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Smith ES, Weakley J, McKay AKA, McCormick R, Tee N, Kuikman MA, Harris R, Minahan C, Buxton S, Skinner J, Ackerman KE, Elliott‐Sale KJ, Stellingwerff T, Burke LM. Minimal influence of the menstrual cycle or hormonal contraceptives on performance in female rugby league athletes. Eur J Sport Sci 2024; 24:1067-1078. [PMID: 38877892 PMCID: PMC11295101 DOI: 10.1002/ejsc.12151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 05/08/2024] [Accepted: 05/31/2024] [Indexed: 08/03/2024]
Abstract
We examined performance across one menstrual cycle (MC) and 3 weeks of hormonal contraceptives (HC) use to identify whether known fluctuations in estrogen and progesterone/progestin are associated with functional performance changes. National Rugby League Indigenous Women's Academy athletes [n = 11 naturally menstruating (NM), n = 13 using HC] completed performance tests [countermovement jump (CMJ), squat jump (SJ), isometric mid-thigh pull, 20 m sprint, power pass and Stroop test] during three phases of a MC or three weeks of HC usage, confirmed through ovulation tests alongside serum estrogen and progesterone concentrations. MC phase or HC use did not influence jump height, peak force, sprint time, distance thrown or Stroop effect. However, there were small variations in kinetic and kinematic CMJ/SJ outputs. NM athletes produced greater mean concentric power in MC phase four than one [+0.41 W·kg-1 (+16.8%), p = 0.021] during the CMJ, alongside greater impulse at 50 ms at phase one than four [+1.7 N·s (+4.7%), p = 0.031] during the SJ, without differences between tests for HC users. Among NM athletes, estradiol negatively correlated with mean velocity and power (r = -0.44 to -0.50, p < 0.047), progesterone positively correlated with contraction time (r = 0.45, p = 0.045), and both negatively correlated with the rate of force development and impulse (r = -0.45 to -0.64, p < 0.043) during the SJ. During the CMJ, estradiol positively correlated to 200 ms impulse (r = 0.45, p = 0.049) and progesterone to mean power (r = 0.51, p = 0.021). Evidence of changes in testing performance across a MC, or during active HC use, is insufficient to justify "phase-based testing"; however, kinetic or kinematic outputs may be altered in NM athletes.
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Affiliation(s)
- Ella S. Smith
- Mary MacKillop Institute for Health ResearchAustralian Catholic UniversityMelbourneVictoriaAustralia
| | - Jonathon Weakley
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research CentreAustralian Catholic UniversityBrisbaneQueenslandAustralia
- Carnegie Applied Rugby Research (CARR) CentreCarnegie School of SportLeedsUK
| | - Alannah K. A. McKay
- Mary MacKillop Institute for Health ResearchAustralian Catholic UniversityMelbourneVictoriaAustralia
| | - Rachel McCormick
- Mary MacKillop Institute for Health ResearchAustralian Catholic UniversityMelbourneVictoriaAustralia
| | - Nicolin Tee
- Mary MacKillop Institute for Health ResearchAustralian Catholic UniversityMelbourneVictoriaAustralia
| | - Megan A. Kuikman
- Mary MacKillop Institute for Health ResearchAustralian Catholic UniversityMelbourneVictoriaAustralia
| | - Rachel Harris
- Female Performance and Health InitiativeAustralian Institute of SportCanberraAustralian Capital TerritoryAustralia
- Perth Orthopaedic and Sports Medicine Research InstituteWest PerthWestern AustraliaAustralia
| | - Clare Minahan
- Griffith Sport ScienceGriffith UniversityGold CoastQueenslandAustralia
| | - Simon Buxton
- National Rugby LeagueSydneyNew South WalesAustralia
| | | | - Kathryn E. Ackerman
- Wu Tsai Female Athlete ProgramBoston Children's Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Kirsty J. Elliott‐Sale
- Department of Sport and Exercise SciencesInstitute of SportManchester Metropolitan UniversityManchesterUK
| | - Trent Stellingwerff
- Canadian Sport Institute‐PacificVictoriaBritish ColumbiaCanada
- Exercise SciencePhysical and Health EducationUniversity of VictoriaVictoriaBritish ColumbiaCanada
| | - Louise M. Burke
- Mary MacKillop Institute for Health ResearchAustralian Catholic UniversityMelbourneVictoriaAustralia
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Santabarbara KL, Helms ER, Stewart TI, Armour MJ, Harris NK. Menstrual cycle patterns and their relationship with measures of well-being and perceived performance metrics in competitive and recreational resistance-trained athletes. J Sports Med Phys Fitness 2024; 64:694-706. [PMID: 38916093 DOI: 10.23736/s0022-4707.24.15752-0] [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: 06/26/2024]
Abstract
