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Kuikman MA, McKay AKA, Minahan C, Harris R, Elliott-Sale KJ, Stellingwerff T, Smith ES, McCormick R, Tee N, Skinner J, Ackerman KE, Burke LM. Effect of Menstrual Cycle Phase and Hormonal Contraceptives on Resting Metabolic Rate and Body Composition. Int J Sport Nutr Exerc Metab 2024; 34:207-217. [PMID: 38653456 DOI: 10.1123/ijsnem.2023-0193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 01/17/2024] [Accepted: 02/29/2024] [Indexed: 04/25/2024]
Abstract
The cyclical changes in sex hormones across the menstrual cycle (MC) are associated with various biological changes that may alter resting metabolic rate (RMR) and body composition estimates. Hormonal contraceptive (HC) use must also be considered given their impact on endogenous sex hormone concentrations and synchronous exogenous profiles. The purpose of this study was to determine if RMR and dual-energy X-ray absorptiometry body composition estimates change across the MC and differ compared with HC users. This was accomplished during a 5-week training camp involving naturally cycling athletes (n = 11) and HC users (n = 7 subdermal progestin implant, n = 4 combined monophasic oral contraceptive pill, n = 1 injection) from the National Rugby League Indigenous Women's Academy. MC phase was retrospectively confirmed via serum estradiol and progesterone concentrations and a positive ovulation test. HC users had serum estradiol and progesterone concentrations assessed at the time point of testing. Results were analyzed using general linear mixed model. There was no effect of MC phase on absolute RMR (p = .877), relative RMR (p = .957), or dual-energy X-ray absorptiometry body composition estimates (p > .05). There was no effect of HC use on absolute RMR (p = .069), relative RMR (p = .679), or fat mass estimates (p = .766), but HC users had a greater fat-free mass and lean body mass than naturally cycling athletes (p = .028). Our findings suggest that RMR and dual-energy X-ray absorptiometry body composition estimates do not significantly differ due to changes in sex hormones in a group of athletes, and measurements can be compared between MC phases or with HC usage without variations in sex hormones causing additional noise.
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Affiliation(s)
- Megan A Kuikman
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Alannah K A McKay
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Clare Minahan
- Griffith Sports Science, Griffith University, Gold Coast, QLD, Australia
- Female Performance and Health Initiative, Australian Institute of Sport, Canberra, ACT, Australia
| | - Rachel Harris
- Female Performance and Health Initiative, Australian Institute of Sport, Canberra, ACT, Australia
- Perth Orthopaedic and Sports Medicine Research Institute, West Perth, WA, Australia
| | - Kirsty J Elliott-Sale
- Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom
| | - Trent Stellingwerff
- Canadian Sport Institute-Pacific, Pacific Institute for Sport Excellence, Victoria, BC, Canada
- Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Ella S Smith
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Rachel McCormick
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Nicolin Tee
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | | | - Kathryn E Ackerman
- Female Athlete Program, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Louise M Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
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Oester C, Norris D, Scott D, Pedlar C, Bruinvels G, Lovell R. Inconsistencies in the perceived impact of the menstrual cycle on sport performance and in the prevalence of menstrual cycle symptoms: A scoping review of the literature. J Sci Med Sport 2024; 27:373-384. [PMID: 38508888 DOI: 10.1016/j.jsams.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 02/16/2024] [Accepted: 02/29/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVES This scoping review aimed to summarize the findings of studies regarding the perceived impact of the menstrual cycle on athletic performance, as well as the prevalence of negative menstrual cycle symptoms. DESIGN Scoping review. METHODS Three databases were searched and the Preferred Reporting Items for Systematic reviews and Meta Analyses extension for Scoping Reviews (PRISMA-ScR) was used as guidance. RESULTS A total of 39 studies were included in the final analysis. Between 2.8 and 100 % of athletes reported their performance being negatively impacted by their menstrual cycle, and the main reason was the occurrence of menstrual cycle symptoms. Additionally, a large variability in the prevalence of menstrual cycle symptoms was reported in the different studies mainly due to methodological differences and recall biases. CONCLUSIONS Similarly, as to what has been reported in reviews summarizing performance outcomes during different menstrual cycle phases, this review highlights the high degree of variability between how athletes perceive to be impacted by their menstrual/hormonal contraceptive cycle. REGISTRATION The protocol of this scoping review was registered at the Open Science Framework on 14 September 2023 (osf.io/efu9x).
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Affiliation(s)
- Chelsea Oester
- Western Sydney University, School of Health Sciences, Australia.
| | - Dean Norris
- Western Sydney University, School of Health Sciences, Australia. https://twitter.com/DNorrisSC
| | - Dawn Scott
- Washington Spirit, USA. https://twitter.com/DawnScott06
| | - Charles Pedlar
- St Mary's University, Faculty of Sport, Health and Applied Science, United Kingdom; National University of Ireland, Orreco Business Innovation Unit, Ireland; University College of London, Institute of Sport, Exercise and Health, United Kingdom. https://twitter.com/PedlarCR
| | - Georgie Bruinvels
- St Mary's University, Faculty of Sport, Health and Applied Science, United Kingdom; National University of Ireland, Orreco Business Innovation Unit, Ireland; University College of London, Institute of Sport, Exercise and Health, United Kingdom. https://twitter.com/GBruinvels
| | - Ric Lovell
- Western Sydney University, School of Health Sciences, Australia; University of Wollongong, Faculty of Science, Medicine and Health, Australia. https://twitter.com/Ric_Lovell
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Oxfeldt M, Marsi D, Christensen PM, Andersen OE, Johansen FT, Bangshaab M, Risikesan J, Jeppesen JS, Hellsten Y, Phillips SM, Melin AK, Ørtenblad N, Hansen M. Low Energy Availability Followed by Optimal Energy Availability Does Not Benefit Performance in Trained Females. Med Sci Sports Exerc 2024; 56:902-916. [PMID: 38181220 DOI: 10.1249/mss.0000000000003370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
PURPOSE Short periods of reduced energy availability are commonly undertaken by athletes to decrease body mass, possibly improve the power-to-mass ratio, and enhance physical performance. Our primary aim was to investigate the impact of 10 d of low energy availability (LEA) followed by 2 d of optimal energy availability (OEA) on physical performance parameters in trained females. Second, physiological markers at the whole-body and molecular level related to performance were evaluated. METHODS Thirty young trained eumenorrheic females were matched in pairs based on training history and randomized to a 10-d intervention period of LEA (25 kcal·fat-free mass (FFM) -1 ·d -1 ) or OEA (50 kcal·FFM -1 ·d -1 ) along with supervised exercise training. Before the intervention, participants underwent a 5-d run-in period with OEA + supervised exercise training. After the LEA intervention, 2 d of recovery with OEA was completed. Participants underwent muscle biopsies, blood sampling, physical performance tests, body composition measurements, and resting metabolic rate measurements. A linear mixed model was used with group and time as fixed effects and subject as random effects. RESULTS Compared with OEA, LEA resulted in reduced body mass, muscle glycogen content, repeated sprint ability, 4-min time-trial performance, and rate of force development of the knee extensors (absolute values; P < 0.05). Two days of recovery restored 4-min time-trial performance and partly restored repeated sprint ability, but performance remained inferior to the OEA group. When the performance data were expressed relative to body mass, LEA did not enhance performance. CONCLUSIONS Ten days of LEA resulted in impaired performance (absolute values), with concomitant reductions in muscle glycogen. Two days of recovery with OEA partially restored these impairments, although physical performance (absolute values) was still inferior to being in OEA. Our findings do not support the thesis that LEA giving rise to small reductions in body mass improves the power-to-mass ratio and thus increases physical performance.
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Affiliation(s)
- Mikkel Oxfeldt
- Department of Public Health, Aarhus University, Aarhus C, DENMARK
| | - Daniel Marsi
- Department of Public Health, Aarhus University, Aarhus C, DENMARK
| | | | | | | | | | - Jeyanthini Risikesan
- Department of Child and Adolescent Medicine, Regional Hospital Gødstrup, Gødstrup, DENMARK
| | - Jan S Jeppesen
- Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, DENMARK
| | - Ylva Hellsten
- Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, DENMARK
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, Ontario, CANADA
| | - Anna K Melin
- Department of Sport Science, Linnaeus University, Växjö/Kalmar, SWEDEN
| | - Niels Ørtenblad
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, DENMARK
| | - Mette Hansen
- Department of Public Health, Aarhus University, Aarhus C, DENMARK
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4
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Flood TR, Clausen E, Kuikman MA, Smith E, McKay AKA, Burke LM, Elliott-Sale KJ. Auditing the representation of hormonal contraceptives in studies assessing exercise performance in women. J Sports Sci 2024; 42:825-839. [PMID: 38896557 DOI: 10.1080/02640414.2024.2368762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 06/09/2024] [Indexed: 06/21/2024]
Abstract
Hormonal contraceptive (HC) users have a different ovarian hormonal profile compared to eumenorrheic women. Due to the prevalence of HC use amongst sportswomen, there has been increased research efforts to understand their impact on exercise performance. The aim was to audit this research. Studies identified were assessed for HC type, athlete calibre, performance outcome, study design, and quality of methodological control regarding ovarian hormonal profiles. Sixty-eight different HCs were reported across 61 studies. Monophasic combined oral contraceptive (OCP) pills represented 60% of HCs, followed by other pills [34%, phasic-combined, progestogen-only, and un-specified], phasic and long acting reversible contraceptives [5%, vaginal ring, patch, implant, injection, intrauterine system] and unspecified HCs (1%). Eleven percent of participants using HCs were classified as highly trained or elite/international with no participants being classed as world class. Whilst the number of studies involving HCs has increased two-fold over the past decade, the number of studies ranked as gold standard has not increased (HC; 2003-57%, 2011-55%, 2022-43%. OCP; 2003-14%, 2011-17%, 2022-12%). Future research assessing HCs and exercise performance should adopt high-quality research designs and include a broader range of HCs in highly trained to world-class populations to increase the reach and impact of research in this area.
