Abbie E. Smith-Ryan

1. Creatine supplementation is well documented for its host of performance benefits (i.e. strength, power, and lean mass) [1,2], and emerging health benefits including improved cognitive function a...

Introduction Perimenopause (PERI) women experience cognitive dysfunction, sleep disturbances, and menopause-related symptoms, yet few accessible and time-efficient interventions have been evaluated. The purpose of the current study was to determine the impact of creatine monohydrate (CM) during six weeks of high-intensity resistance training (HIRT) on cognition, sleep, and menopause symptoms in PERI females. Methods PERI females (n = 51; Age: 46 ± 5 yrs) were randomized to CM (n = 18), placebo (PLA) (n = 20), or a non-training control (CON) group (n = 13). CM and PLA groups completed a 5-day loading phase (20 g·day⁻¹) followed by six weeks of maintenance (~ 4.5 g·day⁻¹) combined with twice-weekly progressive HIRT. Cognitive performance (Stroop, Rey 15-item memory test) and prefrontal oxygenation via functional near-infrared spectroscopy were assessed at baseline (BASE), pre- (PRE), and post-training (POST). Sleep and self-reported menopause symptoms (temperature sensitivity, fatigue, soreness, brain fog, and bloating) were monitored daily using a WHOOP wearable wristband. Results Stroop reaction time improved over time (congruent: p < 0.001; incongruent: p = 0.004) with no group differences. Prefrontal oxygenation during the Stroop test increased with CM at POST (+ 0.32 ± 2.01%) compared to a decrease with PLA (− 1.62 ± 2.01%; p = 0.003). Sleep consistency showed a time × treatment interaction (p < 0.001), with higher consistency in CM than PLA at week 6 (baseline-adjusted mean difference: +7.4% points, p = 0.015). Conclusions In this exploratory analysis, CM combined with HIRT was associated with greater prefrontal oxygenation, higher sleep consistency, and fewer self-reported temperature sensitivity days relative to PLA in PERI females.

Introduction: Perimenopause is associated with adverse body composition and strength changes, yet resistance training and creatine monohydrate (CM) remain underrepresented in this population. This study examined the effect of six-weeks of high-intensity resistance training (HIRT) with or without CM on body composition, muscle size and quality, strength, volume, and sleep in perimenopause. Methods: Fifty-one perimenopausal women (Age: 46.2±4.6 years; Body Mass Index: 25.4±4.0 kg/m2) were randomized to CM, placebo (PL), or control (CON). CM and PL completed a 5-day loading (CM: 20g/day; non-caloric PL: 14.5g/day), followed by a maintenance phase (CM 4.5g/day; PL gummies) combined with six-weeks of HIRT; CON maintained normal activity. Lean soft-tissue (LST; kg) was assessed from dual-energy x-ray absorptiometry. Muscle characteristics were determined from peripheral quantitative computed-tomography [muscle area (MuA); cm2; muscle density (MuD); mg/cm3]; and ultrasound [muscle cross-sectional area (mCSA): cm2; echo intensity (EI): a.u.]. Sleep was determined from a wrist-worn wearable. Results: CM resulted in increased LST compared to PL (mean difference±standard error: 0.380±0.431 kg, p=0.999) and CON (1.052±0.474 kg, p=0.096). Muscle size increased in CM compared to CON (MuA: 6.11±2.19 cm2; mCSA: 3.222±1.051 cm2; p=0.011-0.023), but not PL. No main treatment effects were observed for MuD or EI. Both lower (CM: 139.6±34.1 lbs; PL: 126.2±31.5 lbs; p< 0.001) and upper body (CM: 9.0±3.4 lbs; p=0.031; PL: 8.1±3.0 lbs; p=0.032) strength increased compared to CON, with no volume differences. No training by treatment interactions were observed for sleep. Conclusion: HIRT improved muscle outcomes, with CM adding 0.38 kg to LST and 148.6 lbs to strength.

Previous research supports the role of 17-β-estradiol (E2) and progesterone (P4) in altering lipid oxidation (LOx) rates during aerobic exercise, but it has yet to be determined if LOx is altered between menstrual cycle (MC) phases following strength-based resistance exercise (RE). This study examined post-exercise LOx rates in eumenorrheic females, following a bout of RE during the early-follicular, low hormone phase (LHP) and mid-luteal, high hormone phase (HHP). Twenty-two (age: 25.1±5.7 years; fat-free mass: 44.7±4.9 kg; relative strength: 1.2±0.2) well-trained females completed a repetition maximum (RM) test for the back squat, bench press, and deadlift. Participants then completed one resistance exercise session consisting of five sets of 3 repetitions at 80-85% 1RM for each exercise during the first 5 days of the participants’ MC (LHP) and once during the calculated mid-luteal phase (HHP). Metabolic testing occurred at baseline (BL) and again immediately post, 30-, 60-, and 90-min post-exercise. Despite expected hormonal differences in E2 (LHP = 1.53±0.58 pg/mL; HHP = 1.88±0.48 pg/mL) and P4 (LHP = 230.51±152.55 pg/mL; HHP = 545.22±295.72 pg/mL), there were no differences in LOx at any timepoint between MC phase (p>0.05). However, RE increased absolute LOx rates by ~49% compared to BL across the entire metabolic collection period (p<0.05), with the highest LOx rates recorded at 60-min post-exercise (0.077±0.016 g·min⁻¹, p<0.001). These findings suggest that RE acutely increases LOx rates above BL levels in well-trained, eumenorrheic females post-exercise, regardless of MC phase.