BACKGROUND There is mixed evidence on how the menstrual cycle (MC) affects sports performance, with many studies showing variations in performance during different phases of the MC, while other evidence shows that the MC's effects on performance may be trivial. Therefore, this exploratory longitudinal monitoring study was designed to investigate MC characteristics and symptoms in a resistance-trained (RT) population to look for associations between measures of well-being and perceived performance metrics across the MC. METHODS RT females reported their workout habits, perceived performance metrics, and measures of well-being while tracking their MC with detailed methods via daily check-ins in an app. RESULTS Most MC characteristics and symptoms in the present RT population aligned with previous research on the general population. However, the frequency of irregular cycles was higher than in previous research on the general population. The amount of individual variation and within-subject cycle-to-cycle variation in MC characteristics and MC symptoms was also high. All measures of well-being were significantly associated with specific days of the MC, demonstrating a change in well-being based on the timing of the MC. Several perceived performance metrics were significantly associated with changes across the MC, while others were not. CONCLUSIONS Overall, with the current evidence as it stands, a highly individualized approach should be taken for any training or performance considerations surrounding the MC due to the high levels of individual variation.
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Affiliation(s)
- Kimberly L Santabarbara
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand -
- Department of Kinesiology and Health Promotion, California State Polytechnic University, Pomona, CA, USA -
| | - Eric R Helms
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
- Department of Exercise Science and Health Promotion, Florida Atlantic University, Laboratory of Muscle Physiology, Boca Raton, FL, USA
| | - Tom I Stewart
- Human Potential Center, Auckland University of Technology, Auckland, New Zealand
| | - Mike J Armour
- NICM Health Research Institute, Western Sydney University, Sydney, Australia
- Medical Research Institute of New Zealand (MRINZ), Wellington, New Zealand
| | - Nigel K Harris
- Human Potential Center, Auckland University of Technology, Auckland, New Zealand
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Gravholt CH, Andersen NH, Christin-Maitre S, Davis SM, Duijnhouwer A, Gawlik A, Maciel-Guerra AT, Gutmark-Little I, Fleischer K, Hong D, Klein KO, Prakash SK, Shankar RK, Sandberg DE, Sas TCJ, Skakkebæk A, Stochholm K, van der Velden JA, Backeljauw PF. Clinical practice guidelines for the care of girls and women with Turner syndrome. Eur J Endocrinol 2024; 190:G53-G151. [PMID: 38748847 DOI: 10.1093/ejendo/lvae050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 04/19/2024] [Indexed: 06/16/2024]
Abstract
Turner syndrome (TS) affects 50 per 100 000 females. TS affects multiple organs through all stages of life, necessitating multidisciplinary care. This guideline extends previous ones and includes important new advances, within diagnostics and genetics, estrogen treatment, fertility, co-morbidities, and neurocognition and neuropsychology. Exploratory meetings were held in 2021 in Europe and United States culminating with a consensus meeting in Aarhus, Denmark in June 2023. Prior to this, eight groups addressed important areas in TS care: (1) diagnosis and genetics, (2) growth, (3) puberty and estrogen treatment, (4) cardiovascular health, (5) transition, (6) fertility assessment, monitoring, and counselling, (7) health surveillance for comorbidities throughout the lifespan, and (8) neurocognition and its implications for mental health and well-being. Each group produced proposals for the present guidelines, which were meticulously discussed by the entire group. Four pertinent questions were submitted for formal GRADE (Grading of Recommendations, Assessment, Development and Evaluation) evaluation with systematic review of the literature. The guidelines project was initiated by the European Society for Endocrinology and the Pediatric Endocrine Society, in collaboration with members from the European Society for Pediatric Endocrinology, the European Society of Human Reproduction and Embryology, the European Reference Network on Rare Endocrine Conditions, the Society for Endocrinology, and the European Society of Cardiology, Japanese Society for Pediatric Endocrinology, Australia and New Zealand Society for Pediatric Endocrinology and Diabetes, Latin American Society for Pediatric Endocrinology, Arab Society for Pediatric Endocrinology and Diabetes, and the Asia Pacific Pediatric Endocrine Society. Advocacy groups appointed representatives for pre-meeting discussions and the consensus meeting.
