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Lecce E, Conti A, Nuccio S, Felici F, Bazzucchi I. Characterising sex-related differences in lower- and higher-threshold motor unit behaviour through high-density surface electromyography. Exp Physiol 2024; 109:1317-1329. [PMID: 38888901 PMCID: PMC11291872 DOI: 10.1113/ep091823] [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: 02/14/2024] [Accepted: 05/28/2024] [Indexed: 06/20/2024]
Abstract
Emerging questions in neuromuscular physiology revolve around whether males and females share similar neural control in diverse tasks across a broad range of intensities. In order to explore these features, high-density electromyography was used to record the myoelectrical activity of biceps brachii during trapezoidal isometric contractions at 35% and 70% of maximal voluntary force (MVF) on 11 male and 13 female participants. Identified motor units were then classified as lower-threshold (recruited at ≤30%MVF) and higher-threshold (recruited at >30%MVF). The discharge rate, interspike interval variability, recruitment and derecruitment thresholds, and estimates of neural drive to motor neurons were assessed. Female lower-threshold motor units showed higher neural drive (P < 0.001), accompanied by higher discharge rate at recruitment (P = 0.006), plateau (P = 0.001) and derecruitment (P = 0.001). On the other hand, male higher-threshold motor units showed greater neural drive (P = 0.04), accompanied by higher discharge rate at recruitment (P = 0.005), plateau (P = 0.04) and derecruitment (P = 0.01). Motor unit discharge rate normalised by the recruitment threshold was significantly higher in female lower-threshold motor units (P < 0.001), while no differences were observed in higher-threshold motor units. Recruitment and derecruitment thresholds are higher in males across all intensities (P < 0.01). However, males and females have similar activation and deactivation strategies, as evidenced by similar recruitment-to-derecruitment ratios (P > 0.05). This study encompasses a broad intensity range to analyse motor unit sex-related differences, highlighting higher neural drive and discharge rates in female lower-threshold motor units, elevated recruitment and derecruitment thresholds in males, and convergences in activation and deactivation strategies. HIGHLIGHTS: What is the central question of the study? Do male and female motor units behave similarly in low- and high-intensity contractions? What is the main finding and its importance? Female motor units show higher discharge rates in low-intensity tasks and lower discharge rates in high-intensity tasks, with no differences in recruitment behaviour. A broader inter-spike interval variability was also observed in females. These findings underline that there are sex-specific differences concern the firing strategies based on task intensity.
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Affiliation(s)
- Edoardo Lecce
- Department of Movement, Human and Health Sciences, Laboratory of Exercise PhysiologyUniversity of Rome ‘Foro Italico’RomeItaly
| | - Alessandra Conti
- Department of Movement, Human and Health Sciences, Laboratory of Exercise PhysiologyUniversity of Rome ‘Foro Italico’RomeItaly
| | - Stefano Nuccio
- Department of Movement, Human and Health Sciences, Laboratory of Exercise PhysiologyUniversity of Rome ‘Foro Italico’RomeItaly
| | - Francesco Felici
- Department of Movement, Human and Health Sciences, Laboratory of Exercise PhysiologyUniversity of Rome ‘Foro Italico’RomeItaly
| | - Ilenia Bazzucchi
- Department of Movement, Human and Health Sciences, Laboratory of Exercise PhysiologyUniversity of Rome ‘Foro Italico’RomeItaly
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Rodriguez LA, Casey E, Crossley E, Williams N, Dhaher YY. The hormonal profile in women using combined monophasic oral contraceptive pills varies across the pill cycle: a temporal analysis of serum endogenous and exogenous hormones using liquid chromatography with tandem mass spectroscopy. Am J Physiol Endocrinol Metab 2024; 327:E121-E133. [PMID: 38775726 DOI: 10.1152/ajpendo.00418.2023] [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: 12/11/2023] [Revised: 05/17/2024] [Accepted: 05/17/2024] [Indexed: 07/18/2024]
Abstract
Oral contraceptive pills, of all types, are used by approximately 151 million women worldwide; however, a clear understanding of the concentrations of endogenous and exogenous hormones across a 28-day combination monophasic oral contraceptive pill pack is not well described. In our study of 14 female participants taking various combination monophasic oral contraceptive pills, we found significant fluctuations in endogenous and exogenous hormone levels throughout the pill cycle. Our analysis revealed significantly greater levels of ethinyl estradiol on the 20th and 21st days of active pill ingestion, compared with days 1-2 (active) and days 27-28 (inactive pill ingestion). Conversely, estradiol concentrations decreased during active pill consumption, while progestin and progesterone levels remained stable. During the 7 days of inactive pill ingestion, estradiol levels rose sharply and were significantly higher at days 27-28 compared with the mid and late active phase time points, while ethinyl estradiol declined and progestin did not change. These findings challenge the previous assumption that endogenous and exogenous hormones are stable throughout the 28-day pill cycle.NEW & NOTEWORTHY The results from this study have wide-ranging implications for research and treatment in women's health including considerations in research design and interpretation for studies including women taking oral contraceptives, the potential for more precise and personalized methods of dosing to reduce unwanted side effects and adverse events, and the potential treatment of a variety of disorders ranging from musculoskeletal to neurological with exogenous hormones.