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Affiliation(s)
- Tessa R Flood
- Department of Sport and Exercise Science, Manchester Metropolitan University Institute of Sport, Manchester, UK
| | - Emma Clausen
- Department of Sport and Exercise Science, Manchester Metropolitan University Institute of Sport, Manchester, UK
| | - Megan A Kuikman
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Ella Smith
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Alannah K A McKay
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Louise M Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Kirsty J Elliott-Sale
- Department of Sport and Exercise Science, Manchester Metropolitan University Institute of Sport, Manchester, UK
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Lee SJL, Peiffer JJ, Haakonssen E, Van Rens FECA. Can period-related symptoms predict menstrual manipulation among Australian female cyclists? J Sports Sci 2024:1-10. [PMID: 38590213 DOI: 10.1080/02640414.2024.2334485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/18/2024] [Indexed: 04/10/2024]
Abstract
This study explored the extent of menstrual manipulation and its associated impact on period-related symptoms and training disruptions in Australian Female Cyclists. 205 female cyclists, from recreational to elite level, participated in an online "Female Cyclist Questionnaire (FCQ)". The FCQ utilised a series of validated questionnaires to obtain demographic information and menstrual function of the respondents, and to investigate their menstrual manipulation habits and perceptions on how their period-related symptoms affected their well-being, mood, energy and training tolerance. More than 80% of the cyclists reported that their period-related symptoms impacted upon training and 41% made training adjustments based on these symptoms. Two-thirds of respondents thought their training should be phase-controlled yet only half discussed their hormonal cycles with their coaches. Menstrual manipulation was predicted by reduced "workout tolerance" in these cyclists (odds ratio = 0.632). Half of the respondents reported compromised ability to tolerate high-intensity interval training with period-related symptoms. Period pain, increased irritability, lower energy levels and more sugar cravings were commonly reported but did not predict menstrual manipulation. The data indicated that period-related symptoms are present in Australian female cyclists across all levels of participation. However, the perceived impact to training and subsequent behavioural changes varied among individuals.
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Affiliation(s)
- Serene J L Lee
- Centre for Healthy Ageing, Murdoch University, Perth, Australia
- Murdoch Applied Sports Science Laboratory, Murdoch University, Perth, Australia
| | - Jeremiah J Peiffer
- Centre for Healthy Ageing, Murdoch University, Perth, Australia
- Murdoch Applied Sports Science Laboratory, Murdoch University, Perth, Australia
| | - Eric Haakonssen
- Australian Cycling Team, Cycling Australia, Adelaide, Australia
| | - Fleur E C A Van Rens
- Centre for Healthy Ageing, Murdoch University, Perth, Australia
- Discipline of Exercise Science, Murdoch University, Perth, Australia
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Oxfeldt M, Pedersen AB, Hørmann D, Lind JH, Larsen EB, Aagaard P, Hansen M. Influence of Second-Generation Oral Contraceptives on Muscle Recovery after Repeated Resistance Exercise in Trained Females. Med Sci Sports Exerc 2024; 56:499-510. [PMID: 38356164 DOI: 10.1249/mss.0000000000003316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
PURPOSE Oral contraceptives (OCs) are commonly used by female athletes, but their effects on skeletal muscle are still poorly understood. We investigated if physically trained females using second-generation OCs differed from nonusers of OCs in the recovery of muscle function and muscle damage markers after repeated resistance exercise sessions. METHODS We recruited 20 trained second-generation OC users and 20 trained nonusers to perform three strenuous resistance exercise sessions. Before, and 3, 24, and 48 h after exercise, blood samples were collected, and participants were evaluated for muscle soreness, maximal isometric and isokinetic muscle strength, vertical jump height, Wingate power performance, leg press strength, and intermittent recovery capacity (yo-yo test). All participants were provided with an energy-macronutrient-balanced diet during the experimental period. RESULTS After resistance exercise, maximal isometric and isokinetic muscle strength, rate of force development, vertical jump height, and Wingate peak and average power were reduced, whereas markers of muscle damage were increased in both groups (P < 0.05). OC users experienced a greater reduction in isokinetic strength 3, 24, and 48 h after exercise compared with nonusers of OCs (interaction: P < 0.05). No other interactions were observed. CONCLUSIONS We demonstrate that measures of muscle strength recovery after three strenuous resistance exercise sessions are comparable between trained females using second-generation OCs and nonusers of OCs. However, group differences were observed for isolated dynamic (isokinetic) muscle strength, suggesting a marginal benefit of not using OCs when accelerated recovery is needed.
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Affiliation(s)
- Mikkel Oxfeldt
- Department of Public Health, Aarhus University, Aarhus C, DENMARK
| | - Anton B Pedersen
- Department of Public Health, Aarhus University, Aarhus C, DENMARK
| | - Daniel Hørmann
- Department of Public Health, Aarhus University, Aarhus C, DENMARK
| | - Jesper H Lind
- Department of Public Health, Aarhus University, Aarhus C, DENMARK
| | - Emil B Larsen
- Department of Public Health, Aarhus University, Aarhus C, DENMARK
| | - Per Aagaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, DENMARK
| | - Mette Hansen
- Department of Public Health, Aarhus University, Aarhus C, DENMARK
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7
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Oxfeldt M, Frederiksen LK, Gunnarson T, Hansen M. Influence of menstrual cycle phase and oral contraceptive phase on exercise performance in endurance-trained females. J Sports Med Phys Fitness 2024; 64:236-247. [PMID: 38213268 DOI: 10.23736/s0022-4707.23.15458-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
BACKGROUND Limited data exists on the influence of menstrual cycle (MC) phase and oral contraceptive (OC) phase on physical performance in endurance-trained females due to poor control regarding MC verification and differentiation. We aimed to evaluate exercise performance and the respiratory response to exercise in three distinct phases of the MC and OC cycle in endurance-trained females. METHODS Using a prospective cohort study design, we recruited trained females (Vo2max 52±4 mL O2/min/kg) who were either not using oral contraceptives (NOC) or using monophasic OCs. NOC were tested in the early and late follicular phase (FP) and the mid-luteal phase (LP). OC-users were tested in the withdrawal phase (WP) and two times in the active OC phase (OCP). The test battery included DXA scans, blood sampling, a submaximal bike test, a maximal isometric knee-extensor strength test, 4 and 20-second bike sprints, and a 6 min time trial on a bike. MC phases were verified by the use of ovulation kits and circulating sex hormone levels. RESULTS After the exclusion of four NOCs due to inadequate sex hormone levels, 11 NOC and 13 OC users were included in the final analysis. 6 min time trial performance, sprint performance, and most submaximal exercise intensity variables did not differ between MC phases and OC cycle phases. However, in NOC, ventilation (L/min) during exercise at 30% of aerobic peak power was 7.6% lower in the late FP compared to the LP (P<0.05). In OC users, muscle strength was 3.9% higher in the early OCP compared to WP (P<0.05), whereas body mass was higher in the late OCP compared to WP (P<0.05). CONCLUSIONS Collectively, our study suggests that MC phase and OCP influence exercise performance to a limited extent in endurance-trained females.
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Affiliation(s)
- Mikkel Oxfeldt
- Department of Public Health, University of Aarhus, Aarhus, Denmark
| | - Louise K Frederiksen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Gunnarson
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Mette Hansen
- Department of Public Health, University of Aarhus, Aarhus, Denmark -
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Collomp K, Lorenzetti S. Editorial: Women in sports 2022. Front Physiol 2024; 15:1367605. [PMID: 38415008 PMCID: PMC10897034 DOI: 10.3389/fphys.2024.1367605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 01/26/2024] [Indexed: 02/29/2024] Open
Affiliation(s)
- Katia Collomp
- CIAMS, Université d'Orléans, Orléans, France
- CIAMS, Université Paris-Saclay, Orsay, France
- Sport, Physical Activity, Rehabilitation and Movement for Performance and Health Research Group, Orléans, France
- Laboratoire Anti-Dopage Français, LADF, Université Paris-Saclay, Orsay, France
| | - Silvio Lorenzetti
- Swiss Federal Institute of Sport Magglingen, Magglingen, Switzerland
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Seidman L, Seidman DS, Constantini NW. Hormonal contraception for female athletes presents special needs and concerns. EUR J CONTRACEP REPR 2024; 29:8-14. [PMID: 38108091 DOI: 10.1080/13625187.2023.2287960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/17/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE Oral contraceptives (OCs) are commonly used by female athletes raising concerns regarding the possible adverse effects of OCs on physical performance, musculoskeletal injuries, and bone density. We aimed to review all current studies on the physiological effects of OCs in physically active women. MATERIALS AND METHODS A review of literature in electronic search in PubMed and Google Scholar databases from December 2002 to December 2022 using relevant keywords. The reference lists of the articles found eligible were also reviewed. RESULTS Out of 344 articles in the initial database, 54 clinical studies were eligible for inclusion in our literature review. OCs are used by about two-thirds of female athletes. Current research suggests that OCs' effects on endurance performance and muscle strength are mostly reassuring. OCs do not seem to have a major negative impact on bone health or sports injuries. In fact, new data suggests that they may even significantly reduce the risk of anterior cruciate ligament (ACL) injury. CONCLUSIONS OCs can be safely used by young female athletes, who may also benefit from better menstrual cycle control. OCs offer newly realised protection from ACL injuries. The use of OCs must be carefully individualised according to their preferences, expectations, and experience.