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Affiliation(s)
- Claus H Gravholt
- Department of Endocrinology, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Molecular Medicine, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8200 Aarhus N, Denmark
| | - Niels H Andersen
- Department of Cardiology, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Sophie Christin-Maitre
- Endocrine and Reproductive Medicine Unit, Center of Rare Endocrine Diseases of Growth and Development (CMERCD), FIRENDO, Endo ERN Hôpital Saint-Antoine, Sorbonne University, Assistance Publique-Hôpitaux de Paris, 75012 Paris, France
| | - Shanlee M Davis
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO 80045, United States
- eXtraOrdinarY Kids Clinic, Children's Hospital Colorado, Aurora, CO 80045, United States
| | - Anthonie Duijnhouwer
- Department of Cardiology, Radboud University Medical Center, Nijmegen 6500 HB, The Netherlands
| | - Aneta Gawlik
- Departments of Pediatrics and Pediatric Endocrinology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
| | - Andrea T Maciel-Guerra
- Area of Medical Genetics, Department of Translational Medicine, School of Medical Sciences, State University of Campinas, 13083-888 São Paulo, Brazil
| | - Iris Gutmark-Little
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio 45229, United States
| | - Kathrin Fleischer
- Department of Reproductive Medicine, Nij Geertgen Center for Fertility, Ripseweg 9, 5424 SM Elsendorp, The Netherlands
| | - David Hong
- Division of Interdisciplinary Brain Sciences, Stanford University School of Medicine, Stanford, CA 94304, United States
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94304, United States
| | - Karen O Klein
- Rady Children's Hospital, University of California, San Diego, CA 92123, United States
| | - Siddharth K Prakash
- Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX 77030, United States
| | - Roopa Kanakatti Shankar
- Division of Endocrinology, Children's National Hospital, The George Washington University School of Medicine, Washington, DC 20010, United States
| | - David E Sandberg
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109-2800, United States
- Division of Pediatric Psychology, Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109-2800, United States
| | - Theo C J Sas
- Department the Pediatric Endocrinology, Sophia Children's Hospital, Rotterdam 3015 CN, The Netherlands
- Department of Pediatrics, Centre for Pediatric and Adult Diabetes Care and Research, Rotterdam 3015 CN, The Netherlands
| | - Anne Skakkebæk
- Department of Molecular Medicine, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8200 Aarhus N, Denmark
- Department of Clinical Genetics, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Kirstine Stochholm
- Department of Endocrinology, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Center for Rare Diseases, Department of Pediatrics, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Janielle A van der Velden
- Department of Pediatric Endocrinology, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen 6500 HB, The Netherlands
| | - Philippe F Backeljauw
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio 45229, United States
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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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Buchner L, Moore SR, Finkenzeller T, Amesberger G, Rieser H, Würth S. Influence of running on incidental and integral vitality and fatigue: An intensive longitudinal intervention in young Women's daily life. Appl Psychol Health Well Being 2024. [PMID: 38689528 DOI: 10.1111/aphw.12547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 04/05/2024] [Indexed: 05/02/2024]
Abstract
Exercise intensity and perceived autonomy are important factors for the affective response toward exercise and adherence. Dual-mode theory suggests an inverted-J response curve of affect with increased exercise intensity, but little is known about how different running programs affect the affective response and subsequent incidental affect in daily life. This ambulatory assessment study examines the short- to long-term effects of two 8-week running interventions (affect-based vs. polarized-prescribed) on subjective vitality and perceived fatigue in young female novices. Participants engaged in 3 × 30 minute running sessions weekly in their natural environments and completed electronic diaries three times daily. Autoregressive multilevel models indicate small effects of training intensity on immediate affective subjective vitality (ß = -2.37; p = .03; f2 = 0.02) but negligible non-significant effects on fatigue (ß = 0.26; p = 0.12; f2 = 0.002). Novices experienced increased vitality throughout the day when their running was evaluated positively (ß = 0.23; p = .03; f2 = 0.04), with effects lasting over two days before returning to baseline (ß = -0.26; p < .001; f2 = 0.004). However, no significant long-term effects were observed over 8 weeks in vitality or fatigue. Results indicate between- and within-person variations, but limited sample power does not allow differentiating between programs. This study supports the dual-mode theory and highlights the importance of distinguishing affective response from incidental affect.