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Affiliation(s)
- Luis A Rodriguez
- Department of Bioengineering, The University of Texas at Dallas, Richardson, Texas, United States
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, Texas, United States
| | - Ellen Casey
- Department of Physiatry, Hospital for Special Surgery, New York, New York, United States
| | - Eric Crossley
- Department of Biochemistry, UT Southwestern Medical Center, Dallas, Texas, United States
| | - Noelle Williams
- Department of Biochemistry, UT Southwestern Medical Center, Dallas, Texas, United States
| | - Yasin Y Dhaher
- Department of Bioengineering, The University of Texas at Dallas, Richardson, Texas, United States
- Department of Physiatry, Hospital for Special Surgery, New York, New York, United States
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, Texas, United States
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3
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Badenhorst CE. The Menstrual Health Manager (MHM): A Resource to Reduce Discrepancies Between Science and Practice in Sport and Exercise. Sports Med 2024:10.1007/s40279-024-02061-w. [PMID: 38904920 DOI: 10.1007/s40279-024-02061-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2024] [Indexed: 06/22/2024]
Abstract
Inadequate research on female health and performance; the complexity of the research; low menstrual health literacy of athletes, coaches, and support staff; and ethical and cultural sensitivities are all recognized as barriers to effective health monitoring for females in sports. Frameworks have been developed for academics to follow to help improve the quality of female-specific research. However, a similar resource that enables correct terminology, and use of health monitoring techniques has not been provided for sporting organizations, coaches, support staff or athletes. Therefore, this critical commentary presents a new resource, the Menstrual Health Manager. This resource may be used to determine the level of menstrual health monitoring detail that may be used by organisations, coaches or athletes, and specifies what reproductive health details the data will provide. This resource aims to provide organizations and coaches with a means of understanding the data that inform their decisions for female athletes. Utilization of this resource may aid in the consistent use of terminology and methods for female-specific health monitoring in both sports and research.
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Affiliation(s)
- Claire E Badenhorst
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
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Fabunmi OA, Dludla PV, Nkambule BB. Effect of combined oral contraceptive on cardiorespiratory function and immune activation in premenopausal women involved in exercise: A systematic review protocol. PLoS One 2024; 19:e0298429. [PMID: 38394139 PMCID: PMC10889868 DOI: 10.1371/journal.pone.0298429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/24/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The use of combined oral contraceptive (COC) is common among women of reproductive age despite the potential risk of them developing thrombotic events. There is a need to understand how COC affects cardiorespiratory function and markers of immune activation in premenopausal women involved in exercise. This highlights a need for a systematic review to enhance our understanding of how the use of COC affects cardiovascular health in premenopausal women subjected to exercise. METHOD This systematic review protocol was prepared following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) 2015 statement. An extensive search of relevant literature by two independent reviewers will be conducted through the EBSCOhost interface to access databases such as MEDLINE, EMBASE, and CINAHL. Other health sources, including Cochrane CENTRAL, unpublished studies and grey literature, will also be searched. The search will include all studies that report the effect of COC on essential parameters of cardiorespiratory function and markers of immune activation in premenopausal women involved in exercise. All included studies will be appraised using appraisal tools, while appropriate extraction tools will be used for data extraction. Where possible, eligible studies will be pooled for meta-analysis. If statistical pooling is not feasible, our findings will be presented in a narrative format. The certainty of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation Assessment (GRADE) tool. TRIAL REGISTRATION PROSPERO registration number: CRD42021265257.
