the luteal phase
7
. Ellard et
al. in their hydrodensitometric analysis, as well as Glei-
hauf and Roe and some other authors did not note any
signi cant changes in fat mass and total body water dur-
ing the menstrual cycle
5,8,29,30
. McKee and Cameron did not
nd any differences in body composition, despite increased
body mass
6
. They asserted that BIA did not re ect chang-
es in body composition taking place during the menstrual
cycle
6
. However, Dehghan and Merchant revealed that the
given phase of the menstrual cycle in uences the bioimped-
ance and body composition estimation
31
.
The present study showed that the interpretation of
observed changes in body girths and skinfold thickness
during the menstrual cycle is problematic because of mea-
surement error values. However, signi cant positive cor-
relation between the observed interphases changes in
girths (hip and waist) and suprailiac skinfold thickness
indicate the in uence of some biological factors. Among
all measured body girths, only the hip girth changed in
the consecutive phases of the cycle, with the lowest values
in the ovulatory phase. The differences in the hip girth in
examined women did not affect signi cantly the WHR. A
tendency towards a lower WHR was noted between the
follicular phase and the ovulatory one, however, a non-
signi cant WHR drop was observed after ovulation in
many women. Kirhengast and Gartner found a signi -
cantly decreased WHR in women in the ovulatory phase,
which was explained by the sexual selection mechanism1.
In the study of Tasmektepligil et al. the waist girth was
the longest and hip girth was the shortest during menses3.
The abdominal and subscapular skinfolds were the thick-
est after menstruation, whereas the triceps, calf and iliac
skinfolds remained the same in the follicular and the lu-
teal phases3. Those researchers did not, however, perform
measurements in the ovulatory phase. The present study
showed that the abdominal skinfold in studied women was
a little thicker in the ovulatory phase than in the follicular
phase, but only in less hydrated women and in slim wom-
en. The iliac skinfold in slim women was a little thicker in
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A. J. Stachoń: Menstrual Changes in Athletes, Coll. Antropol. 40 (2016) 2: 111–122
the luteal phase than in the follicular phase. The triceps
skinfolds did not differ in thickness between the subse-
quent phases of the cycle in any of the studied groups of
women. The performed multiple comparison tests that ac-
counted for interactions between the phases of the men-
strual cycle did not permit discerning one phase with
signi cantly different skinfold thickness and the value of
observed differences was smaller than measurement er-
ror. However, autocorrelation between measurements and
phases is another source of error which should be taken
into consideration. According to Dehghan and Merchant,
the thickness of subcutaneous adiposity varies throughout
the menstrual cycle31. Some other authors did not observe
any differences in skinfold thickness or fat distribution
during the menstrual cycle5,8,29,30.
Limitation of the study
Limitation of the study
Besides interesting ndings resulted from the
longitudinal study design on female athletes, the present-
ed study had several limitations which should be dis-
cussed. The basic problem in research on the menstrual
cycle is a proper determination of the cycle’s phases. Self-
reported onset of menses, although is the most popular
method, when introduced alone (without any additional
method) may provide some errors in determining phases
of the menstrual cycle. It is recommend combining sev-
eral methods to improve accuracy of phase identi cation,
minimize costs and burden, and reduce selection bias and
confounding10. In our sample we introduced a careful se-
lection of females with respect to menses regularity and
also a retrospective (after following menses) check-up of
the dates chosen for measurements. Additionally, it is
wort h mention ing th at prev ious studies r epor ted some dif-
ferent confounders of the changeability of body mass
across the menstrual cycle which was not tested in detail
during this study23–27. The overall dietary inhabits, con-
sumptions of supplements and level of physical activity
were checked using a questionnaire and interview once
before inclusion to the study.
Conclusion and implication of the ndings
Conclusion and implication of the ndings
The increase in body mass and intracellular water con-
tent between the follicular phase and the luteal one of the
menstrual cycle is very common among female athletes,
but the intensity of observed changes depends on female
body build. Considering the results of the present study
and previously published data it seems that slim women
with more hydrated body build characteristic for athletes
are more exposed to cyclic changes in body mass and tis-
sue composition.
The obtained results are most likely to be of interest
for young women, especially athletes, who in view of their
occupation or practiced sport, struggle with changes in
their body mass and hydration during the menstrual cycle.