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Affiliation(s)
- Laura Buchner
- Department of Sport Science and Kinesiology, University of Salzburg, Department for Sport and Exercise Science, Schloßallee 49, A-5400 Hallein-Rif, Salzburg, Austria
| | - Stephanie R Moore
- Department of Sport Science and Kinesiology, University of Salzburg, Department for Sport and Exercise Science, Schloßallee 49, A-5400 Hallein-Rif, Salzburg, Austria
| | - Thomas Finkenzeller
- Department of Sport Science and Kinesiology, University of Salzburg, Department for Sport and Exercise Science, Schloßallee 49, A-5400 Hallein-Rif, Salzburg, Austria
| | - Günter Amesberger
- Department of Sport Science and Kinesiology, University of Salzburg, Department for Sport and Exercise Science, Schloßallee 49, A-5400 Hallein-Rif, Salzburg, Austria
| | - Harald Rieser
- Salzburg Research Forschungsgesellschaft m.b.H., Jakob Haringer Straße 5/3, Salzburg, 5020, Austria
| | - Sabine Würth
- Department of Sport Science and Kinesiology, University of Salzburg, Department for Sport and Exercise Science, Schloßallee 49, A-5400 Hallein-Rif, Salzburg, Austria
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6
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Ekenros L, von Rosen P, Norrbom J, Holmberg HC, Sundberg CJ, Fridén C, Hirschberg AL. Impact of Menstrual cycle-based Periodized training on Aerobic performance, a Clinical Trial study protocol-the IMPACT study. Trials 2024; 25:93. [PMID: 38287424 PMCID: PMC10823667 DOI: 10.1186/s13063-024-07921-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 01/09/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND The menstrual cycle and its impact on training and performance are of growing interest. However, evidence is lacking whether periodized exercise based on the menstrual cycle is beneficial. The primary purpose of this proposed randomized, controlled trial, the IMPACT study, is to evaluate the effect of exercise periodization during different phases of the menstrual cycle, i.e., comparing follicular phase-based and luteal phase-based training with regular training during the menstrual cycle on physical performance in well-trained women. METHODS Healthy, well-trained, eumenorrheic women between 18 and 35 years (n = 120) will be recruited and first assessed for physical performance during a run-in menstrual cycle at different cycle phases and then randomized to three different interventions: follicular phase-based training, luteal phase-based training, or regular training during three menstrual cycles. The training intervention will consist of high-intensity spinning classes followed by strength training. The menstrual cycle phases will be determined by serum hormone analysis throughout the intervention period. Assessment of aerobic performance (primary outcome) and muscle strength, body composition, and blood markers will be performed at baseline and at the end of the intervention. DISCUSSION With a robust methodology, this study has the potential to provide evidence of the differential effects of exercise periodization during different phases of the menstrual cycle in female athletes. TRIAL REGISTRATION ClinicalTrials.gov NCT05697263 . Registered on 25 January 2023.
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Affiliation(s)
- Linda Ekenros
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, SE-141 83, Huddinge, Sweden.
| | - Philip von Rosen
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, SE-141 83, Huddinge, Sweden
| | - Jessica Norrbom
- Department of Physiology and Pharmacology, Molecular Exercise Physiology, Karolinska Institutet, Stockholm, 171 77, Sweden
| | - Hans-Christer Holmberg
- Department of Physiology and Pharmacology, Molecular Exercise Physiology, Karolinska Institutet, Stockholm, 171 77, Sweden
- Department of Health Sciences, Lulea University of Technology, 971 87, Lulea, Sweden
| | - Carl Johan Sundberg
- Department of Physiology and Pharmacology, Molecular Exercise Physiology, Karolinska Institutet, Stockholm, 171 77, Sweden
| | - Cecilia Fridén
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, SE-141 83, Huddinge, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, 171 76, Stockholm, Sweden
- Department of Healthcare and Welfare, Malardalens University, 721 23, Vasteras, Sweden
| | - Angelica Lindén Hirschberg
- Department of Women's and Children's Health, Karolinska Institutet, 171 76, Stockholm, Sweden
- Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, 171 76, Stockholm, Sweden
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7
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Lee SJL, Sim MP, VAN Rens FECA, Peiffer JJ. Fatigue Resistance Is Altered during the High-Hormone Phase of Eumenorrheic Females but Not Oral Contraceptive Users. Med Sci Sports Exerc 2024; 56:92-102. [PMID: 37699150 DOI: 10.1249/mss.0000000000003289] [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: 09/14/2023]
Abstract
