New publications
Does the menstrual cycle affect attention and spatial reasoning in female athletes?
Last reviewed: 02.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
In a study recently published in the journal Neuropsychologia, researchers examine whether cognitive performance fluctuates across the menstrual cycle and whether these variations are influenced by sport participation and skill level.
Previous research has shown that female athletes are more likely to sustain injuries during certain stages of the menstrual cycle, depending on the type of injury. Cognitive function, hormone levels, and spatial perception can all be negatively affected by different phases of the menstrual cycle.
The present study examined changes in cognitive control, spatial perception, and temporal expectation across menstrual cycle phases. Associations between sport knowledge and experience and performance in these activities were also examined.
Participants aged 18 to 35 years were recruited for the study through convenience and snowball sampling, as well as the online platform Prolific, which uses stratified sampling. Participants with irregular menstrual cycles, amenorrhea, using non-contraceptive hormones, perimenopause, currently pregnant or breastfeeding or within the last three months, and neurological disorders were excluded.
At baseline, 394 participants completed an online questionnaire on demographics, sport activity and competition level, frequency of physical activity, use of hormonal medications or contraceptives, and cycle characteristics (for women). Participants then completed cognitive tests, a mood questionnaire, and a symptom questionnaire at two-week intervals. The final sample included 241 people with an average age of 28 years.
Cognitive tests assessed reaction speed, attention, visual-spatial abilities, and temporal expectation. Three indices were derived from factor analysis, including reaction time, within-subject variation, and errors.
The cognitive tasks included simple reaction time (SRT), sustained attention (SA), and inhalation. In the SRT task, participants pressed the spacebar when a happy or winking face appeared on the screen. In the SA task, they pressed the spacebar when they saw a winking face, and in the inhalation task, they pressed the spacebar when they saw a happy face.
In the three-dimensional (3D) spatial perception task, participants counted cubes in a 3D object. In the 3D mental rotation task, the prime stimulus appeared with two other objects, one of which represented the prime stimulus and one of which did not.
In the rhythmic temporal expectation test, participants pressed the space bar when they thought the cat image would appear in the last window. In the spatial temporal expectation test, they pressed the space bar when they expected two balls to collide.
Men and women showed similar reaction speed and accuracy, regardless of contraceptive use. However, within-person analyses showed that women with regular menstrual cycles performed better on tasks during the menstrual phase compared to other phases, showing faster reaction times, fewer errors, and reduced within-person variability.
Women showed slower reaction times and worse latency in the luteal phase of the cycle and made more errors in the ovulatory phase. Self-reports of emotional, physical, and cognitive symptoms were worst in the menstrual phase. Many women also expressed a belief that their symptoms were negatively affecting their cognitive performance on the day of the test, which was at odds with their actual results.
No significant correlations were found between cognitive composite scores and sport types. Cognitive performance was not affected by competition level or sport type. Women with natural cycling reported worse mood and more physical and cognitive symptoms compared to men.
Anticipatory and visuospatial processes, which may be involved in various sports, are altered in different phases of the menstrual cycle. Cognitive tests, especially spatial temporal anticipation, show better results in the menstrual phase and worse in the luteal phase, indicating that cognitive factors influence injury risk in some women.
The discrepancy between women’s perceptions of the impact of their cycle on their mood and their actual reports of mood and symptoms may help alter perceptions of performance in naturally cycling women. However, more research is needed to confirm these findings and create actionable solutions.