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Affiliation(s)
- Oyesanmi A. Fabunmi
- School of Laboratory Medicine and Medical Sciences (SLMMS), University of KwaZulu-Natal, Durban, South Africa
- Health-awareness, Exercise and Cardio-immunologic Research Unit (HECIRU), Department of Physiology, College of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Phiwayinkosi V. Dludla
- Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa
- Department of Biochemistry and Microbiology, University of Zululand, KwaDlangezwa, South Africa
| | - Bongani B. Nkambule
- School of Laboratory Medicine and Medical Sciences (SLMMS), University of KwaZulu-Natal, Durban, South Africa
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5
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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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Williams JS, Stone JC, Masood Z, Bostad W, Gibala MJ, MacDonald MJ. The impact of natural menstrual cycle and oral contraceptive pill phase on substrate oxidation during rest and acute submaximal aerobic exercise. J Appl Physiol (1985) 2023; 135:642-654. [PMID: 37498292 DOI: 10.1152/japplphysiol.00111.2023] [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: 02/21/2023] [Revised: 07/03/2023] [Accepted: 07/24/2023] [Indexed: 07/28/2023] Open
Abstract
Previous research has identified sex differences in substrate oxidation during submaximal aerobic exercise including a lower respiratory exchange ratio (RER) in females compared with males. These differences may be related to differences in sex hormones. Our purpose was to examine the impact of the natural menstrual cycle (NAT) and second- and third-generation oral contraceptive pill (OCP2 and OCP3) cycle phases on substrate oxidation during rest and submaximal aerobic exercise. Fifty female participants (18 NAT, 17 OCP2, and 15 OCP3) performed two experimental trials that coincided with the low (i.e., nonactive pill/early follicular) and the high hormone (i.e., active pill/midluteal) phase of their cycle. RER and carbohydrate and lipid oxidation rates were determined from gas exchange measurements performed during 10 min of supine rest, 5 min of seated rest, and two 8-min bouts of submaximal cycling exercise at ∼40% and ∼65% of peak oxygen uptake (V̇o2peak). For all groups, there were no differences in RER between the low and high hormone phases during supine rest (0.73 ± 0.05 vs. 0.74 ± 0.05), seated rest (0.72 ± 0.04 vs. 0.72 ± 0.04), exercise at 40% (0.77 ± 0.04 vs. 0.78 ± 0.04), and 65% V̇o2peak (0.85 ± 0.04 vs. 0.86 ± 0.03; P > 0.19 for all). Similarly, carbohydrate and lipid oxidation rates remained largely unchanged across phases during both rest and exercise, apart from higher carbohydrate oxidation in NAT vs. OCP2 at 40% V̇o2peak (P = 0.019) and 65% V̇o2peak (P = 0.001). NAT and OCPs do not appear to largely influence substrate oxidation at rest and during acute submaximal aerobic exercise.NEW & NOTEWORTHY This study was the first to examine the influence of NAT and two generations of OCPs on substrate oxidation during rest and acute submaximal aerobic exercise. We reported no differences across cycle phases or groups on RER, and minimal impact on carbohydrate or lipid oxidation apart from an increase in carbohydrate oxidation in NAT compared with OCP2 during exercise. Based on these findings, NAT/OCP phase controls may not be necessary in studies investigating substrate oxidation.
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Affiliation(s)
- Jennifer S Williams
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Jenna C Stone
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Zaryan Masood
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - William Bostad
- Human Performance Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Martin J Gibala
- Human Performance Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Maureen J MacDonald
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
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7
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Moran RN, Guin JR, Gardner J, Simer J. Baseline Computerized Neurocognitive Testing and Oculomotor Measures are not Altered by Hormonal Contraceptive Use. Arch Clin Neuropsychol 2023; 38:922-928. [PMID: 36759181 DOI: 10.1093/arclin/acad015] [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: 12/06/2022] [Revised: 01/09/2023] [Accepted: 01/13/2023] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVE Neurocognitive testing and oculomotor assessment have been an integral component to provide objective measures for sport-related concussion (SRC) detection and management. Hormonal contraceptive (HC) use is common among collegiate female athletes and may modify baseline SRC performance. The purpose was to examine the effects of HC use on baseline computerized neurocognitive testing (CNT) and oculomotor testing in college-aged individuals. METHOD A total of 63 participants (22 HC using females, 22 non-HC using females, 19 males) completed a baseline SRC battery consisting of CNT, near point of convergence (NPC), and the King-Devick (KD) test. CNT measures were composite scores of verbal and visual memory, visual motor processing speed and reaction time, impulse control, and cognitive efficiency index (CEI). NPC was measured as the average convergence distance across three trials. KD time was recorded as total time for each of the two trials and best trial marked as baseline. RESULTS There were no group differences between HC, non-HC, and male control groups on all baseline CNT composite scores (p = .13-.98), impulse control (p = .47), and CEI (p = .49). NPC distance was similar between groups (p = .41), as well as KD time by trial (Trial 1 p = .65; 2 p = .48) and best time (p = .49). CONCLUSIONS HC use does not appear to influence baseline SRC measures of neurocognition and oculomotor assessment. Clinicians should continue to consider the effects of modifying factors at baseline and post-concussion. Additional research is needed to better understand sex hormone levels and SRC performance measures.