PURPOSE This study aimed to examine the effect of ovarian hormones and their synthetic equivalents on substrate utilization and fatigue resistance during a race-specific cycling protocol. METHODS Seventeen well-trained female cyclists (nine eumenorrheic females, eight oral contraceptive users) completed two experimental trials, in a randomized order, in their low- (follicular/sugar pill) and high-hormone (luteal/active pill) phases. Each 91-min trial consisted of a 45-min moderate-intensity component (submaximal cycling, or SMC) followed by 6 min of high-intensity (HIT) and then a fatigue resistance test (FRT): 6 × 1-min all-out efforts with 1-min active recovery. Meals, comprising carbohydrate (CHO) intake of 8 g·kg -1 body mass, were standardized 24-h pretrial. An electrolyte-only solution was provided ad libitum during each trial. RESULTS In eumenorrheic females, a large reduction in average power during FRT was observed in the luteal phase (277 ± 31 vs 287 ± 33 W; P = 0.032). Greater CHO ox (~ 4%, P = 0.020) during SMC and ventilatory inefficiencies during SMC and HIT (~7%, P < 0.001) were also observed in the luteal phase. In contraceptive users, despite some phasal changes in cardiorespiratory and metabolic data in SMC (~6% higher blood glucose and ~2% higher minute ventilation in active pill phase), none of the performance parameters in the FRT were different. CONCLUSIONS Fatigue resistance was compromised only in high-hormone phase of the menstrual cycle, with eumenorrheic females likely susceptible because of increased CHO utilization during SMC. Hormone-induced ventilatory inefficiencies may also have increased metabolic demand. These findings emphasize the need to maintain CHO availability for power production, particularly in high-hormone phases.
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Affiliation(s)
| | | | - Fleur E C A VAN Rens
- Discipline of Exercise Science, Murdoch University, Perth, Western Australia, AUSTRALIA
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Vogel K, Larsen B, McLellan C, Bird SP. Female Athletes and the Menstrual Cycle in Team Sports: Current State of Play and Considerations for Future Research. Sports (Basel) 2023; 12:4. [PMID: 38275983 PMCID: PMC10818287 DOI: 10.3390/sports12010004] [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: 11/16/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 01/27/2024] Open
Abstract
Over the past ten years there has been a dramatic rise in female sport participation and accompanying female professional national leagues across multiple sports, yet research has not followed suit. Although there are known variations between female and male physiology, training protocols in female sport are predominantly underpinned by research undertaken in male athletes. The hormonal variability experienced by women across the menstrual cycle, as well as the menstrual cycle variability between women, may contribute to the complexity of conducting rigorous physiological studies, leading to a paucity of robust sports-specific research that can be confidently applied to female athletes. Moreover, barriers exist in female sport that potentially limit the ability to conduct research, including the lack of full-time programs and limited resources. Recently, there has been increased interest in the potential effects of fluctuations in the female sex hormones, progesterone and oestrogen, on sport performance across different phases of the menstrual cycle. However, current research evaluating the menstrual cycle and physical performance (such as strength, speed, aerobic fitness, and athletes' perception of their performance) have shown inconsistent results. Additionally, methodological design across studies has shown little consistency, making it difficult to draw firm conclusions, which potentially prevents female athletes optimising their physical and sporting performance. It further impacts coaches and sports science researchers in their ability to provide appropriate training recommendations and educational opportunities. It is important to progress in female athlete research with an understanding of how the unique physiology of female athletes may influence their ability to physically perform in their respective sport, which requires representation in sports science research. This paper will provide an overview on current evidence and limitations within menstrual cycle research and provide considerations and directions for future research in this space within team sports.
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Affiliation(s)
- Kurt Vogel
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD 4305, Australia; (K.V.); (B.L.); (C.M.)
- Centre for Health Research, University of Southern Queensland, Ipswich, QLD 4305, Australia
- Lions Football Club, Richlands, QLD 4077, Australia
- Brisbane Tigers Rugby League Club, Coorparoo, QLD 4151, Australia
| | - Brianna Larsen
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD 4305, Australia; (K.V.); (B.L.); (C.M.)
- Centre for Health Research, University of Southern Queensland, Ipswich, QLD 4305, Australia
| | - Chris McLellan
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD 4305, Australia; (K.V.); (B.L.); (C.M.)
- Florida Panthers, Sunrise, FL 33323, USA
| | - Stephen P. Bird
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD 4305, Australia; (K.V.); (B.L.); (C.M.)
