REF-963 · Wang et al., 2026 · Journal of Thermal Biology, Vol. 140, article · Paper · PubMed

Acute topical menthol application and exercise performance: A systematic review and meta-analysis of perceptual and physiological responses

A-fairly strong evidenceMeasured on a mixed groupWritten before October 2026, being re-checked

This systematic review with a three-level meta-analysis looked only at topical menthol applied acutely during exercise, and at its effects on performance as well as perceptual and physiological responses. Six databases were searched up to March 2026 from their inception; eligible designs were randomized or controlled trials, and RoB-2 was used for risk of bias.

The analysis included 16 studies with 191 participants in total. Menthol gave a small, significant performance gain (g = 0.27, p = 0.02). It reduced perceived exertion (g = -0.35) and thermal sensation (g = -0.74) and slightly improved thermal comfort (g = 0.34); core body temperature did not change.

The performance benefit was clearest for aerobic endurance tasks, with rub-on application and in temperate conditions; in hot environments (≥30 °C) the effect was smaller and did not reach statistical significance. Several subgroup results shifted when influential observations were handled.

Participants

Sixteen studies involving 191 participants. Sex and training status were prespecified moderators; their distribution is not given in the abstract.

Protocol

Six databases searched from inception to March 2026.
Included: randomized or controlled trials examining acute topical menthol application during exercise.
Risk of bias: RoB-2. The three-level models allowed for multiple outcomes not being independent of each other.
Prespecified moderators: sex, training status, environmental condition, application method, application site, exercise modality.
Sensitivity analyses for outliers and influential cases.

Key Results

OutcomeEffect (g)
Exercise performance0.27 (p = 0.02) — small but significant
Thermal sensation-0.74 (reduced)
Perceived exertion-0.35 (reduced)
Thermal comfort0.34 (small improvement)
Core body temperatureunchanged
The gains showed most clearly in aerobic endurance tasks, after rub-on application and in temperate conditions; in the heat (≥30 °C) the effect was smaller and did not reach statistical significance.
Several subgroup results shifted when influential observations were handled and need to be read with caution.
Authors' conclusion: a small ergogenic benefit that comes mainly from perceptual cooling rather than from reduced physiological heat strain.

Practical Application

Across sixteen trials with 191 participants (systematic review and meta-analysis), menthol applied to the skin improved exercise performance by a small margin (g = 0.27, p = 0.02) and made athletes feel cooler (thermal sensation g = -0.74) and the effort feel easier (g = -0.35) while core body temperature was unchanged; the performance benefit was most evident in endurance tasks under temperate conditions, and in hot environments (≥30 °C) it was smaller and not statistically significant. To "should I put menthol gel on for a hot race?": the pooled gain shrank and lost significance exactly where it is hot, and the feeling of coolness came without a cooler body.
The feeling and the body part ways: sensation and exertion fall, core temperature does not. Inference, not tested here: an athlete who paces by feel may ride harder than the heat load warrants.
Rub-on application did better than other methods in the subgroup analysis; the authors warn that subgroup findings were sensitive to influential observations.
Not from this paper: sweat responses to topical menthol in single trials are in REF-965 (spray, sweating reduced) and REF-966 (gel, sweating increased); routes compared in the heat are in REF-964; the base's protocol is in SYNTH-25.

Limitations

Sixteen studies and 191 participants in total — small trials; several subgroup results were sensitive to influential observations.
No concentration, dose or timing in the abstract; no sweating or adverse-event outcome.
The hot-environment subgroup result is reported without an effect size in the abstract.
Acute application only.
Written from the abstract and record metadata only (full text not read).
How this entry was checked and changed
Why this level

meta-analysis of sixteen small studies (191 participants in all); the authors report that several subgroup findings were sensitive to influential observations