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Affiliation(s)
- Liron Seidman
- Soroka Medical School, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Daniel S Seidman
- Department of Obstetrics and Gynecology, the Chaim Sheba Medical Center, and the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Naama W Constantini
- Heidi Rothberg Sport Medicine Center, Shaare Zedek Medical Center, affiliated to the Hebrew University, Jerusalem, Israel
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Olenick AA, Pearson RC, Jenkins NT. Impact of aerobic fitness status, menstrual cycle phase, and oral contraceptive use on exercise substrate oxidation and metabolic flexibility in females. Appl Physiol Nutr Metab 2024; 49:93-104. [PMID: 37657080 DOI: 10.1139/apnm-2023-0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
The influence of menstrual cycle phase and fitness status on metabolism during high-intensity interval exercise (HIIE) was assessed. Twenty-five females (24.4 (3.6) years) were categorized by normal menstrual cycle (n = 14) vs. oral contraceptive (OC) use (n = 11) and by aerobic fitness, high-fitness females (HFF; n = 13) vs. low-fitness females (LFF; n = 12). HIIE was four sets of four repetitions with a 3 min rest between intervals on a cycle ergometer at a power output halfway between the ventilatory threshold and V̇O2peak and performed during follicular (FOL: days 2-7 or inactive pills) and luteal phases (LUT: day ∼21 or 3rd week of active pills). Substrate oxidation was assessed via indirect calorimetry, blood lactate via finger stick, and recovery of skeletal muscle oxidative metabolism (mV̇O2) via continuous-wave near-infrared spectroscopy. HFF oxidized more fat (g·kg-1) during the full session (FOL: p = 0.050, LUT: p = 0.001), high intervals (FOL: p = 0.048, LUT: p = 0.001), low intervals (FOL: p = 0.032, LUT: p = 0.024), and LUT recovery (p = 0.033). Carbohydrate oxidation area under the curve was greater in HFF during FOL (FOL: p = 0.049, LUT: p = 0.124). Blood lactate was lower in LFF in FOL (p ≤ 0.05) but not in LUT. Metabolic flexibility (Δ fat oxidation g·kg-1·min-1) was greater in HFF than LFF during intervals 2-3 in FOL and 1-4 in LUT (p ≤ 0.05). Fitness status more positively influences exercise metabolic flexibility during HIIE than cycle phase or OC use.
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Affiliation(s)
- Alyssa A Olenick
- Department of Endocrinology and Metabolism, University of Colorado Anschutz Medical School, Aurora, CO, USA
| | - Regis C Pearson
- Department of Kinesiology, College of Education, University of Georgia, Athens, GA 30602, USA
| | - Nathan T Jenkins
- Department of Kinesiology, College of Education, University of Georgia, Athens, GA 30602, USA
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D'Souza AC, Wageh M, Williams JS, Colenso-Semple LM, McCarthy DG, McKay AKA, Elliott-Sale KJ, Burke LM, Parise G, MacDonald MJ, Tarnopolsky MA, Phillips SM. Menstrual cycle hormones and oral contraceptives: a multimethod systems physiology-based review of their impact on key aspects of female physiology. J Appl Physiol (1985) 2023; 135:1284-1299. [PMID: 37823207 PMCID: PMC10979803 DOI: 10.1152/japplphysiol.00346.2023] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/18/2023] [Accepted: 10/10/2023] [Indexed: 10/13/2023] Open
Abstract
Hormonal changes around ovulation divide the menstrual cycle (MC) into the follicular and luteal phases. In addition, oral contraceptives (OCs) have active (higher hormone) and placebo phases. Although there are some MC-based effects on various physiological outcomes, we found these differences relatively subtle and difficult to attribute to specific hormones, as estrogen and progesterone fluctuate rather than operating in a complete on/off pattern as observed in cellular or preclinical models often used to substantiate human data. A broad review reveals that the differences between the follicular and luteal phases and between OC active and placebo phases are not associated with marked differences in exercise performance and appear unlikely to influence muscular hypertrophy in response to resistance exercise training. A systematic review and meta-analysis of substrate oxidation between MC phases revealed no difference between phases in the relative carbohydrate and fat oxidation at rest and during acute aerobic exercise. Vascular differences between MC phases are also relatively small or nonexistent. Although OCs can vary in composition and androgenicity, we acknowledge that much more work remains to be done in this area; however, based on what little evidence is currently available, we do not find compelling support for the notion that OC use significantly influences exercise performance, substrate oxidation, or hypertrophy. It is important to note that the study of females requires better methodological control in many areas. Previous studies lacking such rigor have contributed to premature or incorrect conclusions regarding the effects of the MC and systemic hormones on outcomes. While we acknowledge that the evidence in certain research areas is limited, the consensus view is that the impact of the MC and OC use on various aspects of physiology is small or nonexistent.
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Affiliation(s)
- Alysha C D'Souza
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Mai Wageh
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Devin G McCarthy
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Alannah K A McKay
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | | | - Louise M Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Gianni Parise
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | | | - Mark A Tarnopolsky
- Department of Pediatrics, McMaster University Medical Center, Hamilton, Ontario, Canada
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
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12
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Nabeyama T, Suzuki Y, Saito H, Yamamoto K, Sakane M, Sasaki Y, Shindo H, Takita M, Kami M. Prevalence of iron-deficient but non-anemic university athletes in Japan: an observational cohort study. J Int Soc Sports Nutr 2023; 20:2284948. [PMID: 38018828 PMCID: PMC11018321 DOI: 10.1080/15502783.2023.2284948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/14/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Iron deficiency (ID) and iron deficiency anemia (IDA) are long-standing health problems in athletes, affecting both performance and health. ID prevalence in young athletes remains high and a matter of concern. ID and IDA can lead to fatigue, reduced endurance, and decreased oxygen transport, potentially compromising athletic performance. We hypothesized that ID would still be a major health concern in university athletes across sports clubs in Japan. PURPOSE The study aimed to investigate the prevalence of ID and IDA in athletes participating in Kendo, badminton, baseball, and handball at the University of Tsukuba (Tsukuba, Ibaraki Prefecture, Japan). The study also examined the correlation between hypoferritinemia and other variables, such as previous use of iron supplements, body mass index (BMI), energy intake, and years of athletics. METHODS Between January and December 2019, 126 university athletes, consisting of 79 males and 47 females, underwent physical measurements and blood tests. The blood test included complete blood count, levels of serum ferritin, serum iron, and total iron-binding capacity. The anemia was defined in accordance with the WHO criteria. Daily energy and iron intake were estimated with the food frequency questionnaire in Japanese (FFQg). Thirty-four female athletes responded to a survey about their menstruation and low-dose estrogen-progestin (LEP) usage. RESULTS While none of the athletes had anemia, 22 (47%) female athletes exhibited serum ferritin levels of 30 ng/mL or less, defining them as hypoferritinemia. The multivariate logistic regression model revealed that a shorter duration of the athletic experience (adjusted odd ratio [95% confidence interval]: 0.62 [0.43-0.90]), lower energy intake (0.994 [0.989-0.999]), and higher dietary iron intake (4.40 [1.12-17.26]) were associated with hypoferritinemia. Seventeen (50%) female athletes reported a decline in subjective performance during menstruation, albeit two took LEP regularly. CONCLUSIONS This study reveals that ID is a prevalent health concern among young female athletes across sports clubs. It underscores the need for their education on the importance of assessing ID status. Limitation includes the nature of single-site and observational study, the absence of hepcidin measurement, and an unspecified amount of exercise. Comprehensive investigations are needed to elucidate the causes and optimal treatments for ID in young athletes.
