An Analysis of Wellness Responses in Female Lacrosse Athletes Throughout Their Menstrual Cycles

ABSTRACT Introduction The purpose of this observational study was to assess the differences in wellness responses while menstruating and not menstruating in National Collegiate Athletic Association Division I women’s collegiate lacrosse athletes who took hormonal contraceptives (HC) and those who were naturally cycling (NC). Methods Female collegiate lacrosse athletes (HC, n = 12; NC, n = 11) completed daily surveys scoring their session ratings of perceived exertion (sRPE) and well-being in several wellness domains (1 to 5 in arbitrary units (AU)): muscle readiness, energy, sleep quality, yesterday’s nutrition, mood, health status, and stress. Athletes also indicated their menstrual cycle status as “menses” or “not menses.” Data were collected for 4 months during the lacrosse competitive season. Analyses compared differences between HC and NC groups and differences with menstruation on game and training days for participant wellness and sRPE. Results On game days, athletes had higher energy scores when they were not menstruating/withdrawal bleeding (NC = 4.1 ± 0.3 AU, HC = 4.1 ± 0.3 AU) compared to when they were (NC = 3.9 ± 0.3 AU, HC = 3.9 ± 0.2 AU; P = 0.03), but there were no group differences. On training days, HC users had higher sRPE (menses = 673.0 ± 104.6 AU, not menses = 669.1 ± 96.1 AU) than NC athletes (menses = 561.8 ± 177.0 AU, not menses = 565.2 ± 98.2 AU; P = 0.006). Conclusion The only differences found were in energy, strengthening the concept that athletes adapt to physically stressful scenarios regardless of their menstrual cycle; however, this may be nuanced for athletes competing in a team sport compared to individual sport athletes. An increased perception of exertion in HC users might be due to accompanying inflammatory responses and changes in fat mass and lean mass that often accompany HC use.