They are not aware, or not always accept the fact, that
these changes are the natural consequence of maintaining
fertility, and that pharmacological interventions aimed to
affect changes in body composition may lead to impaired
fertility. The physicians and trainers should also consider
these ndings while preparing medical diagnosis or train-
ing plan and controlling their results in female athletes.
R E F E R E N C E S
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122
A. J. Stachoń: Menstrual Changes in Athletes, Coll. Antropol. 40 (2016) 2: 111–122
A. J. Stachoń
University School of Physical Education in Wroclaw, Department of Physical Anthropology, Podarewskego 35,
51-612 Wroc ław, Poland
e-mail: olastachon@gmail.com
MENSTRUALNE PROMJENE SASTAVA TIJELA KOD GRAĐE TIJELA ATLETIČARKI
MENSTRUALNE PROMJENE SASTAVA TIJELA KOD GRAĐE TIJELA ATLETIČARKI
S A Ž E T A K
SAŽETAK
Cilj istraživanja bio je utvrditi da li su tendencije i opseg promjena u tjelesnoj masi, sastavu tijela i opsegu tijela u
menstrualnom ciklusu bili slični ili različiti kod žena različite tjelesne građe. Antropometrijska ispitivanja provedena
su u grupi od 40 žena koje imaju menstruaciju i redovito se bave sportom (u dobi od 19 do 21, 169, 3 +/– 6,4 cm BV, tjele-
sna masa 59,6 +/– 7,0 kg) u folikularnoj, periovulatornoj i lutealnoj fazi menstrualnog ciklusa. Faze su određene na
temelju podataka iz dva uzastopna menstrualnog ciklusa, uzimajući u obzir duljinu ciklusa. Kako bi se utvrdio tip tjele-
sne građe, mjereni su indeks tjelesne mase, status hidratacije i debljina kože. Za statističku analizu su primijenjene
višestruke usporedbe s više intervala pouzdanosti. Porast tjelesne mase između folikularne i lutealne faze bio je uočen
u svim skupinama žena, najveći dobitak je izmjeren kod mršavih žena, koje su u lutealne faze u prosjeku imale 0,8 kg
više. Količina masnog tkiva značajno je porasla u prvom dijelu ciklusa samo kod više hidratiziratiziranih i vitkih žena.
Značajne međufaze promjene kod obujma struka i kuka I debljine kože u jednoj skupini žena također ukazuje na utjecaj
somatskih čimbenika. S obzirom na prikazane rezultate, građa tijela se čini važnim za analizu uzoraka promjena poje-
dinih komponenti na cijelom menstrualnom ciklusu, posebno kod sportašica. Neke promjene mogu se vidjeti samo u
nekim skupinama žena, dakle, somatske značajke mogu se uzeti u obzir kao prediktor intenziteta promjena.
... 1 However, other studies failed to report any change in body composition parameters across the menstrual cycle. 5,6 The assessment of body composition includes a series of parameters, which should be measured using their reference methods. 7 However, such reference methods often consist of expensive devices and unfeasible procedures in practical contexts. ...
... 12 Recently, no change in body composition across the menstrual cycle was reported using BIA in well-trained women. 5,6 However, the procedures were not conducted using specific equations for well-trained subjects or athletes, 5,6 possibly misinterpreting the results. Since the extent of the fluctuations may be relatively small, the use of BIVA could have led to a more appropriate evaluation. ...
... In contrast, other studies have assessed body composition during the menstrual cycle using BIA, reporting no fluctuations in total body water. 5,6,23 However, the assessment of body composition using BIA can be performed using different technologies and procedures, and both can affect the results. For example, the foot-to-hand technology used here has been identified as reference method, 18 and results from other technologies showed no consistency when compared to the foot-to-hand as criterion. ...