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Affiliation(s)
- Takahiro Nabeyama
- University of Tsukuba, Faculty of Health and Sport Sciences, Tsukuba, Ibaraki, Japan
| | - Yosuke Suzuki
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Hiroaki Saito
- Department of Internal medicine, Soma Central Hospital, Soma, Fukushima, Japan
| | - Kana Yamamoto
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | | | - Yoichiro Sasaki
- University of Tsukuba, Graduate School of Comprehensive Human Sciences, Tsukuba, Ibaraki, Japan
| | - Haruka Shindo
- University of Tsukuba, Graduate School of Comprehensive Human Sciences, Tsukuba, Ibaraki, Japan
| | - Morihito Takita
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
- Navitas Clinic, Department of Internal Medicine, Tachikawa, Tokyo, Japan
| | - Masahiro Kami
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
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Blumenstock SM, Barber JS. Hormonal Contraception Use and Sexual Frequency across Young Women's Intimate Relationships. JOURNAL OF SEX RESEARCH 2023; 60:1283-1296. [PMID: 35435786 PMCID: PMC9576816 DOI: 10.1080/00224499.2022.2059649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
We examined whether hormonal contraception (HC) use predicts sexual frequency throughout and across young women's intimate relationships. From 2008-2012, the Relationships Dynamics and Social Life Study collected weekly surveys over 2.5 years, and included 893 women (aged 18-19 at baseline) who reported 2,547 intimate relationships across 32,736 weeks. Three-level logistic multilevel models assessed the weekly probability of sexual intercourse based on 1) weekly HC use (vs. nonuse) and 2) duration of HC use, both accounting for several relational and individual characteristics, including relationship duration. Women had more frequent sexual intercourse when they were using HC than when they were not (predicted probabilities .65 vs .41). The weekly probability of sexual intercourse increased sharply within the first month of HC initiation (by about 27 percentage points), remained high for several months, then began to slowly decline (yet remained above that of nonuse). When separated by method type, similar trajectories were found for the pill, ring, and IUD/implant; following the initial increase, steeper declines in intercourse frequency were found for the contraceptive injectable, eventually dropping below pre-initiation levels. Findings signify the immediate influence of reduced pregnancy fears in facilitating sexual intercourse among young women, which may decline as HC use continues long-term.
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Affiliation(s)
| | - Jennifer S. Barber
- Kinsey Institute, Indiana University, Bloomington, IN, United States
- Department of Sociology, Indiana University, Bloomington, IN, United States
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14
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Taim BC, Ó Catháin C, Renard M, Elliott-Sale KJ, Madigan S, Ní Chéilleachair N. The Prevalence of Menstrual Cycle Disorders and Menstrual Cycle-Related Symptoms in Female Athletes: A Systematic Literature Review. Sports Med 2023; 53:1963-1984. [PMID: 37389782 DOI: 10.1007/s40279-023-01871-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Menstrual cycle (MC) disorders and MC-related symptoms can have debilitating effects on the health and performance of female athletes. As the participation of women in sports continues to increase, understanding the prevalence of a range of MC disorders and MC-related symptoms may guide preventive strategies to protect the health and optimise the performance of female athletes. OBJECTIVE To examine the prevalence of MC disorders and MC-related symptoms among female athletes who are not using hormonal contraceptives and evaluate the assessment methods used to identify MC disorders and MC-related symptoms. METHODS This systematic review was performed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Six databases were searched until September 2022 for all original research that reported the prevalence of MC disorders and/or MC-related symptoms in athletes not using hormonal contraceptives, which included the definitions of the MC disorders examined, and the assessment methods used. MC disorders included amenorrhoea, anovulation, dysmenorrhoea, heavy menstrual bleeding (HMB), luteal phase deficiency (LPD), oligomenorrhoea, premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). MC-related symptoms included any affective and physical symptoms related to the MC that do not cause significant personal, interpersonal or functional impairment. The prevalence data across eligible studies were combined, and all studies were qualitatively synthesised to evaluate the assessment methods and tools used to identify MC disorders and MC-related symptoms. The methodological quality of studies was assessed using a modified Downs and Black checklist. RESULTS Sixty studies involving 6380 athletes were included. A wide range of prevalence was observed for all types of MC disorders, with a dearth of data on anovulation and LPD. Based on pooled data, dysmenorrhoea (32.3%; range 7.8-85.6%) was the most prevalent MC disorder. Studies reporting MC-related symptoms mostly examined the premenstrual and menstruation phases, where affective symptoms appeared more prevalent than physical symptoms. A larger proportion of athletes reported symptoms during the initial days of menstruation compared with the premenstrual phase. MC disorders and MC-related symptoms were retrospectively assessed using self-report methods in 90.0% of studies. Most studies (76.7%) in this review were graded as moderate quality. DISCUSSION MC disorders and MC-related symptoms are commonplace among female athletes, warranting further research examining their impact on performance and preventive/management strategies to optimise athlete health. To increase the quality of future studies, researchers should adopt standardised definitions of MC disorders and assessment methods such as a combination of calendar counting, urinary ovulation tests and a mid-luteal phase serum progesterone measurement when assessing menstrual function. Similarly, standardised diagnostic criteria should be used when examining MC disorders such as HMB, PMS and PMDD. Practically, implementing prospective cycle monitoring that includes ovulation testing, mid-luteal blood sampling (where feasible) and symptom logging throughout the MC could support athletes and practitioners to promptly identify and manage MC disorders and/or MC-related symptoms. TRIAL REGISTRATION This review has been registered in the PROSPERO database (CRD42021268757).
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Affiliation(s)
- Bernadette Cherianne Taim
- Department of Sport and Health Sciences, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland.
- SHE Research Group, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland.
| | - Ciarán Ó Catháin
- Department of Sport and Health Sciences, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland
- SHE Research Group, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland
| | - Michèle Renard
- Department of Sport and Health Sciences, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland
- SHE Research Group, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland
| | - Kirsty Jayne Elliott-Sale
- Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, 99 Oxford Road, M1 7EL, Manchester, UK
| | - Sharon Madigan
- Sport Ireland Institute, Dublin, Ireland
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Niamh Ní Chéilleachair
- Department of Sport and Health Sciences, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland
- SHE Research Group, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland
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15
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Baumgartner S, Bitterlich N, Geboltsberger S, Neuenschwander M, Matter S, Stute P. Contraception, female cycle disorders and injuries in Swiss female elite athletes-a cross sectional study. Front Physiol 2023; 14:1232656. [PMID: 37565143 PMCID: PMC10410265 DOI: 10.3389/fphys.2023.1232656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/10/2023] [Indexed: 08/12/2023] Open
Abstract
Aim: The national Olympic committee of Switzerland has conducted an online survey among female elite athletes with a focus on cycle disorders, contraception, and injuries in 2021. Methods: A total of 1,092 female elite athletes from 107 different sports were asked to answer the questionnaire. A descriptive analysis was carried out to determine location parameters and create frequency tables. Results: The questionnaire was completed by 408 athletes (37.4%) from 92 different sports. 43.4% participated in a lean sport. 57.1% reported no injuries, 32.6% one injury, and 10.2% two or more injuries per year. A considerable proportion reported being affected by primary amenorrhoea (10.8%). Primary amenorrhoea occurred significantly more often in female athletes with a BMI lower than 21.7 kg/m2 (15.2%) than in athletes with a BMI above 21.7 kg/m2 (7.4%, p = 0.021). Considering contraception, 25.8% of female athletes were currently using an oral contraceptive pill. The proportion of female athletes not using contraception at all or using non-hormonal contraceptive methods was high at 54.4%. In lean sports, significantly more athletes used no or non-hormonal contraceptives (p < 0.05). Conclusion: Among top Swiss female athletes, a considerable proportion used non-hormonal or no contraceptives. This trend was more evident in lean sports. Delayed menarche and cycle irregularities were common among female athletes, especially among athletes with high training volumes as well as a BMI below 21.7 kg/m2. This orienting survey underlines the importance of specialized gynecological care for elite female athletes.
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Affiliation(s)
- Sabrina Baumgartner
- Department of Obstetrics and Gynecology, Inselspital, University of Bern, Bern, Switzerland
- Swiss Federal Institute of Sport—BASPO, Magglingen, Switzerland
| | | | | | | | | | - Petra Stute
- Department of Obstetrics and Gynecology, Inselspital, University of Bern, Bern, Switzerland
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16
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Ahokas EK, Hanstock HG, Löfberg I, Nyman M, Wenning P, Kyröläinen H, Mikkonen RS, Ihalainen JK. Nocturnal Heart Rate Variability in Women Discordant for Hormonal Contraceptive Use. Med Sci Sports Exerc 2023; 55:1342-1349. [PMID: 36893303 DOI: 10.1249/mss.0000000000003158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
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 wk (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 E 2 , M2 = M1 + 7 d, M3 = M1 + 14 d, and M4 = M1 + 21 d) 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 the inactive phases in the CU group. In the NM and PU groups, some of the HRV values were higher, whereas in the NM group, HR was lower during M2 compared with 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 with the first week of the active phase. CONCLUSIONS The MC and the 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.