- Centre for Health Research, University of Southern Queensland, Ipswich, QLD 4305, Australia
- Basketball New Zealand, Wellington 6012, New Zealand
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9
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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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10
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Morenas-Aguilar MD, Ruiz-Alias SA, Blanco AM, Lago-Fuentes C, García-Pinillos F, Pérez-Castilla A. Does the Menstrual Cycle Impact the Maximal Neuromuscular Capacities of Women? An Analysis Before and After a Graded Treadmill Test to Exhaustion. J Strength Cond Res 2023; 37:2185-2191. [PMID: 37883397 DOI: 10.1519/jsc.0000000000004542] [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: 10/28/2023]
Abstract
ABSTRACT Morenas-Aguilar, MD, Ruiz-Alias, SA, Blanco, AM, Lago-Fuentes, C, García-Pinillos, F, and Pérez-Castilla, A. Does the menstrual cycle impact the maximal neuromuscular capacities of women? An analysis before and after a graded treadmill test to exhaustion. J Strength Cond Res 37(11): 2185-2191, 2023. This study explored the effect of the menstrual cycle (MC) on the maximal neuromuscular capacities of the lower-body muscles obtained before and after a graded exercise test conducted on a treadmill to exhaustion. Sixteen physically active women were tested at -11 ± 3, -5 ± 3, and 5 ± 3 days from the luteinizing peak for the early follicular, late follicular, and midluteal phases. In each session, the individualized load-velocity (L-V) relationship variables (load-axis intercept [L0], velocity-axis intercept [v0], and area under the L-V relationship line [Aline]) were obtained before and after a graded exercise test conducted on a treadmill to exhaustion using the 2-point method (3 countermovement jumps with a 0.5-kg barbell and 2 back squats against a load linked to a mean velocity of 0.55 m·second-1). At the beginning of each session, no significant differences were reported for L0 (p = 0.726; ES ≤ 0.18), v0 (p = 0.202; ES ≤ 0.37), and Aline (p = 0.429; ES ≤ 0.30) between the phases. The MC phase × time interaction did not reach statistical significance for any L-V relationship variable (p ≥ 0.073). A significant main effect of "time" was observed for L0 (p < 0.001; ES = -0.77) and Aline (p = 0.002; ES = -0.59) but not for v0 (p = 0.487; ES = 0.12). These data suggest that the lower-body maximal neuromuscular capacities obtained before and after a graded treadmill test are not significantly affected by MC, although there is a high variability in the individual response.
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Affiliation(s)
| | - Santiago A Ruiz-Alias
- Department of Physical Education and Sport, University of Granada, Granada, Spain
- Sport and Health University Research Center (iMUDS), Granada, Spain
| | - Aitor Marcos Blanco
- Department of Physical Education and Sport, University of Granada, Granada, Spain
- Sport and Health University Research Center (iMUDS), Granada, Spain
| | - Carlos Lago-Fuentes
- Faculty of Health Sciences, European University of Atlantic, Santander, Spain
| | - Felipe García-Pinillos
- Department of Physical Education and Sport, University of Granada, Granada, Spain
- Sport and Health University Research Center (iMUDS), Granada, Spain
- Department of Physical Education, Sports and Recreation, Universidad de La Frontera, Temuco, Chile
| | - Alejandro Pérez-Castilla
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain; and
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
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11
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Piasecki J, Guo Y, Jones EJ, Phillips BE, Stashuk DW, Atherton PJ, Piasecki M. Menstrual Cycle Associated Alteration of Vastus Lateralis Motor Unit Function. SPORTS MEDICINE - OPEN 2023; 9:97. [PMID: 37874413 PMCID: PMC10597975 DOI: 10.1186/s40798-023-00639-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 09/21/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND Estrogen and progesterone are the primary female sex hormones and have net excitatory and inhibitory effects, respectively, on neuronal function. Fluctuating concentrations across the menstrual cycle has led to several lines of research in relation to neuromuscular function and performance; however evidence from animal and cell culture models has yet to be demonstrated in human motor units coupled with quantification of circulating hormones. Intramuscular electromyography was used to record motor unit potentials and corresponding motor unit potential trains from the vastus lateralis of nine eumenorrheic females during the early follicular, ovulation and mid luteal phases of the menstrual cycle, alongside assessments of neuromuscular performance. Multi-level regression models were applied to explore effects of time and of contraction level. Statistical significance was accepted as p < 0.05. RESULTS Knee extensor maximum voluntary contraction, jump power, force steadiness, and balance did not differ across the menstrual phases (all p > 0.4). Firing rate of low threshold motor units (10% maximum voluntary contraction) was lower during the ovulation and mid luteal phases (β = - 0.82 Hz, p < 0.001), with no difference in motor unit potentials analysed from 25% maximum voluntary contraction contractions. Motor unit potentials were more complex during ovulation and mid luteal phase (p < 0.03), with no change in neuromuscular junction transmission instability (p > 0.3). CONCLUSIONS Assessments of neuromuscular performance did not differ across the menstrual cycle. The suppression of low threshold motor unit firing rate during periods of increased progesterone may suggest a potential inhibitory effect and an alteration of recruitment strategy; however this had no discernible effect on performance. These findings highlight contraction level-dependent modulation of vastus lateralis motor unit function over the eumenorrheic cycle, occurring independently of measures of performance.
