Sleep and the Menstrual Cycle from Puberty to Menopause: A Review of Literature with Extra Focus on Athletes

Abstract

Introduction
Sleep is essential for recovery and is influenced by circadian rhythms and hormonal changes across a woman’s lifespan. However, evidence on how the menstrual cycle affects sleep remains inconsistent. As sleep is critical for athletic performance, understanding these relationships is important for optimizing recovery in female athletes.

Aim
This review examines clinical evidence on how ovarian hormone fluctuations and related symptoms influence sleep across different life stages, with a focus on athletes.

Material and Methods
A literature search was conducted in PubMed using keywords such as “menstrual cycle,” “estradiol,” “luteal,” “perimenopause,” “sleep,” “sleep disturbances,” and “athletes.”

Results
In adolescents, menstrual pain is a greater cause of poor sleep than cycle phase. During reproductive years, sleep disturbances are more common in the luteal phase, although lifestyle and health factors also contribute. Athletes similarly report poorer sleep and fatigue in this phase, with training load and physical symptoms playing a major role. In menopause, reduced deep sleep and weakened circadian rhythms lead to more frequent sleep disruptions.

Conclusions
Sleep varies across life stages, with the luteal phase being most associated with disturbances. For adolescents and athletes, managing pain and physical stress may be more effective than tracking cycle phases. Improving women’s sleep requires individualized approaches focused on overall health and symptom management.