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Affiliation(s)
- Essi K Ahokas
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
| | - Helen G Hanstock
- Department of Health Sciences, Swedish Winter Sports Research Centre, Mid Sweden University, Östersund, SWEDEN
| | - Ida Löfberg
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
| | - Mari Nyman
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
| | - Piia Wenning
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
| | - Heikki Kyröläinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
| | | | - Johanna K Ihalainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
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17
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Bougault V, Schiano-Lomoriello S, Castanier C, Buisson C, Ericsson M, Teulier C, Collomp K. Physical activity and combined hormonal contraception: association with female students' perception of menstrual symptoms. Front Physiol 2023; 14:1185343. [PMID: 37265844 PMCID: PMC10230043 DOI: 10.3389/fphys.2023.1185343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/02/2023] [Indexed: 06/03/2023] Open
Abstract
Aim: The aim of this study was to examine the association between physical activity (PA) and combined hormonal contraceptive (CHC) on female students' self perceptio of their menstrual cycle symptoms. Methods: Healthy French female students (n = 834) completed an online questionnaire to assess their PA level (Group 1: non-active; Group 2: moderate physical activity; Group 3: high physical activity; Group 4: very high physical activity), menstrual status or contraception use, self-reported diet and medication, impact on engagement in some social activities, and self-assessment of perceived mental and physical symptoms during the week prior to menses (PM) for students with a normal menstrual cycle (NMC), and the week of menses (ME) for normal menstrual cycle students and those using combined hormonal contraception. Results: Whatever the conditions (PM and ME, NMC and CHC), fewer self-perceived symptoms and self-reported alteration in fat intake were reported by the students in Group 4, and more analgesic and anti-inflammatory medication use was reported by Group 1. Fewer self-perceived symptoms were also found in CHC vs NMC female students for all physical activity levels, but in a more marked way when associated with very high physical activity. In addition, less university and sports practice absenteeism was observed with high and very high physical activity. Conclusion: In conclusion, the perception of menstrual cycle symptoms was lower with very high physical activity, as with combined hormonal contraception. Moreover, female students training more than 5 h/week also reported less university absenteeism and impairment in physical activities. Further studies are necessary to establish the causal link of physical activity and combined hormonal contraception on menstrual symptoms.
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Affiliation(s)
| | - Sandrine Schiano-Lomoriello
- CIAMS, Université d'Orléans, Orléans, France
- CIAMS, Université Paris-Saclay, Orsay, France
- Sport, Physical Activity, Rehabilitation and Movement for Performance and Health Research Group, Orléans, France
| | - Carole Castanier
- CIAMS, Université d'Orléans, Orléans, France
- CIAMS, Université Paris-Saclay, Orsay, France
| | - Corinne Buisson
- Laboratoire Anti-Dopage Français, LADF, Université Paris-Saclay, Chatenay-Malabry, France
| | - Magnus Ericsson
- Laboratoire Anti-Dopage Français, LADF, Université Paris-Saclay, Chatenay-Malabry, France
| | - Caroline Teulier
- CIAMS, Université d'Orléans, Orléans, France
- CIAMS, Université Paris-Saclay, Orsay, France
| | - Katia Collomp
- CIAMS, Université d'Orléans, Orléans, France
- CIAMS, Université Paris-Saclay, Orsay, France
- Sport, Physical Activity, Rehabilitation and Movement for Performance and Health Research Group, Orléans, France
- Laboratoire Anti-Dopage Français, LADF, Université Paris-Saclay, Chatenay-Malabry, France
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18
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Duggan JD, Keane K, Moody J, Byrne PJ, Malone S, Collins K, Ryan L. Strength and Conditioning Recommendations for Female Athletes: The Gaelic Footballer. Strength Cond J 2023. [DOI: 10.1519/ssc.0000000000000761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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19
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Roles of Estrogen, Estrogen Receptors, and Estrogen-Related Receptors in Skeletal Muscle: Regulation of Mitochondrial Function. Int J Mol Sci 2023; 24:ijms24031853. [PMID: 36768177 PMCID: PMC9916347 DOI: 10.3390/ijms24031853] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 01/19/2023] Open
Abstract
Estrogen is an essential sex steroid hormone that functions primarily in female reproductive system, as well as in a variety of tissues and organs with pleiotropic effects, such as in cardiovascular, nervous, immune, and musculoskeletal systems. Women with low estrogen, as exemplified by those in postmenopause, are therefore prone to suffer from various disorders, i.e., cardiovascular disease, dementia, metabolic syndrome, osteoporosis, sarcopenia, frailty, and so on. Estrogen regulates the expression of its target genes by binding to its cognate receptors, estrogen receptors (ERs) α and β. Notably, the estrogen-related receptors (ERRs) α, β, and γ are originally identified as orphan receptors that share substantial structural homology and common transcriptional targets with ERs. Accumulating evidence suggests that ERs and ERRs play crucial roles in skeletal muscles, such as muscle mass maintenance, muscle exercise physiology, and muscle regeneration. In this article, we review potential regulatory roles of ERs and ERRs in muscle physiology, particularly with regard to mitochondrial function and metabolism.
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20
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Mkumbuzi NS, Dlamini SB, Chibhabha F, Govere FM, Manda-Taylor L. The menstrual cycle and football: The experiences of African women football players. SCI MED FOOTBALL 2022; 6:626-632. [PMID: 36540914 DOI: 10.1080/24733938.2021.2005252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND The menstrual cycle is a normal biological process in women and girls. However, it is often the reason why they tend to be excluded from football medicine research. Consequently, our understanding of the menstrual cycle and football performance is still limited, especially in African women football players. AIM The study aimed to explore African women football players' current and historical menstrual cycle status, menstrual symptoms, lived experiences, and perceptions of the menstrual cycle. METHODS Women football players at the COSAFA Women's Championship 2020 completed demographic questionnaires and the Moos Menstrual Distress Questionnaire. RESULTS The main findings were that 90% of the players did not use contraceptives, . Most of the players had access to their preferred choice of sanitary product; however, 36% used alternatives such as old rags during their periods, . The most commonly reported symptoms during menses were abdominal cramps (53%), headache (41%), mood swings (41%) and irritability (47%). Further, players reported irritability (48%), mood swings (52%), and breast tenderness (48%) in the week before their period. CONCLUSION The low use of contraceptives is likely due to community level socio-cultural factors. While the use of old rags as impromptu sanitary products is likely because they cannot always afford their preferred choice. Menstrual symptoms can affect training and competition; therefore, team support personnel should be aware of the menstrual cycle's implications for African women football players and their effect on athletic performance and well-being. Additionally, team support personnel ought to be mindful of African women football players' socio-economic and religio-cultural contexts and their interaction with biological processes such as the menstrual cycle and contraceptive use.
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Affiliation(s)
- Nonhlanhla S Mkumbuzi
- Health through Physical Activity, Lifestyle and Sport Research Centre (HPALS). Department of Human Biology, University of Cape Town, Cape Town, South Africa.,African Evaluation and Research Development, Johannesburg
| | - Senanile B Dlamini
- Health through Physical Activity, Lifestyle and Sport Research Centre (HPALS). Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Fidelis Chibhabha
- Anatomy Department, Faculty of Medicine, Midlands State University, Gweru, Zimbabwe
| | | | - Lucinda Manda-Taylor
- Department of Health Systems and Policy, School of Public Health and Family Medicine, University of Malawi, Zomba, Malawi
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21
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DAM TINEVRIST, DALGAARD LINEBARNER, SEVDALIS VASSILIS, BIBBY BOMARTIN, JANSE DE JONGE XANNE, GRAVHOLT CLAUSH, HANSEN METTE. Muscle Performance during the Menstrual Cycle Correlates with Psychological Well-Being, but Not Fluctuations in Sex Hormones. Med Sci Sports Exerc 2022; 54:1678-1689. [PMID: 36106832 PMCID: PMC9473716 DOI: 10.1249/mss.0000000000002961] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE We aimed to study variations in strength and power performance during the menstrual cycle (MC) in eumenorrheic young women and during the pill cycle in oral contraceptives (OC) users. METHODS Forty healthy, normal-weight women between 18 and 35 yr (n = 30 eumenorrheic women; n = 10 OC users) completed this prospective cohort study. Seven to nine times during the MC/pill-cycle, the participants completed a physical performance test series, a questionnaire about psychological well-being, blood sampling, and determination of body mass. The physical tests included isometric handgrip strength, elbow flexor strength, countermovement jump (CMJ) height, and a 10-s Wingate bike test. RESULTS No direct correlation was observed between the variations in sex hormones and physical performance parameters. However, positive correlations were observed between physical performance outcomes and self-reported motivation, perception of own physical performance level, pleasure level, and arousal level. CMJ was 6% lower in the late luteal phase (LL) compared with the midluteal phase (ML) (P = 0.04). Wingate peak power was 3% lower in early follicular (EF) compared with the ML (P = 0.04). Furthermore, Wingate average power was 2%-5% lower in LL compared with all other MC phases. In line with these observations, physical pain was higher in EF and LL, and the pleasure level was lower in EF compared with the other MC phases. In OC users, we observed no variation in performance and self-reported parameters between the placebo-pill phase and the OC-pill phase. CONCLUSIONS Impairments in CMJ and Wingate performance were observed at the end and start of MC compared with other MC phases, which were associated with lower psychological well-being, but not the sex hormone fluctuations.