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Affiliation(s)
- Ryan N Moran
- Department of Health Science, Athletic Training Research Laboratory, The University of Alabama, Tuscaloosa, AL, USA
| | - J Russell Guin
- Department of Health Science, Athletic Training Research Laboratory, The University of Alabama, Tuscaloosa, AL, USA
| | - James Gardner
- Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Josh Simer
- Department of Health Science, Athletic Training Research Laboratory, The University of Alabama, Tuscaloosa, AL, USA
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Schumpf LF, Braun C, Peric A, Schmid MJ, Lehnick D, Christmann-Schmid C, Brambs C. The influence of the menstrual cycle and hormonal contraceptives on cardiorespiratory fitness in physically active women: A systematic review and meta-analysis. Heliyon 2023; 9:e17049. [PMID: 37484400 PMCID: PMC10361115 DOI: 10.1016/j.heliyon.2023.e17049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 05/18/2023] [Accepted: 06/06/2023] [Indexed: 07/25/2023] Open
Abstract
Objective To systematically review and summarize the existing evidence related to the influence of the menstrual cycle (MC) and hormonal contraceptive (HC) use on V˙O2max in physically active women. Methods This systematic review and meta-analysis conforms to the PRISMA statement guidelines. Four (sub-)meta-analyses were performed. Two focused on longitudinal studies examining the same women several times to compare the V˙O2max during the different menstrual phases or oral contraceptive (OC) use and withdrawal. Two meta-analyses examined if there is a difference in V˙O2max between OC users and normally menstruating women by analyzing cross-sectional studies assigning physically active women to one of these two groups as well as intervention-based studies (cross-over studies, randomized controlled trials considering only the data of the intervention group) comparing women intra-individually with and without OCs. Results Nine of the included studies (107 women) evaluated the influence of the MC, five studies (69 women) the impact of OCs on V˙O2max, and six studies investigated both topics (88 women). A mean difference of V˙O2max -0.03 ml/kg/min (95%CI -1.06 to 1.01) between the early follicular and luteal menstrual phase was observed. Between the active and inactive phases of OCs, a mean difference of -0.11 ml/kg/min (95%CI -2.32 to 2.10) was found. The inter-individual comparison of naturally menstruating women and OC users showed a mean difference in V˙O2max of 0.23 ml/kg/min (95% CI -2.33 to 2.79) in favor of OC use. The intra-individual comparison of the same women showed a mean decrease in V˙O2max of -0.84 ml/kg/min (95% CI -2.38 to 0.70) after a new start with OCs. Conclusions Our meta-analyses showed no effects of the MC or the OCs on V˙O2max. More high-quality studies are needed determining the MC phases more precisely, including OCs with the current standard formulations and comparing the influence of different progestins.
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Affiliation(s)
| | | | - Adriana Peric
- Gynecologic Endocrinology, Zollikerberg Hospital, Zurich, Switzerland
| | | | - Dirk Lehnick
- Biostatistics & Methodology, Dept. of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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Glenner-Frandsen A, With C, Gunnarsson TP, Hostrup M. The Effect of Monophasic Oral Contraceptives on Muscle Strength and Markers of Recovery After Exercise-Induced Muscle Damage: A Systematic Review. Sports Health 2023; 15:318-327. [PMID: 36154748 PMCID: PMC10170231 DOI: 10.1177/19417381221121653] [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: 11/16/2022] Open
Abstract
CONTEXT Oral contraceptives (OCs) manipulate hormonal fluctuations of the menstrual cycle and affect physical performance. Most investigations on the effect of OCs on physical performance did not discriminate between different types of OCs. Thus, the effects of monophasic OCs (MOCs) - the most common type of OCs - on muscle strength and recovery from exercise are largely unknown. OBJECTIVE To examine the effect of MOC use on muscle strength and markers of recovery after exercise-induced muscle damage (EIMD) in premenopausal women. DATA SOURCES Electronic databases Embase, PubMed, SportDiscus, and Web of Science were searched for studies examining the effect of MOCs on acute muscle strength and recovery. STUDY SELECTION Keywords applied for the study selection were oral contraceptive* AND muscle strength or oral contraceptive* AND muscle damage. STUDY DESIGN Systematic review. LEVEL OF EVIDENCE Lowest quality assessed for an included study in this review was serious risk of bias using ROBINS-I tool made from Cochrane for nonrandomized studies. DATA EXTRACTION A total of 104 studies on muscle strength were identified, of which 11 met the inclusion criteria. Concerning recovery, 51 studies were identified, of which 4 met the inclusion criteria. RESULTS Of the 11 studies included, 10 showed no effect of MOCs on acute muscle strength. Of the 4 studies on recovery, 2 found a greater decrease in muscle strength, and 3 found higher creatine kinase (CK) levels after EIMD in MOC users than in nonusers. The included studies were all rated with moderate-to-serious risk of bias. CONCLUSION These findings suggest that MOCs may impair recovery from EIMD as indicated by lowered muscle strength and elevated CK levels. There is insufficient evidence to conclude whether MOCs acutely affect muscle strength. Moderate-to-serious risk of bias in studies makes interpretation challenging.