Perimenopause, a stage in the female lifespan lasting as long as 10 years, is associated with progressive, adverse changes in body composition (1,2), resulting in an average 6 lbs loss of LST throu...

This paper synthesizes current research on women’s football to develop comprehensive, evidence-informed nutritional strategies tailored to the specific demands of the sport. Four key themes are addressed: (1) energy requirements in women’s football; (2) macronutrient and nutrient-timing applications around training and match play, including an illustrative case study; (3) supporting a player with inadequate energy intake, including an illustrative case study; and (4) nutritional considerations relating to fluctuations in female sex hormones. Rather than providing another descriptive narrative review, this synthesis translates research findings into practical strategies for implementation in real-world performance environments. Adequate energy availability is identified as a fundamental nutritional priority. Carbohydrate and protein intake are emphasized as essential for sustaining training quality, supporting recovery, and maximizing match performance. Nutrient timing is highlighted as a critical determinant of in-season performance and effective match preparation. Consideration is also given to the influence of hormonal fluctuations on thermoregulation and menstrual cycle–related symptoms, alongside nutritional strategies to mitigate these effects. This synthesis underscores the importance of individualized nutritional strategies to optimize health, performance, and return-to-play outcomes in women footballers.

Purpose : Athlete monitoring has emerged as a common method to track athlete status and adjust training for optimal performance. Despite the influx of monitoring-related resources at the collegiate level, actual training load modifications are largely anecdotal. This prospective cohort study investigated relationships between previous day training load, objective nightly recovery, and next-day subjective wellness and max speed (MS) in elite soccer athletes across a collegiate season. Methods : Twenty-six collegiate female soccer athletes were tracked across the duration of their season (2024–2025) for training load (wearable global positioning systems monitors), objective nightly recovery (wearable recovery rings), next-day subjective wellness (morning wellness survey), and MS performance. Results : Previous day training load measures of distance and high-speed running were significant predictors of variables related to nightly objective sleep recovery, next day subjective readiness, and next day speed performance. High-speed running models consistently performed better than total distance for predicting changes in recovery, wellness, and MS. Conclusions : Numerous associations between previous day training load and objective and subjective measures increase accessibility of female athlete monitoring methods for applied practitioners. Although the magnitudes of coefficients vary, the consistency of significant findings across monitoring methods provides utility for continuous and comprehensive athlete monitoring, demonstrating the importance of subjective readiness measures beyond traditional performance metrics, while also addressing the paucity of literature in elite female athletes.

The menstrual cycle (MC), characterized by hormonal fluctuations, may impact skeletal muscle oxygenation (SMO) during high-intensity interval training (HIIT). SMO measured around HIIT in eumenorrheic (EUM) or hormonal contraceptive (HC) users can inform exercise and recovery practices. Females who were EUM (no hormonal contraceptive n = 21; copper intrauterine device n = 5) or using HC (oral n = 5; hormonal intrauterine n = 6) completed two HIIT protocols (HIIT _1:1 : 10 × 60 s work/60 s rest; HIIT _2:1 : 20 × 20 s work/10 s rest) during both low-hormone (LHP) and high-hormone phases (HHP) of the MC, in randomized order. SMO (tissue saturation index (TSI) and total hemoglobin (THb) were measured at rest, during HIIT, and during 15 min recovery using near-infrared spectroscopy. Data were analyzed as repeated measures ANOVA. During HIIT _1:1 , TSI desaturation was greater in LHP (−8.30 ± 3.30%) compared to HHP (−6.77 ± 4.55%; MC phase p < 0.001). During HIIT _2:1 , TSI desaturation was greater in HHP (−6.98 ± 3.54%) compared to LHP (−6.71 ± 3.61%; MC phase p < 0.001). During HIIT _2:1 , TSI resaturation was greater in LHP (−5.05 ± 3.31%) compared to HHP (−5.33 ± 3.31%; MC phase p = 0.004). During recovery from HIIT _1:1 , THb was greater in LHP (16.25 ± 6.32 µmol/L) compared to HHP (15.91 ± 6.46 µmol/L; MC phase p = 0.039). During HIIT _2:1 recovery, THb was higher in HHP (15.92 ± 5.47 µmol/L) compared to LHP (14.08 ± 5.05 µmol/L; MC phase p = 0.039). During HIIT _2:1 , HC demonstrated greater TSI desaturation and resaturation in HHP compared to LHP ( p < 0.001). These data suggest MC influences SMO during HIIT, with HHP favoring longer work/rest intervals (HIIT _1:1 ), while recovery remains unaffected; HC demonstrated greater SMO fluctuations during HIIT _2:1 in HHP.