Article
Full-text available
Purpose: To examine whether menstrual cycle affects body composition and bioimpedance vector analysis (BIVA) patterns, jumping and sprinting ability, and flexibility in elite soccer players. Methods: A total of 20 elite female soccer players (age: 23.8 [3.4] y, height: 1.63 [0.04] m, body mass: 61.4 [5.9] kg, and body mass index: 22.5 [2.4] kg/m2) were monitored during the early follicular and ovulatory phase across 2 consecutive menstrual cycles. Bioimpedance analysis was performed using foot-to-hand technology, and total body water and fat mass were determined by specific equations developed for athletes. Bioelectrical resistance and reactance were adjusted according to the BIVA procedures and plotted as a vector within the resistance-reactance graph. In addition, countermovement jump, 20-m sprint, and sit and reach were assessed. Results: A time effect (P < .05) was found for body mass, total body water, bioelectrical resistance and reactance, and flexibility. Specifically, body mass increased (P = .021) along with a gain in total body water (P = .001) from the ovulatory to the early follicular phase, while it decreased from the early follicular to the ovulatory phase during the second menstrual cycle. The BIVA vector shortened during the early follicular phases (P < .001). No change in jumping and sprinting capacity was observed (P > .05). Flexibility was impaired during the early follicular phases (P < .05). Conclusions: Specific bioelectrical impedance analysis and BIVA procedures are able to detect menstrual cycle-induced changes in body composition in elite soccer players. The early follicular phase resulted in fluid accumulations and BIVA vector shortening. In addition, while menstrual cycle did not affect performance, a fluctuation in flexibility was observed.
... In addition, the methodologies used in these studies may not be sensitive enough to identify the menstrual cycle phases. Some of these studies predicted the menstrual cycle phases using only self-report information from participants (Gualdi-Russo and Toselli 2002;Tomazo-Ravnik and Jakopi c 2006;Daniusevi ci ut _ e et al. 2010;Stacho n 2016;Hicks et al. 2017) or based only on urine luteinizing hormone levels (Cumberledge et al. 2018). Moreover, a few of the studies verified that true ovulation had occurred (Dokumacı and Hazı r 2019;Rael et al. 2021). ...
... Furthermore, to date all studies reported only whole body composition changes (Gualdi-Russo and Toselli 2002;Tomazo-Ravnik and Jakopi c 2006;Hall et al. 2009;Stacho n 2016;Hicks et al. 2017;Cumberledge et al. 2018;Dokumacı and Hazır 2019;Rael et al. 2021). However, body fluid retention may be more prominent in certain regions of the body such as legs, trunk, and abdomen (Tacani et al. 2015;Sawai et al. 2018), where most body fluid resides, and reporting whole body composition changes may mask regional changes. ...
Article
Background: Changes in estradiol and progesterone hormones and associated fluid retention during the menstrual cycle phases might affect body composition (BC) in women. Aim: The main objectives of this study were to determine the changes in whole and regional BC by dual-energy x-ray absorptiometry (DXA) and bioelectrical impedance (BIA) during the mid-follicular (MFP) and mid-luteal (MLP) phases. Subjects and methods: Thirty recreationally active young women participated in this study. BC was measured by DXA and BIA during MFP and MLP. A mixed linear model for repeated measures analysis was used to determine the differences between the two phases. Results: Body mass was higher during MLP than MFP, while total body water, total and segmental fat mass and fat percentages measured by both BIA and DXA were similar during the two phases. DXA-derived fat-free mass and soft lean mass in the android region were higher during MLP than MFP. Large variability in individual responses was evident. Conclusion: On average, whole and segmental BC variables do not change significantly between MFP and MLP. However, given the large variability among the individual responses, it is suggested to perform repeated BC measurements during the same phase of the menstrual cycle.
... 1 To date, various studies that determined whether different MC phases may affect body composition estimates have produced equivocal results. Some authors have reported body mass, 2-4 lean mass (LM) or fat-free mass, 5,6 , fat mass (FM) or body fat % (%BF), 6,7 or skinfolds 2,3 to be relatively stable throughout the MC. However, others have observed LM changes between the early follicular (EF) to mid-late follicular (MF) 7 phase or FM changes between the EF, MF and mid-luteal (ML) phases. ...
... However, others have observed LM changes between the early follicular (EF) to mid-late follicular (MF) 7 phase or FM changes between the EF, MF and mid-luteal (ML) phases. 5 Given the uncertainty to which the MC may have an impact on body composition estimates and thus interfere with monitoring such changes in active females, this study therefore aimed to further investigate the variability of body composition estimates across the MC of these individuals using standardised brightness-mode ultrasound (International Association of Sciences in Medicine and Sports [IASMS]) and skinfolds (SF) (International Society for the Advancement of Kinanthropometry [ISAK]) at eight measurement sites, along with Dual-energy X-ray absorptiometry (DXA). The standardised brightness-mode ultrasound (B-mode US) technique has been recently demonstrated to be highly accurate and reliable for measuring subcutaneous adipose tissue (SAT) in athletes of diverse sports and physiques 8,9 and non-athletes of various obesity classes. ...