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Affiliation(s)
- Astrid Glenner-Frandsen
- Department of Nutrition, Exercise and
Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Cecilie With
- Department of Nutrition, Exercise and
Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Thomas P. Gunnarsson
- Department of Nutrition, Exercise and
Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Morten Hostrup
- Department of Nutrition, Exercise and
Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
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10
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Fabunmi OA, Dludla PV, Nkambule BB. Investigating cardiovascular risk in premenopausal women on oral contraceptives: Systematic review with meta-analysis. Front Cardiovasc Med 2023; 10:1127104. [PMID: 37180788 PMCID: PMC10167286 DOI: 10.3389/fcvm.2023.1127104] [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: 12/19/2022] [Accepted: 03/09/2023] [Indexed: 05/16/2023] Open
Abstract
Background The use of oral contraceptives (OCs) is associated with an increased risk of cardiovascular events such as arterial and venous thrombosis (VTE). Cardiovascular diseases (CVDs) are the leading cause of death worldwide, with low- and middle-income nations accounting for over three-quarter of CVD deaths. The aim of this systematic review is to provide a comprehensive synthesis of the available evidence on the link between OC use and CVD risk in premenopausal women and to further assess the role of geographic disparities in the reported prevalence of CVD risk in women on OCs. Methods A comprehensive search of databases such as MEDLINE, Academic Search Complete, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Health Source: Nursing/Academic Edition was conducted, right from the inception to the present, by using the EBSCOhost search engine. The Cochrane Central Register of Clinical trials (CENTRAL) was also searched to augment relevant sources of information. OpenGrey, which is a repository of information providing open access to bibliographical references, was searched and the reference list of the selected studies was also scanned. The potential risk of bias of the included studies was assessed using the modified Downs and Black checklist. Data analysis was performed using the Review Manager (RevMan) version 5.3. Results We included 25 studies that comprised 3,245 participants, of which 1,605 (49.5%) are OC users, while 1,640 (50.5%) are non-OC users. A total of 15 studies were included for meta-analysis, and the overall pooled estimates suggested a significant increase in the traditional cardiovascular risk variables [standardized mean difference (SMD) = 0.73, (0.46, 0.99) (Z = 5.41, p < 0.001)] and little to no difference in endothelial activation among OC users when compared with non-OC users [SMD = -0.11, (-0.81, 0.60) (Z = 0.30, p = 0.76)]. Europe [SMD = 0.03, (-0.21, 0.27), (Z = 0.25 p = 0.88)] had the least effect size, while North America had the highest effect size [SMD = 1.86, (-0.31, 4.04), (Z = 1.68 p = 0.09)] for CVD risk in OC users when compared with non-OC users. Conclusion The use of OCs suggests a significant increase in the prevalence of traditional cardiovascular risk variables with little to no difference in the risk of endothelial dysfunction when compared with non-OC users, and the magnitude of CVD risks varies across different geographical regions. Registration and protocol This systematic review was registered in the international prospective register of systematic reviews (PROSPERO) under the registration number: CRD42020216169.
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Affiliation(s)
- Oyesanmi A. Fabunmi
- School of Laboratory Medicine and Medical Sciences (SLMMS), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Department of Physiology, Ekiti State University, Ado-Ekiti, Nigeria
| | - Phiwayinkosi V. Dludla
- Biomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg, South Africa
| | - Bongani B. Nkambule
- School of Laboratory Medicine and Medical Sciences (SLMMS), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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11
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Kissow J, Jacobsen KJ, Gunnarsson TP, Jessen S, Hostrup M. Effects of Follicular and Luteal Phase-Based Menstrual Cycle Resistance Training on Muscle Strength and Mass. Sports Med 2022; 52:2813-2819. [PMID: 35471634 DOI: 10.1007/s40279-022-01679-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2022] [Indexed: 11/30/2022]
Abstract
There is an increasing interest in female athletic performance-especially concerning the impact of the female menstrual cycle on training response. Indeed, fluctuations in female sex hormones, estrogen and progesterone, during the menstrual cycle regulate protein metabolism and recovery processes in skeletal muscle and may thus impact exercise training-related outcomes. Studies demonstrate that anaerobic capacity and muscle strength are greatest during the follicular phase of the menstrual cycle, when estrogen levels peak. In addition, studies indicate that resistance training conducted in the follicular phase of the menstrual cycle (follicular phase-based resistance training) may be superior to luteal phase-based training in terms of enhancing muscle strength and mass. This raises the possibility that the physiological capabilities of skeletal muscle to adapt to exercise training are dependent on the menstrual cycle and can be important for female athletes in optimizing their training. In this paper, we critically review the current state of the art concerning the impact of menstrual cycle phase-based resistance training and highlight why follicular phase-based resistance training possibly is superior to luteal phase-based training in enhancing resistance training outcomes. Finally, we identify directions for further research.
