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Fatigue and energy: what the research says

116 studies on fatigue and energy in PMS and PMDD, each explained in plain English. 5 of them use the strongest designs: randomised trials and systematic reviews.

Survey study 67Randomised trial 13Study 11Non-randomised trial 7Cohort study 6Systematic review 5
Systematic review, 2026

Does the menstrual cycle affect athletic performance and fatigue in female athletes?

Lab tests showed stable athletic performance across the menstrual cycle, but the premenstrual phase linked to higher fatigue. In real games, athletes covered less distance during menstruation with separate thinking changes.

Randomised trial, 2025

Does exercise reduce menstrual symptoms and sleep problems?

Yes. Women who exercised for 12 weeks had significantly fewer menstrual symptoms and better sleep than those who did not exercise.

Systematic review, 2022

Do athletes' feelings and performance change across the menstrual cycle?

Some feelings change across the cycle, especially motivation and mood. However, the research methods vary a lot, so we cannot be very confident about most findings.

Systematic review, 2021

Does damask rose help reduce menstrual pain, headache, fatigue, anxiety, and bloating?

Damask rose significantly reduced menstrual-related headache, fatigue, and bloating, but did not clearly reduce menstrual pain or anxiety. More research on pain and anxiety is needed.

Randomised trial, 2014

Does the combination of sumatriptan and naproxen sodium reduce menstrual symptoms and migraine?

Yes. The combination was better than placebo for tiredness, irritability, bloating, abdominal pain, and back pain, as well as migraine. However, women with severe period pain responded less well to migraine treatment.

Systematic review, 2026

Does exercise help with mood problems, pain, and fatigue in women with PMS?

Yes. Exercise including running, yoga, and Pilates significantly reduces negative mood, pain, and fatigue in women with PMS. Running for 9-12 weeks at 3 or more sessions per week works best for mood. Yoga for 9-12 weeks at 3 or more sessions per week works best for pain and fatigue.

Survey study, 2026

How does menstruation affect girls' participation in organized sports?

Most girls reported that menstruation affected their sports performance and attendance. About 91 percent noted skill changes, 77 percent effort changes, and 58 percent attendance changes. Fatigue, mood, and pain were most common, and 18 percent were worried enough to consider quitting.

Study, 2025

Do women have different symptom patterns before, during, and after menopause?

Yes. Women have different symptom patterns depending on whether they are before, during, or after menopause. All women experience fatigue, headache, anxiety, and brain fog regardless of life stage.

Survey study, 2025

How do personality traits like neuroticism affect PMS severity and sexual satisfaction?

Yes, personality traits significantly predict both PMS severity and sexual satisfaction. Women with higher neuroticism had more severe PMS with anxiety, depression, and fatigue, while those with higher extraversion had milder PMS and better sexual satisfaction.

Study, 2025

Does the menstrual cycle affect sleep, energy, and injury risk in young female athletes?

Yes. Young female athletes reported worse sleep and more tiredness during the luteal phase, particularly the week before their period. They also had more injuries during these phases.

Randomised trial, 2025

Does whole-body cryostimulation improve sleep quality in female athletes during different menstrual phases?

Yes, whole-body cryostimulation improved sleep quality and reduced fatigue during the mid-luteal phase, when sleep naturally worsens. It did not help during other phases.

Randomised trial, 2025

Does yoga help reduce pain and fatigue in women with premenstrual syndrome?

Yes. Women who did yoga had significantly greater reductions in pain and fatigue after 8 weeks compared to a control group.

Cohort study, 2024

How does sleep change across your menstrual cycle?

Sleep was best during the mid-to-late follicular phase (when estrogen is rising) compared to menstruation and the luteal phase. This is fairly clear evidence from 96 women.

Randomised trial, 2024

Does a banana drink with egg white reduce PMDD symptoms and improve mood?

The banana drink significantly reduced anxiety, fatigue, concentration problems, insomnia and physical symptoms, and improved mood. Serotonin levels did not increase significantly.

Cohort study, 2024

Does shift work worsen PMS symptoms in newly graduated nurses?

Yes. PMS got worse six months after newly graduated nurses started shift work and stayed worse at 18 months. Sleep quality and fatigue were the strongest linked factors.

Survey study, 2024

Are calorie tracking and eating disorders linked to menstrual problems in female athletes?

64.6% of resistance-trained athletes tracked calories. Limited connections appeared between body image concerns or eating disorders and menstrual cycle problems. However, there was a clear link between eating disorders and missing periods.

Survey study, 2024

Are menstrual cycle symptoms related to sleep problems and mental health in female athletes?

Yes. Women with more menstrual symptoms reported more depression, anxiety, stress problems, and sleep issues.

Survey study, 2022

Do women with PMDD have different brain function at different cycle phases?

Yes. Women with PMDD have worse focus and decision-making during the week before their period, and they have more difficulty managing emotions throughout the cycle.

Survey study, 2022

What factors are associated with irregular menstrual cycles and how do irregular cycles affect other symptoms?