Article
Objectives (1) To compare changes in body composition estimates over the menstrual cycle in active eumenorrheic females using dual energy X-ray absorptiometry, brightness-mode ultrasound and skinfolds (2) Correlate ultrasound and skinfold measures against dual-energy x-ray absorptiometry fat mass estimate. Design Thirty eumenorrheic active females (27 ± 5 y) with regularly occurring menstrual cycles participated in a cross sectional study. Methods Participants completed four assessment sessions scheduled according to each individual's menstrual cycle. These sessions took place during their (1) early follicular, (2) mid-to-late follicular, (3) mid-luteal and (4) second early follicular phases. Body composition estimates were acquired using dual-energy x-ray absorptiometry, subcutaneous adipose tissue was measured using brightness mode ultrasound and skinfolds with callipers. Results Mean changes in total and regional dual-energy x-ray absorptiometry lean and fat mass estimates were not significantly different between the menstrual cycle phases and were within the 95% confidence intervals of their respective least significant change values (LSC-95%CI). Additionally, mean changes in body mass as measured by weighing scales, dual-energy x-ray absorptiometry estimate of total mass, sum of eight ultrasound measurements and sum of eight skinfolds between the cycle phases were also not significantly different (p > 0.05). Conclusion Meaningful and true changes in body composition estimates using dual energy X-ray absorptiometry, brightness-mode ultrasound and skinfolds were not significant across the menstrual cycle in active eumenorrheic females. Body composition may thus be assessed via these methods in this population at any phase in their cycle under standardised participant presentation.
... From 2000 to 2014, BIA was used in 15 studies [34,35,[37][38][39][40][41][42][43][44][45][46][47][48][49], with a peak of 11 articles published in 2015 [50][51][52][53][54][55][56][57][58][59][60], followed by a decline 2 years later [24,[61][62][63][64], before undergoing a progressive increase beginning in 2018 up until 2020 . Possibly, all articles published before 2018 mainly used the quantitative assessment of body composition, i.e., the simple estimation of the different body composition parameters using prediction equations. ...
... These perplexities have pushed researchers to develop specific equations [24][25][26] or use alternative evaluation approaches [31,45,56,78,109,110]. From 2000 to 2014, BIA was used in 15 studies [34,35,[37][38][39][40][41][42][43][44][45][46][47][48][49], with a peak of 11 articles published in 2015 [50][51][52][53][54][55][56][57][58][59][60], followed by a decline 2 years later [24,[61][62][63][64], before undergoing a progressive increase beginning in 2018 up until 2020 . Possibly, all articles published before 2018 mainly used the quantitative assessment of body composition, i.e., the simple estimation of the different body composition parameters using prediction equations. ...
Article
Full-text available
Body composition is acknowledged as a determinant of athletic health and performance. Its assessment is crucial in evaluating the efficiency of a diet or aspects related to the nutritional status of the athlete. Despite the methods traditionally used to assess body composition, bioelectric impedance analysis (BIA) and bioelectric impedance vector analysis (BIVA) have recently gained attention in sports, as well as in a research context. Only until recently have specific regression equations and reference tolerance ellipses for athletes become available, while specific recommendations for measurement procedures still remain scarce. Therefore, the present narrative review summarizes the current literature regarding body composition analysis, with a special focus on BIA and BIVA. The use of specific technologies and sampling frequencies is described, and recommendations for the assessment of body composition in athletes are provided. Additionally, the estimation of body composition parameters (i.e., quantitative analysis) and the interpretation of the raw bioelectrical data (i.e., qualitative analysis) are examined, highlighting the innovations now available in athletes. Lastly, it should be noted that, up until 2020, the use of BIA and BIVA in athletes failed to provide accurate results due to unspecific equations and references; however, new perspectives are now unfolding for researchers and practitioners. In light of this, BIA and especially BIVA can be utilized to monitor the nutritional status and the seasonal changes in body composition in athletes, as well as provide accurate within- and between-athlete comparisons.
... Another limitation is the restriction in terms of the sex of participants. The body composition of women may be associated with the day of the menstruation cycle [31]; therefore, all potential female participants should have been examined in the same cycle phase. Given the above-described limitations, collecting a homogenous group of women would be unusually difficult. ...