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Affiliation(s)
- Julie Kissow
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, August Krogh Building 2nd floor, Universitetsparken 13, 2100, Copenhagen, Denmark
| | - Kamine J Jacobsen
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, August Krogh Building 2nd floor, Universitetsparken 13, 2100, Copenhagen, Denmark
| | - Thomas P Gunnarsson
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, August Krogh Building 2nd floor, Universitetsparken 13, 2100, Copenhagen, Denmark
| | - Søren Jessen
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, August Krogh Building 2nd floor, Universitetsparken 13, 2100, Copenhagen, Denmark
| | - Morten Hostrup
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, August Krogh Building 2nd floor, Universitetsparken 13, 2100, Copenhagen, Denmark.
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Castro EA, Rael B, Romero-Parra N, Alfaro-Magallanes VM, Rojo-Tirado MA, García-de-Alcaraz A, Cupeiro R, Peinado AB. Influence of oral contraceptive phase on cardiorespiratory response to exercise in endurance-trained athletes. EUR J CONTRACEP REPR 2022; 27:308-316. [PMID: 35040731 DOI: 10.1080/13625187.2021.2021176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The aim of the study was to analyse the cardiorespiratory response to exercise during an oral contraceptive (OC) cycle in endurance-trained women. METHODS Sixteen low-dose monophasic OC pill (OCP) users performed an interval-running protocol. The protocol consisted of eight 3 min bouts at 85% of participants' maximal aerobic speed (vV̇o2peak) with a 90s recovery at 30% vV̇o2peak in two OC phases: a withdrawal phase (WP) and an active pill phase (APP). The non-parametric Wilcoxon test was applied to analyse differences (p < 0.05) in performance variables between OC cycle phases. RESULTS Throughout the high-intensity intervals, higher ventilation (WP 80.90 ± 11.49 L/min, APP 83.10 ± 13.33 L/min; p < 0.001) and relative perceived exertion (WP 14.51 ± 2.58, APP 15.11 ± 3.11; p = 0.001) during the APP were found, whereas carbon dioxide production (WP 2040.92 ± 262.93 mL/min, APP 2010.25 ± 305.68 mL/min; p = 0.003) was higher in the WP. During the active recovery intervals, ventilation (WP 65.78 ± 9.90 L/min, APP 67.88 ± 12.66 L/min; p < 0.001) was higher in the APP, while heart rate (WP 159.93 ± 10.26 bpm, APP 159.74 ± 12.83 bpm; p = 0.029) was higher in the WP. CONCLUSION An increase in ventilation occurs during the APP, which is accompanied by higher perceived exertion. Therefore, coaches and athletes should be aware of these variations, especially perceived exertion, in regard to women's training programmes, in order to improve their performance, wellness and adherence to physical activity.
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Affiliation(s)
- Eliane A Castro
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain.,Department of Sports Sciences and Physical Conditioning, Faculty of Education, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Beatriz Rael
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Nuria Romero-Parra
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Víctor M Alfaro-Magallanes
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Miguel A Rojo-Tirado
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Antonio García-de-Alcaraz
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain.,Faculty of Educational Sciences, Universidad de Almería, Almería, Spain
| | - Rocío Cupeiro
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Ana B Peinado
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain
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13
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Thompson BM, Drover KB, Stellmaker RJ, Sculley DV, Janse de Jonge XAK. The Effect of the Menstrual Cycle and Oral Contraceptive Cycle on Muscle Performance and Perceptual Measures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010565. [PMID: 34682310 PMCID: PMC8536049 DOI: 10.3390/ijerph182010565] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 12/23/2022]
Abstract
Most reproductive-aged women are exposed to fluctuating female steroid hormones due to the menstrual cycle or oral contraceptive use. This study investigated the potential effect of the menstrual cycle and combined monophasic oral contraceptive cycle on various aspects of muscle performance. Thirty active females (12 with a natural menstrual cycle, 10 taking a high-androgenicity oral contraceptive and 8 taking a low-androgenicity oral contraceptive), aged 18 to 30 years, were tested three times throughout one menstrual or oral contraceptive cycle. Counter-movement jumps, bilateral hop jumps, handgrip strength, isometric knee extensor strength and isokinetic knee flexion and extension were assessed. Perceptual ratings of fatigue, muscle soreness, pain and mood were recorded. Most variables showed no significant changes over the menstrual or oral contraceptive cycle. However, for the menstrual cycle group, isokinetic knee flexion at 240° s−1, and time of flight in bilateral hopping and counter movement jumps showed better results during the mid-luteal phase compared with the late follicular phase. For the high-androgenicity oral contraceptive group, isokinetic knee flexion at 240° s−1 was significantly higher in the late hormone phase compared with the early hormone phase. For the low-androgenicity oral contraceptive group, time of flight for the counter-movement jumps was lower in the late hormone phase compared with the early hormone phase. The findings indicate that faster and explosive aspects of muscle performance may be influenced by endogenous and exogenous female hormones.
