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Participants’ reaction times were slower during the luteal phase, which begins after ovulation and lasts between 12-14 days up to the beginning of menstruation. Credit: Neuroscience News

Women’s Menstrual Cycle Positively Impacts Cognition

Summary: Women perform better on cognitive tasks during menstruation, despite expecting worse performance. The study highlights how cognitive abilities fluctuate throughout the menstrual cycle. Findings suggest potential implications for injury prevention and women’s health.

Key Facts:

  1. Women perform better on cognitive tasks during menstruation.
  2. Cognitive abilities fluctuate throughout the menstrual cycle.
  3. Findings could impact injury prevention and women’s health strategies.

Source: UCL

Participants reacted quicker and made fewer errors during menstruation, despite believing their performance would be worse, according to new research from UCL and the Institute of Sport, Exercise & Health (ISEH).

The study, published in Neuropsychologia, is the first to assess sport-related cognition during the menstrual cycle and is part of a larger research project supported by the FIFA Research Scholarship.

The findings act as a proof-of-principle that specific types of cognition fluctuate throughout the menstrual cycle, which could have implications for injury and other aspects of women’s health.

Previous sports medicine research has shown that women seem to be at greater risk of sport-related injury during the luteal phase, which is the time between ovulation and menstruation.

This is possibly related to the significant hormonal changes that occur throughout the menstrual cycle. But precisely how these changes are linked to an increased likelihood of injury are unknown at present.

In this study, researchers at UCL and ISEH collected reaction time and error data from 241 participants who completed a battery of cognitive tests 14 days apart. Participants also completed a mood scale and a symptom questionnaire twice.

Period-tracking apps were used to estimate which phase of their cycle the participants were in when they took the tests.

The tests were designed to mimic mental processes that are typical in team sports. In one test, participants were shown smiling or winking faces and asked to press the space bar only when they saw a smiley face, to test inhibition, attention, reaction time and accuracy.

In another, they were asked to identify mirror images in a 3D rotation task, which assesses spatial cognition. A task that asked them to click when two moving balls collide on screen measured spatial timing.

Though participants reported feeling worse during menstruation and perceived that this negatively impacted their performance, their reaction times were faster and they made fewer errors.

For example, their timing was on average 10 milliseconds (12%) more accurate in the moving balls task, and they pressed the space bar at the wrong time 25% less in the inhibition task.

Participants’ reaction times were slower during the luteal phase, which begins after ovulation and lasts between 12-14 days up to the beginning of menstruation. They were on average 10-20 milliseconds slower compared to being in any other phase. They didn’t make more errors in this phase, however.

Dr Flaminia Ronca, first author of the study from UCL Division of Surgery and Interventional Science and ISEH, said: “Research suggests that female athletes are more likely to sustain certain types of sports injuries during the luteal phase and the assumption has been that this is due to biomechanical changes as a result of hormonal variation. But I wasn’t convinced that physical changes alone could explain this association.

“Given that progesterone has an inhibitory effect on the cerebral cortex and oestrogen stimulates it, making us react slower or faster, we wondered if injuries could be a result of a change in athletes’ timing of movements throughout the cycle.

“What is surprising is that the participant’s performance was better when they were on their period, which challenges what women, and perhaps society more generally, assume about their abilities at this particular time of the month.

“I hope that this will provide the basis for positive conversations between coaches and athletes about perceptions and performance: how we feel doesn’t always reflect how we perform.”

To put the findings in context, the authors say the fluctuation in timing could be the difference between an injury or not. Previous research has shown that a variation of just 10 milliseconds can mean the difference between a concussion and a lesser injury, for example.

In the colliding balls task, participants’ timing was on average 12 milliseconds slower during the luteal phase compared to every other phase, a difference of 16%.

Dr Megan Lowery, an author of the study from UCL Surgery & Interventional Science and ISEH, said: “There’s lots of anecdotal evidence from women that they might feel clumsy just before ovulation, for example, which is supported by our findings here. My hope is that if women understand how their brains and bodies change during the month, it will help them to adapt.