Article
Full-text available
Although brown adipose tissue (BAT) is considered to play a protective role against obesity and type 2 diabetes, the mechanisms of its activation and associations with clinical parameters are not well described. Male adults underwent a 2 h cold exposure (CE) to activate BAT and, based on the results of PET/MRI performed after the CE, were divided into BAT(+) and BAT(−) groups. During the CE procedure, blood samples were collected and alterations in plasma metabolome in both groups were investigated using LC-MS. Additionally, associations between clinical factors and BAT were examined. Moreover, levels of glucose, insulin, leptin, TNF-α, FGF21, and FABP4 were assessed in serum samples. In the BAT(+) group, levels of LPC(17:0), LPE(20:4), LPE(22:4), LPE(22:6), DHA, linoleic acid, and oleic acid increased during CE, whereas levels of sphinganine-phosphate and sphingosine-1-phosphate decreased. Levels of LPE(O-18:0), 9-HpODE, and oleic acid were elevated, while the level of LPE(20:5) was reduced in BAT(+) compared to BAT(−) subjects. AUCs of LPC(18:2), LPC(O-18:2)/LPC(P-18:1), and SM(d32:2) negatively correlated with BAT. In the BAT(+) group, the concentration of FABP4 during and after CE was decreased compared to the basal level. No alterations were observed in the BAT(−) group. In conclusion, using untargeted metabolomics, we proved that the plasma metabolome is affected by cold-induced BAT activation.
... Recent research using four different BIA analysers at four time-points in the MC and OC cycle did not report significant differences in any body composition measures between the time-points (Cumberledge et al. 2018). Additionally, some researchers report no differences in skinfolds (Ellard et al. 1991) or subcutaneous fat measured via ultrasound (Perin et al. 2000), while others have found significant changes in some skinfold measures (Stachoń 2016) and skin thickness (Eisenbeiss et al. 1998) over the MC. ...
Article
Full-text available
Purpose This study aimed to investigate the effect of fluctuating female hormones during the menstrual cycle (MC) and oral contraceptive (OC) cycle on different measures of body composition. Methods Twenty-two women with a natural MC and thirty women currently taking combined monophasic OC were assessed over three phases of the menstrual or oral contraceptive cycle. Body weight, skinfolds, bioelectric impedance analysis (BIA), ultrasound, dual-energy X-ray absorptiometry (DXA), and peripheral quantitative computed tomography (pQCT) measurements were performed to assess body composition. Urine specific gravity (USG) was measured as an indication of hydration, and serum oestradiol and progesterone were measured to confirm cycle phases. Results Five participants with a natural MC were excluded based on the hormone analysis. For the remaining participants, no significant changes over the MC and OC cycle were found for body weight, USG, skinfolds, BIA, ultrasound and pQCT measures. However, DXA body fat percentage and fat mass were lower in the late follicular phase compared to the mid-luteal phase of the MC, while for the OC cycle, DXA body fat percentage was higher and lean mass lower in the early hormone phase compared with the late hormone phase. Conclusion Our findings suggest that assessment of body fat percentage through BIA and skinfolds may be performed without considering the MC or OC cycle. Body adiposity assessment via DXA, however, may be affected by female hormone fluctuations and therefore, it may be advisable to perform repeat testing using DXA during the same phase of the MC or OC cycle.
... Female athletes have distinct nutritional needs based on their sport, exercise intensity, and season [55], with disordered eating observed in athletes from several sports, especially esthetic ones [56], limiting understanding of the impact of MC on food intake. No difference in body mass or composition, determined by dual-energy absorptiometry (DXA) [57] or bioelectrical impedance [58], was found in well-trained NMC women across MC in most studies, with one study shows, however, an increase in body mass in L vs. F in the more hydrated and slim women [59]. ...
Article
Full-text available
Female athletes have garnered considerable attention in the last few years as more and more women participate in sports events. However, despite the well-known repercussions of female sex hormones, few studies have investigated the specificities of elite female athletes. In this review, we present the current but still limited data on how normal menstrual phases, altered menstrual phases, and hormonal contraception affect both physical and cognitive performances in these elite athletes. To examine the implicated mechanisms, as well as the potential performances and health risks in this population, we then take a broader multidisciplinary approach and report on the causal/reciprocal relationships between hormonal status and mental and physical health in young (18–40 years) healthy females, both trained and untrained. We thus cover the research on both physiological and psychological variables, as well as on the Athlete Biological Passport used for anti-doping purposes. We consider the fairly frequent discrepancies and summarize the current knowledge in this new field of interest. Last, we conclude with some practical guidelines for eliciting improvements in physical and cognitive performance while minimizing the health risks for female athletes.