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Affiliation(s)
- Jessica Piasecki
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, Nottingham Trent University, Nottingham, UK.
| | - Yuxiao Guo
- Centre of Metabolism, Ageing and Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - Eleanor J Jones
- Centre of Metabolism, Ageing and Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - Bethan E Phillips
- Centre of Metabolism, Ageing and Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - Daniel W Stashuk
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Philip J Atherton
- Centre of Metabolism, Ageing and Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - Mathew Piasecki
- Centre of Metabolism, Ageing and Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
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12
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Vardardottir B, Olafsdottir AS, Gudmundsdottir SL. Body dissatisfaction, disordered eating and exercise behaviours: associations with symptoms of REDs in male and female athletes. BMJ Open Sport Exerc Med 2023; 9:e001731. [PMID: 38348179 PMCID: PMC10860738 DOI: 10.1136/bmjsem-2023-001731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2023] [Indexed: 02/15/2024] Open
Abstract
Objectives Disordered eating and compulsive exercise behaviours are common among athletes and can increase the risk of relative energy deficiency in sport (REDs). Contrarily, the prevalence of muscle dysmorphia and its relationship with REDs are unknown. This cross-sectional study aimed to evaluate associations of all three with REDs symptoms. Methods Elite and subelite Icelandic athletes (n=83, 67.5% females) answered the Low Energy Availability in Females/Males Questionnaires (LEAF-Q/LEAM-Q), Eating Disorder Examination-Questionnaire Short (EDE-QS), Exercise Addiction Inventory (EAI) and Muscle Dysmorphic Disorder Inventory (MDDI). Body composition was assessed via dual-energy X-ray absorptiometry; resting metabolic rate via indirect calorimetry; and blood samples were drawn for analysis of nutrition and hormonal status. Females were compared based on LEAF-Q total score (≥8 (at risk) vs <8). Simple linear regression was applied to evaluate associations of (a) testosterone with other objective measures and LEAM-Q scores in males; and (b) LEAF-Q/LEAM-Q scores with EDE-QS, EAI and MDDI scores. Results In total, 8.4% of participants scored above cut-off on EDE-QS, 19.3% on EAI and 13.3% on MDDI. Females with LEAF-Q total score ≥8 had higher median scores on EDE-QS, EAI and MDDI compared with those scoring <8. Testosterone was positively associated with iron and inversely with total iron-binding capacity but was not associated with scoring on any of the administered questionnaires. Conclusion Drive for muscularity and aesthetic physique may play a role in the complex presentation of REDs. Screening for muscle dysmorphia, in addition to disordered eating and compulsive exercise, could therefore facilitate early detection of REDs.
