Influence of Menstrual Cycle Phases on skill-related components of physical fitness in eumenorrheic athletes: A Systematic Review.

Background: the hormonal changes that occur during the menstrual cycle create an impact on both the neuromuscular abilities and cognitive functions in female athletes, impacting their physical performance. While there has been extensive research on endurance and maximal strength, the way different phases on menstruation influence skill related performance in eumenorrheic athletes is still not clearly known. This study systematically reviews the existing literature to understand how different phases of menstrual cycle influence skill related components of physical fitness in eumenorrheic athletes. The method of systematic review is based on the guidelines of the PRISMA 2020 (Preferred Reporting Items for Systematic reviews and Meta-Analyses), in which registration in PROSPERO is required (CRD420251273145). Researcher performed the search for English language studies in PubMed, Cochrane Library, Google Scholar in period January 2020 to December 2025. The studies using experimental and observational methods for considering the skill performance in different phases of the menstrual cycle in athletes aged 16 years and older. To evaluate the Risk of Bias, ROB2 (risk of bias tool in randomised controlled trials), ROBIN-I (Risk of Bias in Non-Randomized Studies - of Interventions), AXIS (Appraisal tool for Cross-Sectional Studies), PEDro (Physiotherapy evidence database) and JBI appraisal tools (Joanna Briggs Institute’s Critical Appraisal Tools) were applied. Multifaceted results due to large methodological variability instead performed meta-analysis research; narrative synthesis performed. 15 studies were included after applying the inclusion criteria. Laboratory assessment of sprint speed, jump performance agility indicated minor changes in these outcomes. However, the premenstrual phases were linked to higher susceptibility to fatigue, in terms of repeated sprint fatigue tests, neuromuscular efficacy and biochemical markers. Ecological match analysis revealed that athletes covered less high speed and total distance during their menstrual cycle and early follicular phase of the cycle with changes in cognitive performance occurring independent of physical measurements. Conclusion: the female athletes are able to maintain a stable physical performance through the different phases of the menstrual cycle under controlled laboratory conditions. The findings suggest the need for individualised monitoring, since fatigue resistance, match intensity and cognitive function are variable in different times. Longitudinal studies which include hormone verification are needed to understand the differences of individuals over time and create performance strategies which fit different biological stages.