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Affiliation(s)
- TINE VRIST DAM
- Section of Sport Science, Department of Public Health, Aarhus University, Aarhus, DENMARK
| | - LINE BARNER DALGAARD
- Section of Sport Science, Department of Public Health, Aarhus University, Aarhus, DENMARK
| | - VASSILIS SEVDALIS
- Section of Sport Science, Department of Public Health, Aarhus University, Aarhus, DENMARK
| | - BO MARTIN BIBBY
- Section of Biostatistics, Department of Public Health, Aarhus University, Aarhus, DENMARK
| | | | - CLAUS H. GRAVHOLT
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, DENMARK
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, DENMARK
| | - METTE HANSEN
- Section of Sport Science, Department of Public Health, Aarhus University, Aarhus, DENMARK
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22
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Ekenros L, von Rosen P, Solli GS, Sandbakk Ø, Holmberg HC, Hirschberg AL, Fridén C. Perceived impact of the menstrual cycle and hormonal contraceptives on physical exercise and performance in 1,086 athletes from 57 sports. Front Physiol 2022; 13:954760. [PMID: 36111164 PMCID: PMC9468598 DOI: 10.3389/fphys.2022.954760] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/02/2022] [Indexed: 11/25/2022] Open
Abstract
Female athletes train and compete under the potential influence of hormonal fluctuations during the menstrual cycle or during use of various hormonal contraceptives. Dysmenorrhea and premenstrual symptoms are common in the general population, as well as side effects of hormonal contraceptives. More detailed knowledge concerning prevalence and perceived impact of these symptoms on training and performance in different sports is required. The aim of the study was to 1) characterize perceptions of training and performance during the menstrual cycle phases and by hormonal contraceptive use in a large population of female athletes; 2) explore whether symptoms experienced are related to perceived performance; and 3) examine potential differences in these factors between athletes at different levels of performance. The study was based on self-reported data from 1,086 athletes from 57 sports at different performance levels via a web-based questionnaire. Thirty-seven percent (n = 407) of the athletes did not use hormonal contraceptives. In this group, menstrual cycle related symptoms were common across all athlete levels, particularly dysmenorrhea (74%, n = 300) and premenstrual symptoms (78%, n = 318), which also influenced perceived performance of aerobic fitness, muscle strength, mental sharpness, balance, and sleep quality. Sixty-three percent (n = 679) of the athletes used various hormonal contraceptives and 40% (n = 272) perceived a variety of side-effects. Physical performance was experienced equally independent of time-point of the pill-chart except for the period of inactive pills, which was associated with more negative impact. Nonetheless, only 18% (n = 191) of the athletes considered menstrual cycle or hormonal contraceptive issues when planning their training or competitions. These results indicate that greater focus is needed to identify and effectively treat different menstrual cycle and hormonal contraceptive related symptoms on an individual level.
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Affiliation(s)
- Linda Ekenros
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy Karolinska Institutet, Huddinge, Sweden
| | - Philip von Rosen
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy Karolinska Institutet, Huddinge, Sweden
| | - Guro Strøm Solli
- School of Sport Sciences, UiT, the Arctic University of Norway, Tromsø, Norway
- Department of Sports Science and Physical Education, Nord University, Bodø, Norway
| | - Øyvind Sandbakk
- School of Sport Sciences, UiT, the Arctic University of Norway, Tromsø, Norway
- Department of Neuromedicine and Movement Science, Centre for Elite Sports Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Hans-Christer Holmberg
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
- Department of Physiology and Pharmacology, Biomedicum C5, Karolinska Institutet, Stockholm, Sweden
| | - Angelica Lindén Hirschberg
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
- Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Cecilia Fridén
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy Karolinska Institutet, Huddinge, Sweden
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
- *Correspondence: Cecilia Fridén,
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McNamara A, Harris R, Minahan C. 'That time of the month' … for the biggest event of your career! Perception of menstrual cycle on performance of Australian athletes training for the 2020 Olympic and Paralympic Games. BMJ Open Sport Exerc Med 2022; 8:e001300. [PMID: 35505980 PMCID: PMC9014077 DOI: 10.1136/bmjsem-2021-001300] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2022] [Indexed: 11/04/2022] Open
Abstract
Objective This study explored the perceived effect of the menstrual cycle (MC) on the performance of Australian female athletes, preparing for the Tokyo Olympic and/or Paralympic Games. Methods 195 female athletes, nominated by 24 National Sporting Organisations as preparing for the Tokyo Olympic and/or Paralympic Games, completed an online questionnaire (‘MCq perceptions’). The MCq perceptions investigated menstrual symptoms, hormonal contraceptive (HC) use and a preferred competition window within the MC. Results Two-thirds (65.6%) athletes reported that their MC affected their performance; in training (65.6%) compared with competition (58.0%). Aesthetic-sport athletes were most likely to perceive their performance to be affected by their MC (RR=1.40) compared with endurance (RR=0.88) and strength-sport (RR=1.04) athletes. Athletes experiencing three or more symptoms were twice as likely to identify as affected. Athletes who reported pain (RR=1.89) or the use of analgesia (RR=1.45) were more likely to identify as affected by their MC. A preferred competition window was identified by athletes as ‘just after your period’ (41.5%). For athletes not using HC, this window was identified by 53.7%. Conclusion In Australia, elite-female athletes perceive their MC to affect their performance, and many have a preferred performance window. Performance-focused strategies should be created for ‘affected’ athletes, aiming to provide these athletes with education, and where appropriate, control over predictability, timing and symptoms of their MC.
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Affiliation(s)
- Alice McNamara
- Australasian College of Sport and Exercise Physicians, Melbourne, Victoria, Australia.,Victorian Institute of Sport, Melbourne, Victoria, Australia
| | - Rachel Harris
- Australasian College of Sport and Exercise Physicians, Melbourne, Victoria, Australia.,Australian Institute of Sport, Belconnen, Australian Capital Territory, Australia.,Perth Orthopaedics and Sports Medicine Research Institute, Perth, Western Australia, Australia
| | - Clare Minahan
- Australian Institute of Sport, Belconnen, Australian Capital Territory, Australia.,Griffith Sports Science, Griffith University, Gold Coast, Queensland, Australia
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Engseth TP, Andersson EP, Solli GS, Morseth B, Thomassen TO, Noordhof DA, Sandbakk Ø, Welde B. Prevalence and Self-Perceived Experiences With the Use of Hormonal Contraceptives Among Competitive Female Cross-Country Skiers and Biathletes in Norway: The FENDURA Project. Front Sports Act Living 2022; 4:873222. [PMID: 35498528 PMCID: PMC9047044 DOI: 10.3389/fspor.2022.873222] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 03/23/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeTo investigate the prevalence of hormonal contraceptive (HC) use by female cross-country (XC) skiers and biathletes competing at a national and/or international level, their reasons for HC use, and to compare negative symptoms related to the HC-/menstrual cycle in HC users and non-HC users. Additionally, to characterize the self-perceived influence of HC use on training and performance.MethodsA total of 113 Norwegian competitive XC skiers and biathletes completed an online questionnaire including both closed and open-ended questions. The questions were designed to assess the type of HC, reasons for use, self-reported negative symptoms related to HC-/menstrual cycle, as well as athletes' experiences regarding how HC use affects training and performance.ResultsIn total, 68% of all the athletes used HC, with 64 and 36% of them using a progestin-only and combined type HC, respectively. Non-contraceptive reasons for HC use were reported by 51% of the progestin-only HC users vs. 75% of the combined HC users (P = 0.039), with reduction of negative menstrual-related symptoms as the most common reason. Of the athletes reporting regular withdrawal bleedings in connection to HC use, 80% of the progestin-only and 86% of combined HC users experienced negative menstrual-related symptoms, which was comparable to the non-HC group (86%). The majority (81%) of HC users experienced solely positive, or no effect, of HC use on training and performance, with no differences between progestin-only and combined HC users (P = 0.942).ConclusionsIn total, 68% of the XC skiers and biathletes used HC, with the highest proportion (64%) using a progestin-only HC. Many athletes used HC to manipulate their menstrual cycle due to perceived negative menstrual-related symptoms that interfered with their training sessions and/or competitions.
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Affiliation(s)
- Tina P. Engseth
- School of Sport Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
- *Correspondence: Tina P. Engseth
| | - Erik P. Andersson
- School of Sport Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Guro S. Solli
- School of Sport Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
- Department of Sports Science and Physical Education, Nord University, Bodø, Norway
| | - Bente Morseth
- School of Sport Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Tor Oskar Thomassen
- School of Sport Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Dionne A. Noordhof
- Department of Neuromedicine and Movement Science, Centre for Elite Sports Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Øyvind Sandbakk
- School of Sport Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
- Department of Neuromedicine and Movement Science, Centre for Elite Sports Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Boye Welde
- School of Sport Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
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Oxfeldt M, Dalgaard LB, Farup J, Hansen M. Sex Hormones and Satellite Cell Regulation in Women. TRANSLATIONAL SPORTS MEDICINE 2022; 2022:9065923. [PMID: 38655160 PMCID: PMC11022763 DOI: 10.1155/2022/9065923] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/17/2022] [Accepted: 03/02/2022] [Indexed: 04/26/2024]
Abstract
Recent years have seen growing scholarly interest in female physiology in general. Moreover, particular attention has been devoted to how concentrations of female sex hormones vary during the menstrual cycle and menopausal transition and how hormonal contraception and hormonal therapy influence skeletal muscle tissue. While much effort has been paid to macro outcomes, such as muscle function or mass, rather less attention has been paid to mechanistic work that may help explain the underlying mechanism through which sex hormones regulate skeletal muscle tissue. Evidence from animal studies shows a strong relationship between the female sex hormone estrogen and satellite cells (SCs), a population of muscle stem cells involved in skeletal muscle regulation. A few human studies investigating this relationship have been published only recently. Thus, the purpose of this study was to bring an updated review on female sex hormones and their role in SC regulation. First, we describe how SCs regulate skeletal muscle maintenance and repair and introduce sex hormone signaling within the muscle. Second, we present evidence from animal studies elucidating how estrogen deficiency and supplementation influence SCs. Third, we present results from investigations from human trials including women whose concentrations of female hormones differ due to menopause, hormone therapy, hormonal contraceptives, and the menstrual cycle. Finally, we discuss research and methodological recommendations for future studies aiming at elucidating the link between female sex hormones and SCs with respect to aging and training.
