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Enhanced Mental Agility: Women Perform Better During Their Period

A female footballer running with the ball.
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A new study from University College London and the Institute of Sport, Exercise & Health (ISEH) investigated how the menstrual cycle can affect sport-related mental cognition. The research, published in Neuropsychologia, is part of a larger research project supported by the FIFA Research Scholarship.

Investigating injury risk in the menstrual cycle

The menstrual cycle is associated with various physiological and psychological changes that can impact a woman’s performance; during a cycle, female sex hormone levels can change by over 100% in 24 hours.

Menstrual cycle phases:

  1. Menstruation: Uterine lining sheds due to decreased estrogen and progesterone levels.
  2. Follicular phase: Pituitary gland releases follicle-stimulating hormone (FSH), promoting ovarian follicle maturation and estrogen production, thickening the uterine lining.
  3. Ovulation: Increase in luteinizing hormone (LH) triggers mature egg release from the ovary.
  4. Luteal phase: Ruptured follicle becomes corpus luteum, secreting progesterone to sustain uterine lining for potential implantation.

Recent research has highlighted that the risk of musculoskeletal injuries in female athletes varies depending on what phase of the menstrual cycle they are in.  Though it is believed these results are caused by typical hormonal fluctuations, how these changes can result in an increased injury risk is unknown.

Several studies have also reported cognition and brain function can change throughout the menstrual cycle.

“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,” said Dr. Flaminia Ronca, associate professor at UCL Division of Surgery and Interventional Science and ISEH, and first author of the study.

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“Given that progesterone has an inhibitory effect on the cerebral cortex and estrogen 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,” said Ronca.

Sport-related cognition tests

Ronca and the team collected reaction time and error data from 241 participants consisting of 96 males, 105 menstruating females and 47 females on contraception using a variety of sport-related cognition tests taken 14 days apart. Period tracking apps were used to estimate what menstrual cycle phase the participants were in. Data on the individual's well-being was also recorded using a mood scale and a symptom questionnaire.


The cognition tests were designed to simulate similar mental processes that are used during team sports, such as soccer. The participant's spatial timing and cognition were assessed using tasks that included asking them to click on a screen when two moving balls collided and asking them to identify mirror images in a 3D rotation task. In a separate task, testing their inhibition, attention, reaction time and accuracy, the participants were shown a series of smiling or winking faces and were asked to press the space bar upon seeing a smiley face.

Cognition impacts athletic performance

Although the participants recorded low mood during menstruation and perceived their cognitive and physical symptoms affected their performance, their reaction times were faster and they made less mistakes. During the moving ball test, the participants were 12% more accurate on average and they made 25% fewer mistakes during the smiley face task.


Reaction times were, however, impacted during the luteal phase. Participants were on average 1020 milliseconds slower compared to any other phase.


The decrease in reaction time could have a substantial impact on whether an athlete sustains an injury or not – studies have found a variation of 10 milliseconds can mean the difference between a concussion and a lesser injury.

Perceived performance may not equal actual performance

“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,” said Ronca.


“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.”


“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,” said Dr. Megan Lowery, a researcher at UCL Surgery and Interventional Science and ISEH, and a co-author of the study.


Reference: Ronca F, Blodgett JM, Bruinvels G, et al. Attentional, anticipatory and spatial cognition fluctuate throughout the menstrual cycle: potential implications for female sport. Neuropsychologia. 2024:108909. doi: 10.1016/j.neuropsychologia.2024.108909


This article is a rework of a press release issued by University College London. Material has been edited for length and content.