Abstract
BackgroundThe need to control for the potential influence of menstrual cycle phase on resting metabolism (RMR) places a burden on research participants who must self-report onset of menstruation and researchers who must schedule metabolic testing accordingly.PurposeTo systematically review and analyze existing research to determine the effect of menstrual cycle on RMR.MethodsWe searched PubMed, CINAHL, MEDLINE, SPORTDiscus, and Scopus databases using the search terms “menstrual cycle and metabolic rate” and “menstrual cycle and energy expenditure.” Eligibility criteria were English language, single-group repeated measures design, and RMR as either a primary or secondary outcome. Risk of bias was assessed based on study sample, measurement, and control of confounders. Differences between the follicular and luteal phases of the menstrual cycle were analyzed using the standardized mean difference in effect size.ResultsThirty English-language studies published between 1930 and December 2019 were included in the systematic review, and 26 studies involving 318 women were included in the meta-analysis. Overall, there was a small but significant effect favoring increased RMR in the luteal phase (ES = 0.33; 95% CI = 0.17, 0.49, p < 0.001).DiscussionLimitations include risk of bias regarding measurement of both menstrual cycle and RMR. Sample sizes were small and studies did not report control of potential confounders. Sub-group analysis demonstrated that in more recent studies published since 2000, the effect of menstrual phase was reduced and not statistically significant (ES = 0.23; 95% CI = -0.00, 0.47; p = 0.055). Until larger and better designed studies are available, based on our current findings, researchers should be aware of the potential confounding influence of the menstrual cycle and control for it by testing consistently in one phase of the cycle when measuring RMR in pre-menopausal women.
Highlights
Resting metabolic rate (RMR) contributes as much as 75% to 24-hour energy expenditure [1]
Thirty English-language studies published between 1930 and December 2019 were included in the systematic review, and 26 studies involving 318 women were included in the meta-analysis
There was a small but significant effect favoring increased RMR in the luteal phase (ES = 0.33; 95% CI = 0.17, 0.49, p < 0.001)
Summary
Resting metabolic rate (RMR) contributes as much as 75% to 24-hour energy expenditure [1] As such, it plays a key role in energy balance and weight management [2]. Measurements have typically been restricted to the follicular phase of the menstrual cycle, which requires young women to self-report the timing and onset of menstruation to researchers. This places a burden on researchers and participants, and may create a barrier to inclusion of young, pre-menopausal women in research studies. The need to control for the potential influence of menstrual cycle phase on resting metabolism (RMR) places a burden on research participants who must self-report onset of menstruation and researchers who must schedule metabolic testing .
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