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Affiliation(s)
- Mikkel Oxfeldt
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Jean Farup
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Mette Hansen
- Department of Public Health, Aarhus University, Aarhus, Denmark
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Contreras-Briceño F, Espinosa-Ramirez M, Keim-Bagnara V, Carreño-Román M, Rodríguez-Villagra R, Villegas-Belmar F, Viscor G, Gabrielli L, Andía ME, Araneda OF, Hurtado DE. Determination of the Respiratory Compensation Point by Detecting Changes in Intercostal Muscles Oxygenation by Using Near-Infrared Spectroscopy. Life (Basel) 2022; 12:life12030444. [PMID: 35330195 PMCID: PMC8954259 DOI: 10.3390/life12030444] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/07/2022] [Accepted: 03/15/2022] [Indexed: 11/20/2022] Open
Abstract
This study aimed to evaluate if the changes in oxygen saturation levels at intercostal muscles (SmO2-m.intercostales) assessed by near-infrared spectroscopy (NIRS) using a wearable device could determine the respiratory compensation point (RCP) during exercise. Fifteen healthy competitive triathletes (eight males; 29 ± 6 years; height 167.6 ± 25.6 cm; weight 69.2 ± 9.4 kg; V˙O2-máx 58.4 ± 8.1 mL·kg−1·min−1) were evaluated in a cycle ergometer during the maximal oxygen-uptake test (V˙O2-máx), while lung ventilation (V˙E), power output (watts, W) and SmO2-m.intercostales were measured. RCP was determined by visual method (RCPvisual: changes at ventilatory equivalents (V˙E·V˙CO2−1, V˙E·V˙O2−1) and end-tidal respiratory pressure (PetO2, PetCO2) and NIRS method (RCPNIRS: breakpoint of fall in SmO2-m.intercostales). During exercise, SmO2-m.intercostales decreased continuously showing a higher decrease when V˙E increased abruptly. A good agreement between methods used to determine RCP was found (visual vs NIRS) at %V˙O2-máx, V˙O2, V˙E, and W (Bland-Altman test). Correlations were found to each parameters analyzed (r = 0.854; r = 0.865; r = 0.981; and r = 0,968; respectively. p < 0.001 in all variables, Pearson test), with no differences (p < 0.001 in all variables, Student’s t-test) between methods used (RCPvisual and RCPNIRS). We concluded that changes at SmO2-m.intercostales measured by NIRS could adequately determine RCP in triathletes.
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Affiliation(s)
- Felipe Contreras-Briceño
- Laboratory of Exercise Physiology, Department of Health Science, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile; (M.E.-R.); (V.K.-B.); (M.C.-R.); (R.R.-V.); (F.V.-B.); (L.G.)
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain;
- Advanced Center for Chronic Diseases (ACCDiS), Division of Cardiovascular Diseases, Facultad de Medicina, Pontificia Universidad Católica de Chile, Marcoleta #367, Santiago 8380000, Chile
- Biomedical Imaging Center, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile;
- Correspondence: ; Tel.: +56-22-3541512
| | - Maximiliano Espinosa-Ramirez
- Laboratory of Exercise Physiology, Department of Health Science, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile; (M.E.-R.); (V.K.-B.); (M.C.-R.); (R.R.-V.); (F.V.-B.); (L.G.)
- Biomedical Imaging Center, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile;
| | - Vicente Keim-Bagnara
- Laboratory of Exercise Physiology, Department of Health Science, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile; (M.E.-R.); (V.K.-B.); (M.C.-R.); (R.R.-V.); (F.V.-B.); (L.G.)
| | - Matías Carreño-Román
- Laboratory of Exercise Physiology, Department of Health Science, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile; (M.E.-R.); (V.K.-B.); (M.C.-R.); (R.R.-V.); (F.V.-B.); (L.G.)
| | - Rafael Rodríguez-Villagra
- Laboratory of Exercise Physiology, Department of Health Science, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile; (M.E.-R.); (V.K.-B.); (M.C.-R.); (R.R.-V.); (F.V.-B.); (L.G.)
| | - Fernanda Villegas-Belmar
- Laboratory of Exercise Physiology, Department of Health Science, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile; (M.E.-R.); (V.K.-B.); (M.C.-R.); (R.R.-V.); (F.V.-B.); (L.G.)
| | - Ginés Viscor
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain;
| | - Luigi Gabrielli
- Laboratory of Exercise Physiology, Department of Health Science, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile; (M.E.-R.); (V.K.-B.); (M.C.-R.); (R.R.-V.); (F.V.-B.); (L.G.)
- Advanced Center for Chronic Diseases (ACCDiS), Division of Cardiovascular Diseases, Facultad de Medicina, Pontificia Universidad Católica de Chile, Marcoleta #367, Santiago 8380000, Chile
| | - Marcelo E. Andía
- Biomedical Imaging Center, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile;
| | - Oscar F. Araneda
- Laboratory of Integrative Physiology of Biomechanics and Physiology of Effort (LIBFE), Kinesiology School, Faculty of Medicine, Universidad de los Andes, Santiago 7620001, Chile;
| | - Daniel E. Hurtado
- Department of Structural and Geotechnical Engineering, School of Engineering, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile;
- Schools of Engineering, Medicine and Biological Sciences, Institute for Biological and Medical Engineering, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile
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Indian Endurance Athletes’ Menstrual Cycle: Practices, Knowledge, Communication, Health, and Changes in Perceptions Across the Phases. Int J Sports Physiol Perform 2022; 17:1706-1715. [DOI: 10.1123/ijspp.2022-0131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 08/02/2022] [Accepted: 08/24/2022] [Indexed: 11/10/2022]
Abstract
Purpose: To describe menstrual cycle (MC)-related practices, knowledge, communication, and health in Indian endurance athletes and to investigate the changes in their perception of sleep quality, readiness to train, training quality, fitness, and performance across the MC. Methods: Data on female Indian athletes (N = 96, age 22 [3] y) competing in 7 endurance sports at (inter)national and state level were collected using an online questionnaire. A Friedman rank sum test was used to assess changes in sleep quality, readiness to train, training quality, fitness, and performance across MC phases (ie, during, immediately after, and just before the bleeding phase). Results: Most of the athletes showed poor MC-related practices and suboptimal knowledge and communication about the MC. Despite no clear signs of serious health conditions, many athletes (63.5%) experienced irregular bleeding phases, particularly during periods with high exercise intensity or high training volume (54.4%). Perceived sleep quality, readiness to train, fitness, performance, and the quality of high-intensity and strength training changed significantly throughout the MC (P < .001), with a higher prevalence of a positive perception immediately after the bleeding phase. The perceived quality of low-intensity training did not change significantly throughout the MC (P = .244). Conclusions: Knowledge and communication about the MC were found to be poor in Indian endurance athletes, who reported that the MC significantly influenced their sleep quality, readiness to train, training quality, fitness, and performance.
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Influence of Female Sex Hormones on Ultra-Running Performance and Post-Race Recovery: Role of Testosterone. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910403. [PMID: 34639701 PMCID: PMC8508191 DOI: 10.3390/ijerph181910403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/21/2021] [Accepted: 09/28/2021] [Indexed: 11/17/2022]
Abstract
In recent years, increasing numbers of women have participated in extremely long races. In adult males, there is a clear association between physiological levels of endogenous sex hormones and physical performance. However, the influence of plasmatic sex hormones and the effects of different types of hormonal contraception (HC) on the modulation of physical performance in adult females remain to be fully clarified. Eighteen female ultra-endurance athletes were recruited to participate in the study. Different variables were studied, including hematological parameters, body mass index, and body composition. Strength measurements were obtained using the squat-jump and hand-grip test. A repeated-measures analysis demonstrated significant differences in hematological values of CK and LDH pre-race as compared to immediately post-race and after 24/48 h. Furthermore, statistical differences were found in squat-jump and hand-grip test results after the ultramarathon. Testosterone, estradiol, and the testosterone/estrogen ratio were significantly correlated with muscle fatigue and were found to be indirect markers of muscle damage. A multivariate analysis demonstrated the protective role of testosterone against muscle damage and severe fatigue. Fluctuations in endogenous testosterone levels were correlated with greater fatigability and muscle damage after the competition. Adjusting the menstrual cycle with HC would not provide any further benefit to the athlete's competitive capacity.
