ECSS Paris 2023: OP-MH44
INTRODUCTION: Twin pregnancy has historically been a contraindication to physical activity. Despite higher incidences of preeclampsia and gestational hypertension (PE/GH) in twin pregnancies, women pregnant with twins have been excluded from studies on physical activity and PE/GH. Hence, we aimed to estimate the association of leisure-time physical activity (LTPA) on risk of PE/GH in women with twin pregnancy. METHODS: We included 1,760 women with twin pregnancies in the Norwegian Mother, Father and Child Cohort Study (1999-2008). Type and frequency of LTPA during pregnancy were prospectively self-reported using a validated questionnaire around gestational week 17. LTPA during the three months before pregnancy was recalled in the same questionnaire. The diagnosis of PE/GH was obtained from the Medical Birth Registry of Norway. We used multiple Poisson regression and restricted cubic splines to examine the associations between weekly frequencies of LTPA and the risk of PE/GH. We stratified the analyses by parity in a secondary analysis. RESULTS: The incidence of PE/GH was 14.3% (n=252), of which preeclampsia constituted 11.4% (n=201). Pre-pregnancy LTPA was not associated with risk of PE/GH in any analysis. The association between LTPA in gestational week 17 and PE/GH was U-shaped with the lowest risk observed among women reporting LTPA twice a week (relative risk (RR): 0.68, 95% confidence interval (CI): 0.48-0.98 [reference: no LTPA]). When stratified by parity, the association was strengthened among parous women during pregnancy, observing the lowest risk of PE/GH for women reporting LTPA three times per week (RR: 0.48, 95% CI: 0.26-0.87). This association attenuated among nulliparous women with the lowest risk observed at LTPA twice a week (RR: 0.85, 95% CI: 0.53-1.38). CONCLUSION: We are not aware of prior studies that examined the association between LTPA and PE/GH in twin pregnancies. The findings from this population-based study suggest that LTPA during twin pregnancy is safe and may lower the risk of PE/GH, particularly at low and moderate levels. Replication in other settings and study populations is warranted to avoid unnecessary activity restriction and develop evidence-based recommendations for physical activity in twin pregnancies.
Read CV Silje Malen AndreassenECSS Paris 2023: OP-MH44
INTRODUCTION: Subjective perceptions suggest that the menstrual cycle (MC) may negatively affect physical activity (PA), particularly in the presence of premenstrual symptoms (Kolic et al., 2021). However, most evidence is based on cross-sectional designs, limiting insight into MC phase-based variability (Goaplan et al., 2024). This study examined daily fluctuations in PA and premenstrual symptoms across two consecutive MCs using a longitudinal design. METHODS: Women aged 18–35 years with a natural MC (21–35 days) completed daily assessments over two consecutive MCs via a mobile application. Measures included MC tracking, premenstrual symptoms (Screening Instrument for Premenstrual Symptoms), and self-reported PA. PA was analyzed separately for light (LPA), moderate (MPA), and vigorous (VPA) intensities. MC phases were classified as menstrual (MP), follicular (FP), ovulatory (OP), luteal (LP), and premenstrual (PP) according to Elliott-Sale et al. (2025). Linear mixed-effects models were used to examine phase-related differences, adjusting for symptom burden and relevant covariates. RESULTS: Thirty-five women (26.5 ± 5.4 years) contributed 1,456 daily observations across two MCs. MC phase was not associated with LPA, MPA, or VPA. For LPA, no significant phase differences were observed, although a trend toward higher activity during the ovulatory phase emerged (β = +7.67, p = 0.079); women with PMS showed higher overall LPA (β = +20.70, p = 0.033). MPA did not differ across MC phases, but higher symptom burden was associated with lower MPA (β = −0.65, p = 0.035). No MC phase effects were observed for VPA (all p > 0.30). CONCLUSION: PA levels were largely stable across MC phases at the