Menstrual cycle phase and carbohydrate ingestion alter immune response following endurance exercise and high intensity time trial performance test under hot conditions

Background: Sex hormones are known to regulate some responses during exercise. Evaluation of the differences in exercise response with regard to menstrual cycle will help understand the menstrual cycle phase specific adaptations to exercise and athletic performance. Methods: We investigated the effects of menstrual cycle phase and carbohydrate (CHO) ingestion on immune response during endurance exercise at 30 degrees C. Six healthy women completed 4 trials comprising 90 min of cycling at 50% peak aerobic power ((V) over dotO(2peak)) and a high intensity time trial performance test (POST). They ingested a placebo- or CHO-containing beverage during the trials, which were performed during both the follicular and luteal phases of the menstrual cycle. In all trials, thermoregulatory, cardiorespiratory, and immune responses were measured during exercise and after POST. Results: Although the thermoregulatory responses differed between the menstrual cycle phases, the cardiorespiratory responses were not different. After placebo ingestion, leukocyte concentration (cells/mu L) at POST (15.9 x 10(3)) in the luteal phase was significantly higher than that in the follicular phase (12.9 x 10(3)). The rise in leukocyte concentration was attenuated upon CHO ingestion, and the difference between menstrual cycle phases disappeared. A significant positive correlation was found between leukocyte concentration and serum free fatty acid concentrations. Interleukin-6, calprotectin, and myeloperoxidase concentrations significantly increased at POST in all trials, but no significant differences were observed between menstrual cycle phase or beverage type. Concentrations of other cytokines did not change during exercise in any of the 4 trials. Menstrual cycle phase and beverage type had no significant effect on the POST outcome. Thus, differences in leukocyte mobilization between menstrual cycle phases could result from the effect of sex hormones on substrate utilization. Conclusions: The menstrual cycle affected circulating leukocyte concentrations during endurance exercise with POST when a placebo was ingested. Therefore, we recommend ingesting CHO beverages to attenuate immune disturbances, especially in the luteal phase, even though they are unlikely to enhance test performance.