Irregular cycles (varying by more than 7 days) affected 21% of nurses. Higher weight, lack of vigorous exercise, shift work, and heavy lifting were associated with irregular cycles. Women with irregular cycles also reported more depression, anxiety, stress, fatigue, and sleep problems.

Survey study, 2022

How common are premenstrual symptoms, and do they change with age?

Very common. Food cravings affect 85%, mood swings 64%, and fatigue 57%. Several symptoms got worse with age, but mood symptoms stayed the same across all age groups.

Study, 2022

Does having COVID-19 affect premenstrual syndrome symptoms?

Yes. Women who recovered from COVID-19 within the previous 6 months reported more PMS symptoms than women who had never had COVID-19.

Randomised trial, 2021

Does hypnotherapy reduce pain and emotional distress in women with PMDD?

Yes. Hypnotherapy focusing on cognitive flexibility and ego strength reduced pain and emotional distress much more than no treatment.

Cohort study, 2021

Do women with PMDD have worse sleep, focus, and tiredness problems that get worse before their period?

Yes, women with PMDD have more severe insomnia, attention problems, and fatigue than women without it, and these symptoms get significantly worse in the late luteal phase (the days before menstruation).

Survey study, 2021

Does the menstrual cycle affect women's ability to train and compete?

Yes. Women who experienced more frequent menstrual symptoms were significantly more likely to miss or change their training, miss competitions, miss work or school, and use pain medication.

Study, 2021

Does exercise affect a woman's balance more during the premenstrual phase?

Yes. Women had lower balance during the premenstrual phase before exercise, and their balance became more unstable after exercise during this phase compared to other times in their cycle.

Survey study, 2021

Does vitamin D affect premenstrual symptoms, and does your genetics matter?

The link depends on your genes. Women with one genetic type and low vitamin D had higher odds of fatigue and nausea. Another type had lower odds. A third type had more appetite changes with low vitamin D.

Case-control study, 2020

Does fatigue change across the menstrual cycle, especially in women with anxiety?

Mental fatigue increases during the high-hormone phase in healthy women, rising to levels that women with anxiety disorder experience. Physical fatigue does not change, and hormone levels alone do not explain fatigue.

Study, 2019

Do muscles get tired at different times during the menstrual cycle?

Yes. Muscles take much longer to get tired around ovulation than at other times of the cycle, showing that menstrual hormones affect muscle strength.

Randomised trial, 2018

Does swimming reduce premenstrual syndrome symptoms?

Yes. Swimming significantly reduced anxiety, depression, cramps, headaches, and most other PMS symptoms, but it did not help irritability or food cravings.

Survey study, 2018

How common are premenstrual symptoms in female workers, and does exercise help?

Fatigue (24%), backache (21.2%), and abdominal bloating (17.4%) were the most common symptoms. Women who exercised regularly reported significantly fewer backaches, less irritability, depression, and less crying.

Survey study, 2018

Does how women think about menstruation affect their PMS symptoms?

Yes, women who view menstruation as debilitating or bothersome reported more PMS symptoms than those with more positive views.

Survey study, 2016

Do hormonal contraceptives reduce PMS symptoms?

Hormonal contraceptives are linked to lower risk of some PMS symptoms, including cramps, fatigue, and depression, but not others like mood swings and bloating.

Survey study, 2015

Is neck and shoulder pain common after birth, and what increases the risk?

Yes, 73.1% of women had neck and shoulder pain one month after birth. Women who had previous PMS, anemia during pregnancy, more breastfeeding, and worse mood had higher rates, though this is observational so causation is not proven.

Cohort study, 2014

Can a brief daily fatigue scale reliably measure changes in fatigue, especially in PMS and PMDD?

Yes. The scale reliably measured fatigue across groups (over 90% reliable), and in women with PMS/PMDD, fatigue increased as their period approached and dropped sharply after menstruation.

Study, 2012

Is low progesterone linked to aggressive behavior and fatigue before menstruation?

Yes. Women with lower aggressive behavior and fatigue had higher progesterone levels during the second half of the cycle. The study suggests that low progesterone may contribute to aggressive behavior and fatigue.

Study, 2012

Do women with severe PMS have poor sleep quality?

Women with severe PMS feel like they sleep poorly before menstruation, but measurements of their actual sleep don't show this. How they feel about sleep is strongly linked to anxiety.

Study, 2010

Why do women with IBS and fibromyalgia or PMDD have similar inflammation patterns?

Women with IBS who also have fibromyalgia, PMDD, or chronic fatigue have higher levels of inflammatory proteins in their blood than women with IBS alone.

Survey study, 2010

Do women with premenstrual asthma have more premenstrual symptoms overall?

Yes. Women whose asthma worsens before their period had greater increases in most premenstrual symptoms, especially belly and breast tension, compared to women without this pattern.

Randomised trial, 2009

Does calcium help PMS symptoms like tiredness and depression?

Yes. Women taking 500 mg calcium carbonate twice daily for 3 months had significant improvements in tiredness, appetite changes, and depression compared to placebo.

Survey study, 2009

How common is PMS in young Iranian women?

PMS is very common: almost all young women have at least one PMS symptom, and 16% have clinically significant PMS. Younger women aged 18-20 have more severe symptoms than slightly older women.