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Affiliation(s)
- Belinda M. Thompson
- Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, NSW 2109, Australia
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, NSW 2258, Australia; (K.B.D.); (R.J.S.); (X.A.K.J.d.J.)
- Correspondence:
| | - Kaitlyn B. Drover
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, NSW 2258, Australia; (K.B.D.); (R.J.S.); (X.A.K.J.d.J.)
| | - Rhiannon J. Stellmaker
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, NSW 2258, Australia; (K.B.D.); (R.J.S.); (X.A.K.J.d.J.)
| | - Dean V. Sculley
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Ourimbah, NSW 2258, Australia;
| | - Xanne A. K. Janse de Jonge
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, NSW 2258, Australia; (K.B.D.); (R.J.S.); (X.A.K.J.d.J.)
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14
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Bozzini BN, McFadden BA, Elliott-Sale KJ, Swinton PA, Arent SM. Evaluating the effects of oral contraceptive use on biomarkers and body composition during a competitive season in collegiate female soccer players. J Appl Physiol (1985) 2021; 130:1971-1982. [PMID: 33955263 DOI: 10.1152/japplphysiol.00818.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
High training demands throughout the competitive season in female collegiate soccer players have been shown to induce changes in biomarkers indicative of stress, inflammation, and reproduction, which may be exacerbated in athletes using oral contraceptives (OCs). This study aimed to compare biomarkers and body composition between OC-using and nonusing (CON) female soccer players throughout a competitive season. Female collegiate soccer players were stratified into two groups based on their reported OC use at the start of preseason (OC: n = 6; CON: n = 17). Before the start of preseason and immediately postseason, athletes underwent a battery of performance tests. Blood draws and body composition assessments were performed before preseason, on wks 2, 4, 8, and 12 of the season, and postseason. Area-under-the-curve ratios (OCAUC:CONAUC) indicated the OC group were exposed to substantially higher levels of sex hormone-binding globulin (AUCratio = 1.4, probability = P > 0.999), total cortisol (1.7; P > 0.999), C-reactive protein (5.2; P > 0.999), leptin (1.4; P = 0.990), growth hormone (1.5; P = 0.97), but substantively lower amounts of estradiol (0.36; P < 0.001), progesterone (0.48; P = 0.008), free testosterone (0.58; P < 0.001), follicle-stimulating hormone (0.67; P < 0.001), and creatine kinase (0.33, P < 0.001) compared with the CON across the season. Both groups increased fat free mass over the season, but CON experienced a greater magnitude of increase along with decreased body fat percentage. Although similar training loads were observed between groups over the season, the elevated exposure to stress, inflammatory, and metabolic biomarkers over the competitive season in OC users may have implications on body composition, training adaptations, and recovery in female athletes.NEW & NOTEWORTHY This study highlights the influence of OC use on physiological changes that occur over a 4-mo intense, competitive season and the differential systemic exposure to biomarkers, specifically those of inflammation, stress, anabolism, and energy balance, between OC-using and nonusing soccer players. Additionally, this study provides insight into changes in body composition with prolonged training between female athletes with and without OC use.
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Affiliation(s)
- Brittany N Bozzini
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina.,New Jersey Institute for Food, Nutrition, & Health (IFNH) Center for Health and Human Performance, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | - Bridget A McFadden
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina.,New Jersey Institute for Food, Nutrition, & Health (IFNH) Center for Health and Human Performance, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | - Kirsty J Elliott-Sale
- Department of Sport Science, Sport, Health and Performance Enhancement (SHAPE) Research Centre, Nottingham Trent University, Nottingham, United Kingdom
| | - Paul A Swinton
- School of Health Sciences, Robert Gordon University, Aberdeen, United Kingdom
| | - Shawn M Arent
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina.,New Jersey Institute for Food, Nutrition, & Health (IFNH) Center for Health and Human Performance, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
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15
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Body Composition Over the Menstrual and Oral Contraceptive Cycle in Trained Females. Int J Sports Physiol Perform 2021; 16:375-381. [DOI: 10.1123/ijspp.2020-0038] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/07/2020] [Accepted: 04/16/2020] [Indexed: 11/18/2022]
Abstract
Purpose: The influence of female sex hormones on body fluid regulation and metabolism homeostasis has been widely studied. However, it remains unclear whether hormone fluctuations throughout the menstrual cycle (MC) and with oral contraceptive (OC) use affect body composition (BC). Thus, the aim of this study was to investigate BC over the MC and OC cycle in well-trained females. Methods: A total of 52 eumenorrheic and 33 monophasic OC-taking well-trained females participated in this study. Several BC variables were measured through bioelectrical impedance analysis 3 times in the eumenorrheic group (early follicular phase, late follicular phase, and midluteal phase) and on 2 occasions in the OC group (withdrawal phase and active pill phase). Results: Mixed linear model tests reported no significant differences in the BC variables (body weight, body mass index, basal metabolism, fat mass, fat-free mass, and total body water) between the MC phases or between the OC phases (P > .05 for all comparisons). Trivial and small effect sizes were found for all BC variables when comparing the MC phases in eumenorrheic females, as well as for the OC cycle phases. Conclusions: According to the results, sex hormone fluctuations throughout the menstrual and OC cycle do not influence BC variables measured by bioelectrical impedance in well-trained females. Therefore, it seems that bioimpedance analysis can be conducted at any moment of the cycle, both for eumenorrheic women and women using OC.
