Background: Menstrual-cycle-associated symptoms and menstrual health conditions are common among female athletes and may influence recovery, perceived readiness, training availability, and athletic performance. However, evidence regarding interventions aimed at managing these symptoms and their functional implications in athletes remains limited and heterogeneous. Objective: The objective of this study is to synthesize the available evidence on pharmacological and non-pharmacological interventions related to menstrual health and menstrual-cycle-associated symptoms in female athletes and to evaluate their impact on performance, recovery, functional capacity, and symptom burden. Materials and Methods: A systematic review with narrative synthesis was conducted following PRISMA 2020 guidelines. Studies evaluating interventions associated with menstrual health or menstrual-cycle-related symptoms in female athletes were included when they reported outcomes related to athletic performance, recovery, functional capacity, or symptom burden. Results: Five studies published between 2023 and 2025 were included. The interventions evaluated included hormonally related strategies involving oral contraceptive timing, recovery interventions such as cryotherapy, mindfulness-based yoga, nutritional supplementation, and pharmacological pain-modulation approaches. However, findings regarding objective athletic performance outcomes were inconsistent, and the included studies showed substantial methodological heterogeneity. Conclusions: The available evidence suggests that certain interventions related to menstrual health may contribute to improvements in symptom burden, perceived recovery, or selected functional outcomes in female athletes. Nevertheless, the current evidence base remains limited, heterogeneous, and insufficient to support strong performance-related recommendations. Further high-quality studies specifically designed in female athlete populations are needed to inform evidence-based sports medicine practice.
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