... However, other studies demonstrated that body composition is affected. In athletes, body mass and total body water increased from the follicular to the luteal phase [56]. Similarly, the body mass [57] and total body water [58] increased from the follicular to the luteal phase in healthy, non-athletic females. ...
Article
Full-text available
The effect of the menstrual cycle on physical performance is being increasingly recognised as a key consideration for women’s sport and a critical field for further research. This narrative review explores the findings of studies investigating the effects of menstrual cycle phase on perceived and objectively measured performance in an athletic population. Studies examining perceived performance consistently report that female athletes identify their performance to be relatively worse during the early follicular and late luteal phases. Studies examining objective performance (using anaerobic, aerobic or strength-related tests) do not report clear, consistent effects of the impact of menstrual cycle phase on physical performance. Overall sport performance can be influenced by both perceived and physical factors. Hence, to optimise performance and management of eumenorrheic female athletes, there is a need for further research to quantify the impact of menstrual cycle phase on perceived and physical performance outcomes and to identify factors affecting variability in objective performance outcomes between studies.
... There could also be increased sodium (thus water) retention in the luteal phase, by way of the progesterone-related increased plasma aldosterone concentrations during this phase (Souza et al., 1989;Stachenfeld et al., 1999aStachenfeld et al., , 2001. Moreover, other studies have also observed an increase in body water content measured by bioelectrical impedance analysis during the luteal versus follicular phase (Bunt et al., 1989;Mitchell et al., 1993;Tomazo-Ravnik and Jakopiè, 2006;Fruzzetti et al., 2007;Stachoń, 2016). Therefore, these findings indicate that women may be more protected against dehydration in the luteal compared to follicular phase. ...
Article
Full-text available
Chronic pain - pain that persists for more than 3 months - is a global health problem and is associated with tremendous social and economic cost. Yet, current pain treatments are often ineffective, as pain is complex and influenced by numerous factors. Hypohydration was recently shown to increase ratings of pain in men, but studies in this area are limited (n = 3). Moreover, whether hypohydration also affects pain in women has not been examined. In women, changes in the concentrations of reproductive hormones across menstrual phases may affect pain, as well as the regulation of body water. This indicates potential interactions between the menstrual phase and hypohydration on pain, but this hypothesis has yet to be tested. This review examined the literature concerning the effects of the menstrual phase and hypohydration on pain, to explore how these factors may interact to influence pain. Future research investigating the combined effects of hypohydration and menstrual phase on pain is warranted, as the findings could have important implications for the treatment of pain in women, interpretation of previous research and the design of future studies.
... Also, we did not attempt to control for the subjects' menstrual cycles when testing. This may have influenced body water and thus assessment of lean mass (Stachoń, 2016). While it can be speculated that random distribution in the cohort would render any observed differences small, we nevertheless cannot rule out confounding effects on body composition. ...
Article
Full-text available
Aspiring female physique athletes are often encouraged to ingest relatively high levels of dietary protein in conjunction with their resistance-training programs. However, there is little to no research investigating higher vs. lower protein intakes in this population. This study examined the influence of a high vs. low protein diet in conjunction with an 8-week resistance training program in this population. Seventeen females (21.2±2.1 years; 165.1±5.1 cm; 61±6.1 kg) were randomly assigned to a high protein diet (HP: 2.5g/kg/day; n=8) or a low protein diet (LP: 0.9g/kg/day, n=9) and were assessed for body composition and maximal strength prior to and after the 8-week protein intake and exercise intervention. Fat-free mass (FFM) increased significantly more in the HP group as compared to the LP group (p=0.009), going from 47.1 ± 4.5kg to 49.2 ± 5.4kg (+2.1kg) and from 48.1 ± 2.7kg to 48.7 ± 2 (+0.6kg) in the HP and LP groups, respectively. Fat mass significantly decreased over time in the HP group (14.1 ± 3.6kg to 13.0 ± 3.3kg; p<0.01) but no change was observed in the LP group (13.2 ± 3.7kg to 12.5 ± 3.0kg). While maximal strength significantly increased in both groups, there were no differences in strength improvements between the two groups. In aspiring female physique athletes, a higher protein diet is superior to a lower protein diet in terms of increasing FFM in conjunction with a resistance training program.
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