Nocturnal Heart Rate Variability in Women Discordant for Hormonal Contraceptive Use

Purpose The aim of this study was to investigate within-cycle differences in nocturnal heart rate (HR) and heart rate variability (HRV) in naturally menstruating women (NM) and women using combined hormonal contraceptives (CU) or progestin-only hormonal contraceptives (PU). Methods Physically active participants were recruited into three groups: NM (n = 19), CU (n = 11), and PU (n = 12). Participants’ HR and HRV (with Bodyguard 2 HRV monitor), and blood hormones were monitored during one menstrual cycle (MC) (NM-group) or for 4 weeks (CU and PU-groups). Estradiol, progesterone, and luteinizing hormone were analyzed from fasting blood samples collected four times in the NM (M1 = bleeding, M2 = follicular phase, M3 = ovulation, and M4 = luteal phase) and PU groups (M1 = lowest E2; M2 = M1 + 7 days; M3 = M1 + 14 days; M4 = M1 + 21 days) and twice in the CU group (active and inactive pill phases). After every blood sample, nightly HR and HRV were recorded and examined as an average from two nights. Results Hormonal concentrations differed (p < 0.05) between MC phases in the NM- and PU-groups, but not (p ≥ 0.116) between the active and inactive phases in the CU-group. In the NM- and PU-groups, some of the HRV values were higher, while in the NM-group, HR was lower during M2 compared to M3 (p < 0.049) and M4 (p < 0.035). In the CU-group, HRV values (p = 0.014-0.038) were higher, and HR was lower (p = 0.038) in the inactive phase compared to the first week of the active phase. Conclusions The MC and hormonal cycle phases influence autonomic nervous system balance, which is reflected in measurements of nocturnal HR and HRV. This should be considered when monitoring recovery in physically active individuals.