Survey study, 2007

How common is severe PMS and what are the most common symptoms?

Severe PMS affects about 6.1% of women. The most frequent symptoms are irritability and anxiety, and most women with severe PMS have significant life disruption.

Non-randomised trial, 2004

Are reproductive hormones abnormal in chronic fatigue syndrome?

Reproductive hormones FSH, LH, estradiol, and progesterone were normal in women with chronic fatigue syndrome. However, cortisol (the stress hormone) was significantly lower than in healthy women.

Case-control study, 2004

Does norepinephrine cycle with the menstrual cycle differently in women with PMS?

Healthy women have a natural norepinephrine cycle that peaks at ovulation and early luteal phase, but women with PMS lack this cycling. Low norepinephrine is linked to mood swings, fatigue, and other symptoms.

Study, 2004

How do work and time off affect women's moods during different phases of their menstrual cycle?

Work days made women feel more anxious, stressed, and tired compared to days off. Menstrual cycle phase also affected mood, but the effect depended on whether it was a work or off day and on the woman's personality traits.

Cohort study, 2003

Do birth control pills change how women experience premenstrual and menstrual symptoms?

Birth control pills do not eliminate the cyclical pattern of premenstrual and menstrual symptoms that healthy women naturally experience. Different pill types produce similar patterns, though pill users reported less fatigue than non-users.

Randomised trial, 1999

Does menstrual cycle phase affect how women respond to triazolam?

No. The effects of triazolam on mood and performance were stable across all three phases of the menstrual cycle.

Randomised trial, 1989

Does vitamin B6 reduce PMS mood symptoms?

Yes, vitamin B6 at 50 mg per day significantly improved mood-related symptoms like depression, irritability, and tiredness. It did not help other PMS symptoms. Only about half the women finished the study.

Survey study, 1982

How common are premenstrual symptoms in American women, and what factors affect them?

Premenstrual symptoms are very common in American women, with over 30% experiencing weight gain, headache, mood changes, and other symptoms, though only 2% to 8% found them severe.

Randomised trial, 1977

Does Bellergal help premenstrual syndrome?

Bellergal significantly improved fatigue, breast tenderness, nervousness, irritability, lethargy and listlessness. The study lacks details like sample size and duration.

Survey study, 2026

Does PMS affect how well young women sleep?

This study set out to check whether premenstrual syndrome is linked to poorer sleep in women aged 18 to 25, but the text available here only describes the background and methods, not the actual results, so no clear answer can be given from what is provided.

Survey study, 2026

Do adolescents have pain in multiple body areas during periods and does this connect to other symptoms?

Yes. Adolescents had pain in an average of 2.8 body areas during menstruation, and widespread pain was significantly linked to more PMS symptoms, fatigue, sleep problems, and body sensitivity.

Survey study, 2026

Can changing your diet help with period and PMS symptoms like fatigue, mood swings and bloating?

This paper suggests certain foods may help, but it is not a real study on people, it is a write-up of general nutrition advice based on a newspaper health article, so it does not prove anything.

Randomised trial, 2026

What types and amounts of exercise help or harm PMS?

Regular moderate aerobic exercise and yoga reduce PMS symptoms like pain, fatigue, anxiety, and low mood. However, very high-intensity training combined with insufficient food can worsen menstrual health.

Survey study, 2026

Does eating more ultra-processed food make PMS symptoms worse?

Yes, this study found that eating more ultra-processed food was linked to worse PMS symptoms, but it cannot prove that the food caused the symptoms.

Survey study, 2025

Do PMS symptoms ease once your period starts, and does diet make them worse?

Yes, many PMS symptoms were significantly less severe after menstruation began, and eating more sugar or fat was linked to worse irritability and tension, while multi-nutrient supplements and higher education seemed to help, in this Bangladeshi study of 400 women.

Survey study, 2025

What are menstrual cycle patterns in elite female basketball players?

Most (78.51%) had regular cycles averaging 27.69 days. Most (86.84%) experienced period pain, and 77.63% had PMS symptoms. About 22.81% experienced absent periods.

Survey study, 2025

Can a plant-based supplement reduce PMS symptoms?

Yes, a multi-ingredient plant-based supplement taken daily for three months significantly reduced anger, irritability, mood problems, and other PMS symptoms in most women. Without a control group, some improvement might be due to placebo effect or natural changes over time.

Survey study, 2025

Does the menstrual cycle affect recovery after football matches?

The menstrual cycle has limited effect on how female footballers feel after matches. Perceived recovery may be slightly worse during menstruation, but overall no clear differences were found between cycle phases.

Survey study, 2025

Does menstruation affect how well women sleep?

Yes. Women who were menstruating had lower sleep efficiency (81%) compared to non-menstruating women (84.2%). No other major differences were found in symptoms or blood inflammation markers.

Survey study, 2024

What premenstrual symptoms do martial arts athletes experience?

Martial arts athletes experience both disturbing and non-disturbing PMS symptoms with regular 35-day menstrual cycles, and they have no significant difference in PMS compared to non-athletes.