Inconsistent findings and substantial inter- and intraindividual variability in the relationships

The gap

Evidence profile

Sourced from the recommendations and future work and future-work section and stated challenges of the source papers, classified as general, drawn from work published between 2025 and 2026, spanning 2 journals. Those papers have been cited 4 times in total.

Supporting evidence — 4 representative gaps

• Evaluating sports nutrition advice provided by general-purpose large language models for recreational female marathon runners: a multidimensional descriptive audit (2026) · Frontiers in Nutrition · doi

  Ackerman and KE. B, 14. De Souza MJ, Williams NI, Misra M, Nattiv A, Joy E, Barrack M, et al. 2025 update to the female athlete triad coalition consensus statement part 1: state of the science and introduction of a new adolescent model. Sports Med. (2026) 56:327– 73. doi: 10.1007/s40279-025-02333-z 15. Mountjoy M, Ackerman KE, Bailey DM, Burke LM, Constantini N, Hackney AC, et al. 2023 International Olympic Committee’s (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs). Br J Sports Med. (2023) 57:1073– 97. doi: 10.1136/bjsports-2023-106994 16. Larrosa M, Gil-Izquierdo A, González-Rodríguez LG, Alférez MJM, San Juan AF, Sánchez-Gómez Á, et al. Nutritional strategies for optimizing health, sports performance, and recovery for female athletes and other physically active women: a systematic review. Nutr Rev. (2025) 83:e1068–89. doi: 10.1093/nutrit/nuae082 17. Williams NI, De Souza MJ, Misra M, Nattiv A, Joy E, Barrack M, et al. 2025 update to the female athlete triad coalition consensus statement part 2: clinical guidelines for screening, diagnosis, treatment, and return to play for adolescents and adults. Sports Med. (2026) 56:375–427. doi: 10.1007/s40279-025-02332-0

  generalrecommendations
  Keywords: sports female consensus statement ackerman souza williams misra nattiv barrack update athlete triad coalition part
• Rating of perceived exertion in continuous sports: a scoping review with evidence gap map (2025) · Frontiers in Sports and Active Living · cited 4× · doi

  should not be extrapolated. While sport-specific RPE protocols Despite RPE’s broad application in numerous settings and contexts, some realms remain largely unexplored. This summary highlights opportunities for funders and researchers to focus under-researched areas of RPE, while potentially reducing research on topics that are already well-studied. On this basis, we accentuate the necessity of investigating sports other than those involving running, swimming, and cycling as the knowledge of their particular interactions with RPE is lacking. Furthermore, should be the development of prioritized to improve to enhance specificity and accuracy of exertion assessments tailored to the unique demands of individual sports. Also, studies focused on elite athletes (tier 4 and 5) (255) are essential due to the unique characteristics of this population, as results from studies involving other types of athletes female athlete participation is increasing, their representation in research has not progressed at the same rate. It seems that RPE, especially due to its psychophysiological nature, can be significantly influenced by hormonal fluctuations that occur throughout the menstrual cycle. These hormonal changes, particularly in estrogen and progesterone levels, have been shown to affect both physical performance leading to altered perceptions of effort during exercise (275). These the need to use RPE as a valuable tool changes highlight load across menstrual cycle phases. for monitoring internal Similarly, master athletes have been the subject of increasing their representation in scientific interest over the years, but literature remains limited. In fact, RPE can be greatly affected by to rigorously age-related changes validate RPE in populations exhibiting greater daily variability in performance and subjective exertion assessment, such as female and master athletes, to ensure its reliability and applicability in these groups. (276). Thus, potentially is critical subjective exertion, and it Additionally, the absence of longitudinal studies on RPE limits intra-individual comparisons, commonly used in practice. the ability to make meaningful which are currently more Longitudinal research would allow for a deeper understanding of how RPE changes over time within individuals, improving the accuracy and applicability of RPE assessments in monitoring training progress (277). To enhance the reproducibility and comparability of findings, researchers and practitioners should adopt a standardized reporting framework. This practice would facilitate the sharing of methodologies, data, and results, enabling more fostering collaborative advancements in the field. Without this, current comparisons may not capture full variability in RPE responses to long-term training adaptations or changes in fitness levels. comparisons studies robust across and studies Finally, the characteristics of their subjects to add context for practitioners to be able to discuss and interpret their findings accurately. incentivized to disclose should be

  generalfuture work
  Keywords: changes athletes exertion comparisons speci researchers potentially sports involving enhance accuracy assessments unique individual characteristics
• Menstrual cycle hormonal fluctuations and their associations with athletic performance and injury susceptibility in female athletes (2026) · Frontiers in Sports and Active Living · doi

  Further research is needed to better understand female-specific physiological factors that may influence athletic performance, recovery, and susceptibility to injury, - Studies should investigate the effects of MC-related hormonal fluctuations on athletic performance and injury susceptibility in different populations and contexts, - Research should aim to develop universally applicable practical guidance for training, nutrition, recovery, and injury prevention in female athletes

  generalfuture-work sectionevidence 5/5
  Keywords: further research needed better understand female-specific physiological factors
• Menstrual cycle hormonal fluctuations and their associations with athletic performance and injury susceptibility in female athletes (2026) · Frontiers in Sports and Active Living · doi

  Inconsistent findings and substantial inter- and intraindividual variability in the relationships between menstrual cycle hormonal fluctuations and athletic performance and injury susceptibility. The complexity of the underlying physiological, biomechanical, and psychological mechanisms. The need for further research to better understand the relationships between menstrual cycle hormonal fluctuations and athletic performance and injury susceptibility.

  generalstated challengesevidence 5/5
  Keywords: inconsistent findings substantial inter- intraindividual variability relationships between

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