group level. Premenstrual symptom burden showed modest but consistent associations with PA, suggesting that symptoms, rather than MC phase per se, may be more relevant for understanding day-to-day PA behavior. References Elliott-Sale, K. J., Altini, M., Doyle-Baker, P., Ferrer, E., Flood, T. R., Harris, R., ... & Burden, R. J. (2025). Why we must stop assuming and estimating menstrual cycle phases in laboratory and field-based sport related research. Sports Medicine, 55(6), 1339. https://doi.org/10.1007/s40279-025-02189-3 Gopalan, S. S., Mann, C., & Rhodes, R. E. (2024). Impact of symptoms, experiences, and perceptions of the menstrual cycle on recreational physical activity of cyclically menstruating individuals: A systematic review. Preventive Medicine, 184, 107980. https://doi.org/10.1016/j.ypmed.2024.107980 Kolić, P. V., Sims, D. T., Hicks, K., Thomas, L., & Morse, C. I. (2021). Physical activity and the menstrual cycle: A mixed-methods study of women’s experiences. Women in Sport and Physical Activity Journal, 29(1), 47-58. https://doi.org/10.1123/wspaj.2020-0050
Read CV Claudia KubicaECSS Paris 2023: OP-MH44
INTRODUCTION: The menstrual cycle is a complex and cyclic process in the female reproductive system, characterized by hormonal fluctuations, which has been understudied. Despite growing interest in this topic, findings remain inconsistent, especially regarding how different phases of the menstrual cycle affect maximal exercise capacity and psychophysiological responses in physically active women (1,2). As such, this study evaluated the exercise capacity and psychophysiological responses to a progressive cycling test throughout the menstrual cycle in women. METHODS: Nineteen physically active and eumenorrheic women (24±4 yrs, V̇O2peak=38.4±3.1 mL.kg-1.min-1) completed five graded exercise tests; three of those were performed at specific phases of the menstrual cycle (i.e., menses, follicular, and luteal). Samples of blood, menstrual distress, mood, and anxiety were collected before and after each test. Affect, exertion, heart rate, and motivation were collected before, during, and after exercise. One-way ANOVA for repeated measures compared the exercise capacity between the menstrual cycle phases (i.e., menses, follicular, and luteal) and a two-way ANOVA to compare the differences between menstrual cycle phases and exercise moment. A simple linear regression was conducted to examine whether the level of menstrual cramps could significantly predict exercise capacity during the menses phase. Statistical significance was set at p < 0.05. RESULTS: Progesterone increased in response to the exercise, and an interaction effect indicated that estrogen responses to exercise varied depending on the phase. The menstrual cycle phase did not significantly impact exercise capacity. However, Wpeak and time to exhaustion were impaired during the menses phase among women who reported high levels of menstrual cramps (p<0.05). Higher affective valence scores were associated with improved outcomes (time to exhaustion: +8.5 s; Wpeak: +4.2 W; p = 0.02; R2 = 0.36), whereas higher arousal scores were associated with reduced exercise capacity (time to exhaustion: -6.4 s; Wpeak: -11.4 W; p = 0.01; R2 = 0.46) between the menstrual cycle. Motivation was lower during menses compared with the follicular phase (p = 0.04). CONCLUSION: These findings suggest that although the menstrual cycle phase does not uniformly affect maximal exercise capacity, individual symptoms, such as menstrual cramps, may play a critical role. Future studies are encouraged to explore both physiological and psychological responses further to exercise across the menstrual cycle, with particular attention to symptom variability and female-specific experiences. [1] Prado et al. (2021). Physiol Behav, 232, 113290 [2] Prado et al. (2022). Int J Sports Physiol Perform, 18(2) 142–14. Funding: CNPq [403633/2021-4], CAPES [Finance Code 001 and #88887.716790/2022-00], and FAPESP [2021/06836-0 and 2022/07327-4].
Read CV Monica Yuri TakitoECSS Paris 2023: OP-MH44