The Effect of Eight weeks of HIFT Training with Ashwagandha Supplementation on Hormonal and Inflammatory Factors and Cognitive Performance in Female Athletes with Premenstrual Syndrome: Protocol for a Single-Blind Randomized Controlled Trial

Background: Premenstrual syndrome (PMS) is associated with hormonal alterations, systemic inflammation, pain, delayed-onset muscle soreness (DOMS), and impaired cognitive performance, which may negatively affect athletic performance in women. This study aims to investigate the effect of eight weeks of high-intensity functional training (HIFT) combined with Ashwagandha supplementation on hormonal and inflammatory factors, pain, DOMS, and cognitive performance in female athletes with PMS. Methods: This randomized controlled trial will include 48 female athletes with PMS, who will be equally allocated into four groups of 12 participants: Ashwagandha supplementation alone (A), HIFT plus Ashwagandha supplementation (HIFT+A), HIFT plus placebo (HIFT+P), and control (CON). The intervention will last eight weeks, with HIFT performed three sessions per week. HIFT will consist of multi-joint functional exercises, and training intensity will be monitored using the Borg rating of perceived exertion scale, ranging from 13 to 17. Participants in the supplementation groups will consume 600 mg/day of standardized Ashwagandha extract as two 300 mg capsules, while the placebo group will receive identical capsules containing microcrystalline cellulose. Capsules will be consumed twice daily, one in the morning and one in the evening, for eight weeks. Serum estrogen, progesterone, cortisol, IL-6, and CRP concentrations will be measured after a 10-hour overnight fast before the intervention and 48 hours after the final training session. Cognitive performance will be assessed using the Stroop test, functional capacity using the Cindy workout, and pain and DOMS using the visual analogue scale (VAS). Pain and DOMS will be recorded at baseline and immediately, 12, 24, 48, and 72 hours after the exercise protocol. Data will be analyzed using analysis of covariance and repeated-measures analysis of variance. Conclusions: The findings of this study may provide evidence regarding the effectiveness of combining HIFT with Ashwagandha supplementation in improving hormonal and inflammatory factors, reducing pain and DOMS, and enhancing cognitive performance in female athletes with PMS.