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Affiliation(s)
- Birna Vardardottir
- Faculty of Health Promotion, Sport and Leisure Studies, University of Iceland, Reykjavik, Iceland
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13
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Recacha-Ponce P, Collado-Boira E, Suarez-Alcazar P, Montesinos-Ruiz M, Hernando-Domingo C. Is It Necessary to Adapt Training According to the Menstrual Cycle? Influence of Contraception and Physical Fitness Variables. Life (Basel) 2023; 13:1764. [PMID: 37629621 PMCID: PMC10455893 DOI: 10.3390/life13081764] [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: 07/12/2023] [Revised: 08/07/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
(1) Background: The influence of the menstrual cycle on physical fitness in athletes is controversial in the scientific literature. There is a marked fluctuation of sex hormones at three key points of the menstrual cycle, where estrogen and progesterone vary significantly. Hormonal contraception induces hormonal levels different from the natural menstrual cycle, requiring specific study in relation to physical fitness. (2) Method: Women aged 18 to 40 years with regular natural menstrual cycles and women using hormonal contraception were recruited, creating two study groups. All participants needed to be athletes classified as level II-III, based on training volume/physical activity metrics, among other variables. To assess their physical fitness, cardiorespiratory fitness (measured by V˙O2max), high-speed strength, hand grip strength, and flexibility were evaluated. Blood samples were taken to determine the menstrual cycle phase through analysis of sex hormone levels. Additionally, urine tests for ovulation detection were performed for the natural menstrual cycle group. Neurosensory stimulation tests were incorporated to measure sensory thresholds and pain thresholds in each phase. Body composition in each phase and its relationship with the other variables were also taken into account. (3) Results: Athletes in the natural cycling group showed differences in V˙O2max (mL·kg-1·min-1) (phase I = 41.75 vs. phase II = 43.85 and (p = 0.004) and phase I vs. phase III = 43.25 mL·kg-1·min-1 (p = 0.043)), as well as in body weight (phase I = 63.23 vs. phase III = 62.48 kg; p = 0.006), first pain threshold (phase I = 1.34 vs. phase II = 1.69 (p = 0.027) and phase III = 1.59 mA (p = 0.011)), and sensitive threshold (phase I = 0.64 vs. phase II = 0.76 mA (p = 0.017)). The pain threshold was found to be an important covariate in relation to V˙O2max, explaining 31.9% of the variance in phase I (p = 0.006). These findings were not observed between the two phases of contraceptive cycling. (4) Conclusion: The natural menstrual cycle will cause significant changes in the physical fitness of athletes. The use of hormonal contraception is not innocuous. Women with natural cycles show an increase in cardiorespiratory fitness in phases II and III, which is a factor to be considered in relation to training level and workload.
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Affiliation(s)
| | - Eladio Collado-Boira
- Faculty of Health Sciences, Jaime I University, 12071 Castello de la Plana, Spain; (P.R.-P.); (P.S.-A.); (M.M.-R.); (C.H.-D.)
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14
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Reschechtko S, Nguyen TN, Tsang M, Giltvedt K, Kern M, Hooshmand S. Postural sway is not affected by estrogen fluctuations during the menstrual cycle. Physiol Rep 2023; 11:e15693. [PMID: 37217442 PMCID: PMC10202824 DOI: 10.14814/phy2.15693] [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: 03/13/2023] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/24/2023] Open
Abstract
When people stand still, they exhibit a phenomenon called postural sway, or spontaneous movement of the body's center of pressure, which is related to balance control. In general females show less sway than males, but this difference only begins to appear around puberty, pointing to different levels of sex hormones as one potential mechanism for sway sex differences. In this study, we followed cohorts of young females using oral contraceptives (n = 32) and not using oral contraceptives (n = 19), to investigate associations between estrogen availability and postural sway. All participants visited the lab four times over the putative 28-day menstrual cycle. At each visit, we performed blood draws to measure plasma estrogen (estradiol) levels, and tests of postural sway using a force plate. During late follicular and mid-luteal phase, estradiol levels were lower in participants using oral contraceptives (mean differences [95% CI], respectively: -231.33; [-800.44, 337.87]; -613.26; [-1333.60, 107.07] pmol/L; main effect p < 0.001), reflecting expected consequences of oral contraceptive use. Despite these differences, postural sway was not significantly different between participants who were using oral contraceptives and participants who were not (mean difference: 2.09 cm; 95% CI = [-1.05, 5.22]; p = 0.132). Overall, we found no significant effects of the estimated menstrual cycle phase-or absolute levels of estradiol-on postural sway.
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Affiliation(s)
- Sasha Reschechtko
- School of Exercise and Nutritional SciencesSan Diego State UniversitySan DiegoCaliforniaUSA
| | - Thuy Ngoc Nguyen
- School of Exercise and Nutritional SciencesSan Diego State UniversitySan DiegoCaliforniaUSA
| | - Michelle Tsang
- School of Exercise and Nutritional SciencesSan Diego State UniversitySan DiegoCaliforniaUSA
| | - Kristine Giltvedt
- School of Exercise and Nutritional SciencesSan Diego State UniversitySan DiegoCaliforniaUSA
| | - Mark Kern
- School of Exercise and Nutritional SciencesSan Diego State UniversitySan DiegoCaliforniaUSA
| | - Shirin Hooshmand
- School of Exercise and Nutritional SciencesSan Diego State UniversitySan DiegoCaliforniaUSA
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