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29
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Anemia in Sports: A Narrative Review. Life (Basel) 2021; 11:life11090987. [PMID: 34575136 PMCID: PMC8472039 DOI: 10.3390/life11090987] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/06/2021] [Accepted: 09/16/2021] [Indexed: 12/12/2022] Open
Abstract
Recent years have brought about new understandings regarding the pathogenesis of anemia in sports. From hemodilution and redistribution considered to contribute to the so-called “sports anemia” to iron deficiency caused by increased demands, dietary restrictions, decreased absorption, increased losses, hemolysis, and sequestration, to genetic determinants of different types of anemia (some related to sport), the anemia in athletes deserves a careful and multifactorial approach. Dietary factors that reduce iron absorption (e.g., phytate, polyphenols) and that augment iron’s bioavailability (e.g., ascorbic acid) should be considered. Celiac disease, more prevalent in female athletes, may underlie an unexplained iron deficiency anemia. Iron loss during exercise occurs in several ways: sweating, hematuria, gastrointestinal bleeding, inflammation, and intravascular and extravascular hemolysis. From a practical point of view, assessing iron status, especially in the athletes at risk for iron deficiency (females, adolescents, in sports with dietary restrictions, etc.), may improve the iron balance and possibly the performance. Hemoglobin and serum ferritin are measures that are easily employable for the evaluation of patients’ iron status. Cutoff values should probably be further assessed with respect to the sex, age, and type of sport. A healthy gut microbiome influences the iron status. Athletes at risk of iron deficiency should perform non-weight-bearing, low-intensity sports to avoid inducing hemolysis.
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Kontrazeption bei Sportlerinnen. GYNAKOLOGISCHE ENDOKRINOLOGIE 2021. [DOI: 10.1007/s10304-021-00399-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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31
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Castanier C, Bougault V, Teulier C, Jaffré C, Schiano-Lomoriello S, Vibarel-Rebot N, Villemain A, Rieth N, Le-Scanff C, Buisson C, Collomp K. The Specificities of Elite Female Athletes: A Multidisciplinary Approach. Life (Basel) 2021; 11:622. [PMID: 34206866 PMCID: PMC8303304 DOI: 10.3390/life11070622] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 12/19/2022] Open
Abstract
Female athletes have garnered considerable attention in the last few years as more and more women participate in sports events. However, despite the well-known repercussions of female sex hormones, few studies have investigated the specificities of elite female athletes. In this review, we present the current but still limited data on how normal menstrual phases, altered menstrual phases, and hormonal contraception affect both physical and cognitive performances in these elite athletes. To examine the implicated mechanisms, as well as the potential performances and health risks in this population, we then take a broader multidisciplinary approach and report on the causal/reciprocal relationships between hormonal status and mental and physical health in young (18-40 years) healthy females, both trained and untrained. We thus cover the research on both physiological and psychological variables, as well as on the Athlete Biological Passport used for anti-doping purposes. We consider the fairly frequent discrepancies and summarize the current knowledge in this new field of interest. Last, we conclude with some practical guidelines for eliciting improvements in physical and cognitive performance while minimizing the health risks for female athletes.
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Affiliation(s)
- Carole Castanier
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | | | - Caroline Teulier
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | | | - Sandrine Schiano-Lomoriello
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Nancy Vibarel-Rebot
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Aude Villemain
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Nathalie Rieth
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Christine Le-Scanff
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Corinne Buisson
- Département des Analyses, AFLD, 92290 Chatenay-Malabry, France;
| | - Katia Collomp
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
- Département des Analyses, AFLD, 92290 Chatenay-Malabry, France;
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Parker LJ, Elliott-Sale KJ, Hannon MP, Morton JP, Close GL. An audit of hormonal contraceptive use in Women’s Super League soccer players; implications on symptomology. SCI MED FOOTBALL 2021; 6:153-158. [DOI: 10.1080/24733938.2021.1921248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Lloyd J. Parker
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
- Everton Football Club, USM Finch Farm, Halewood Liverpool, Liverpool, UK
| | - Kirsty J. Elliott-Sale
- Sport Health and Performance Enhancement Research Centre, Nottingham Trent University, Nottingham, UK
| | - Marcus P. Hannon
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - James P. Morton
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Graeme L. Close
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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Clarke AC, Bruinvels G, Julian R, Inge P, Pedlar CR, Govus AD. Hormonal Contraceptive Use in Football Codes in Australia. Front Sports Act Living 2021; 3:634866. [PMID: 33718869 PMCID: PMC7947621 DOI: 10.3389/fspor.2021.634866] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 01/19/2021] [Indexed: 01/16/2023] Open
Abstract
The recent launch of the new National elite women's football competitions in Australia has seen a 20-50% increase in grassroots female participation. With the growing participation across grassroots to elite competitions, understanding the health of female athletes should be prioritized. In elite level athletes, hormonal contraceptive (HC) use is common (~50%), however, little is known about the prevalence and reasons for use and disuse of HC in elite female football athletes. As such, the impact of HC use is often not considered when monitoring the health of female footballers. This study involved a subset of data collected as part of a larger questionnaire investigating menstrual cycle function, hormonal contraception use, and the interaction with training load volume and perceived performance in elite female football code athletes. A total of 177 participants completed the questionnaire across three football codes within Australia (rugby league, rugby union/sevens, Australian football). One third (n = 58) of athletes were currently using HC, predominately in the form of an oral contraceptive pill (OC, n = 47). Reasons for use included: to avoid pregnancy (71%); to control/regulate cycle (38%); and to reduce menstrual pain (36%). However, most athletes using an OC (89%) could not identify the type of pill used (e.g., mono-, bi-, or triphasic). The main reason for disuse was due to the negative side effects (n = 23), such as mood swings, weight gain, and depression/anxiety. Comparing HC users and non-users, there were no statistical differences in the number of reported menstrual symptoms, use of medication to relieve menstrual pain, or frequency for needing to adapt training due to their menstrual cycle (p > 0.05). Since most athletes were unaware of the type of OC they used, female football athletes require further education about the different types of HC, and specifically OC, available to them. Similarities in the symptoms experienced, pain management, and training adaptation requirements between groups suggests that HC use may not have the intended outcome for certain athletes. As such, greater awareness of athlete's personal experiences with the menstrual cycle, how HC may influence their experience, and acknowledgment of non-pharmacological methods to help manage menstrual cycle related symptoms are warranted.
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Affiliation(s)
- Anthea C Clarke
- Sport and Exercise Science, School of Allied Health, Human Nutrition, and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Georgie Bruinvels
- Orreco Ltd., Business Innovation Centre, National University of Ireland Galway, Galway, Ireland.,Faculty of Sport, Health and Applied Science, St Mary's University, Twickenham, United Kingdom
| | - Ross Julian
- Department of Neuromotor Behavior and Exercise, Institute of Sport Science, Westfaelische Wilhelms-University Muenster, Münster, Germany.,School of Sport and Exercise, Exercise and Sport Research Centre, University of Gloucestershire, Cheltenham, United Kingdom
| | - Pip Inge
- Australian Football League, Docklands, Melbourne, VIC, Australia
| | - Charles R Pedlar
- Orreco Ltd., Business Innovation Centre, National University of Ireland Galway, Galway, Ireland.,Faculty of Sport, Health and Applied Science, St Mary's University, Twickenham, United Kingdom.,Division of Surgery and Interventional Science, Institute of Sport, Exercise and Health, University College London, London, United Kingdom
| | - Andrew D Govus
- Sport and Exercise Science, School of Allied Health, Human Nutrition, and Sport, La Trobe University, Melbourne, VIC, Australia
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Oxfeldt M, Dalgaard LB, Jørgensen EB, Johansen FT, Dalgaard EB, Ørtenblad N, Hansen M. Molecular markers of skeletal muscle hypertrophy following 10 wk of resistance training in oral contraceptive users and nonusers. J Appl Physiol (1985) 2020; 129:1355-1364. [PMID: 33054662 DOI: 10.1152/japplphysiol.00562.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The objective was to determine whether skeletal muscle molecular markers and SC number were influenced differently in users and nonusers of oral contraceptives (OCs) following 10 wk of resistance training. Thirty-eight young healthy untrained users (n = 20) and nonusers of OC (n = 18) completed a 10-wk supervised progressive resistance training program. Before and after the intervention, a muscle tissue sample was obtained from the vastus lateralis muscle for analysis of muscle fiber cross-sectional area (fCSA) and satellite cell (SC) and myonuclei number using immunohistochemistry, gene expression using PCR, protein expression, and myosin heavy chain composition. Following the training period, quadriceps fCSA (P < 0.05), SCs/type I fiber (P = 0.05), and MURF-1 mRNA (P < 0.01) were significantly increased with no difference between the groups. However, SCs/total fiber and SCs/type II fiber increased in OC users only, and SCs/type II fCSA tended (P = 0.055) to be greater in the OC users. Furthermore, in OC users there were a fiber type shift from myosin heavy chain (MHC) IIx to MHC IIa (P < 0.01), and expression of muscle regulatory factor 4 (MRF4) mRNA (P < 0.001) was significantly greater than in non-OC users. Use of second-generation OCs in young untrained women increased skeletal muscle MRF4 expression and SC number following 10 wk of resistance training compared with nonusers.NEW & NOTEWORTHY The effect of oral contraceptive use on the skeletal muscle regulatory pathways in response to resistance training has not been investigated previously. Here we present novel data, demonstrating that use of second-generation oral contraceptives in young untrained women increased skeletal muscle regulatory factor 4 expression and satellite cell number following 10 wk of resistance training compared with nonusers.
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Affiliation(s)
- Mikkel Oxfeldt
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | | | | | - Emil Barner Dalgaard
- Department of Clinical Medicine, Diagnostic Centre, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Niels Ørtenblad
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Mette Hansen
- Department of Public Health, Aarhus University, Aarhus, Denmark
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