“Though there’s a lot more research needed in this area, these findings are an important first step towards understanding how women’s cognition affects their athletic performance at different points during their cycle, which will hopefully facilitate positive conversations between coaches and athletes around performance and wellbeing.”

Professor Paul Burgess, senior author of the study from UCL’s Institute of Cognitive Neuroscience, said: “This study emerged from listening carefully to female soccer players and their coaches.

“We created bespoke cognitive tests to try to mimic the demands made upon the brain at the points in the game where they were telling us that injuries and problems of timing occur at certain times of the menstrual cycle.

“As suggested by what the soccer players had told us, the data suggested that women who menstruate – whether they are athletes or not – do tend to vary in their performance at certain stages of the cycle.

“As a neuroscientist, I am amazed that we don’t already know more about this, and hope that our study will help motivate increasing interest in this vital aspect of sports medicine.”

About this cognition research news

Author: Matt Midgley
Source: UCL
Contact: Matt Midgley – UCL
Image: The image is credited to Neuroscience News

Original Research: Open access.
Attentional, anticipatory and spatial cognition fluctuate throughout the menstrual cycle: potential implications for female sport” by Flaminia Ronca et al. Neuropsychologia


Attentional, anticipatory and spatial cognition fluctuate throughout the menstrual cycle: potential implications for female sport

Current research suggests that menstruating female athletes might be at greater risk of musculoskeletal injury in relation to hormonal changes throughout the menstrual cycle. A separate body of work suggests that spatial cognition might also fluctuate in a similar manner.

Changes in spatial cognition could, in theory, be a contributing risk factor for injury, especially in fast-paced sports that require precise, millisecond accuracy in interactions with moving objects in the environment.

However, existing theories surrounding causes for increased injury risk in menstruating females largely focus on biomechanical mechanisms, with little consideration of possible cognitive determinants of injury risk.

Therefore, the aim of this proof-of-principle study was to explore whether menstruating females exhibit fluctuations in cognitive processes throughout their cycle on a novel sport-oriented cognitive test battery, designed to measure some of the mental processes putatively involved in these sporting situations.

A total of 394 participants completed an online cognitive battery, a mood scale and a symptom questionnaire twice, 14 days apart. After exclusions, 241 eligible participants were included in the analyses (mean: 28 ± 6 years) (male = 96, female(menstruating) = 105, female(contraception) = 47). Cycle phase for menstruating females was based on self-reported information.

The cognitive battery was designed to measure reaction times, attention, visuospatial functions (including 3D mental rotation) and timing anticipation.

Three composite scores were generated using factor analysis with varimax rotation (Errors, Reaction Time, Intra-Individual Variability). Mixed model ANOVAs and repeated measures ANOVAs were performed to test for between and within-subject effects.

There was no group difference in reaction times and accuracy between males and females (using contraception and not).

However, within subject analyses revealed that regularly menstruating females performed better during menstruation compared to being in any other phase, with faster reaction times (10ms, p < .01), fewer errors (p < .05) and lower dispersion intra-individual variability (p < .05). In contrast they exhibited slower reaction times (10ms, p < .01) and poorer timing anticipation (p < .01) in the luteal phase, and more errors in the predicted ovulatory phase (p < .01).

Self-reported mood, cognitive and physical symptoms were all worst during menstruation (p < .01), and a significant proportion of females felt that their symptoms were negatively affecting their cognitive performance during menstruation on testing day, which was incongruent with their actual performance.

These findings suggest that visuospatial and anticipatory processes may fluctuate throughout the menstrual cycle in the general population, with better performance during the menstrual phase and poorer performance during the luteal phase.

If these extend to associations between phase-specific cognitive performance and injury incidence, they would support a cognitive theory of determinants of injury risk in cycling female athletes, opening an opportunity to develop mitigation strategies where appropriate.

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