The Influence of the Phases of the Menstrual Cycle on Intrinsic Injury Risk Factors in Eumenorrheic Female Athletes or Physically Active Women—A Systematic Review

Florent Osmani; Marta Victoria Santiago García; Oliver Ramos-Álvarez

Resumen:

Research in sports science has frequently excluded women due to the complexity of hormonal fluctuations. The overall aim of this study is to systematically analyse the influence of the menstrual cycle (MC) on intrinsic anatomical, biomechanical and neuromuscular injury risk factors in physically active women or eumenorrheic athletes. Methods: A systematic review was conducted following the guidelines of the PRISMA 2020 statement. Searches were carried out in PubMed, the Cochrane Library, Web of Science and Scopus up to March 2026, including studies that analysed at least three phases of the MC. Methodological quality was assessed using the Joanna Briggs Institute checklists. Results: Eleven articles were included in the analysis. It was observed that the late follicular and ovulatory phases were associated with improved biomechanical and neuromuscular profiles, thereby reducing certain risk factors. In contrast, the premenstrual and menstrual phases are associated with a more unfavourable effect, slightly increasing the risk of injury. Conclusion: Although phase-specific trends emerge, methodological heterogeneity and limited evidence preclude a definitive consensus on how the menstrual cycle impacts intrinsic injury risk factors. Nevertheless, practitioners should consider that late follicular and ovulatory phases present more favourable neuromuscular and biomechanical profiles than menstrual and premenstrual phases. Future research must utilize standardized phase verification to provide conclusive evidence.