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16
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Badenhorst CE, Goto K, O'Brien WJ, Sims S. Iron status in athletic females, a shift in perspective on an old paradigm. J Sports Sci 2021; 39:1565-1575. [PMID: 33583330 DOI: 10.1080/02640414.2021.1885782] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Iron deficiency is a common nutrient deficiency within athletes, with sport scientists and medical professionals recognizing that athletes require regular monitoring of their iron status during intense training periods. Revised considerations for athlete iron screening and monitoring have suggested that males get screened biannually during heavy training periods and females require screening biannually or quarterly, depending on their previous history of iron deficiency. The prevalence of iron deficiency in female athletes is higher than their male counterparts and is often cited as being a result of the presence of a menstrual cycle in the premenopausal years. This review has sought to revise our current understanding of female physiology and the interaction between primary reproductive hormones (oestrogen and progesterone) and iron homoeostasis in females. The review highlights an apparent symbiotic relationship between iron metabolism and the menstrual cycle that requires additional research as well as identifying areas of the menstrual cycle that may be primed for nutritional iron supplementation.
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Affiliation(s)
- Claire E Badenhorst
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, New Zealand
| | - Kazushige Goto
- Graduate School of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Wendy J O'Brien
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, New Zealand
| | - Stacy Sims
- Te Huataki Waiora - School of Health, the University of Waikato, Hamilton, New Zealand
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17
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Myllyaho MM, Ihalainen JK, Hackney AC, Valtonen M, Nummela A, Vaara E, Häkkinen K, Kyröläinen H, Taipale RS. Hormonal Contraceptive Use Does Not Affect Strength, Endurance, or Body Composition Adaptations to Combined Strength and Endurance Training in Women. J Strength Cond Res 2021; 35:449-457. [PMID: 29927884 DOI: 10.1519/jsc.0000000000002713] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Myllyaho, MM, Ihalainen, JK, Hackney, AC, Valtonen, M, Nummela, A, Vaara, E, Häkkinen, K, Kyröläinen, H, and Taipale, RS. Hormonal contraceptive use does not affect strength, endurance, or body composition adaptations to combined strength and endurance training in women. J Strength Cond Res 35(2): 449-457, 2021-This study examined the effects of a 10-week period of high-intensity combined strength and endurance training on strength, endurance, body composition, and serum hormone concentrations in physically active women using hormonal contraceptives (HCs, n = 9) compared with those who had never used hormonal contraceptives (NHCs, n = 9). Training consisted of 2 strength training sessions and 2 high-intensity running interval sessions per week. Maximal bilateral isometric leg press (Isom), maximal bilateral dynamic leg press (one repetition maximum [1RM]), countermovement jump (CMJ), a 3,000-m running test (3,000 m), body composition, and serum hormone levels were measured before and after training between days 1-5 of each subject's menstrual cycle. Both groups increased 1RM and CMJ: HC = 13.2% (p < 0.001) and 9.6% (p < 0.05), and NHC = 8.3% (p < 0.01) and 8.5% (p < 0.001). Hormonal contraceptive improved 3,000 m by 3.5% (p < 0.05) and NHC by 1% (n.s.). Never used hormonal contraceptive increased lean mass by 2.1% (p < 0.001), whereas body fat percentage decreased from 23.9 ± 6.7 to 22.4 ± 6.0 (-6.0%, p < 0.05). No significant changes were observed in body composition in HC. No significant between-group differences were observed in any of the performance variables. Luteinizing hormone concentrations decreased significantly (p < 0.05) over 10 weeks in NHC, whereas other hormone levels remained statistically unaltered in both groups. It seems that the present training is equally appropriate for improving strength, endurance, and body composition in women using HC as those not using HC without disrupting hypothalamic-pituitary-gonadal axis function.
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Affiliation(s)
- Moona M Myllyaho
- Biology of Physical Activity, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Johanna K Ihalainen
- Biology of Physical Activity, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Anthony C Hackney
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, North Carolina
- Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina
| | | | - Ari Nummela
- Research Institute for Olympic Sport, Jyväskylä, Finland
| | - Elina Vaara
- JAMK University of Applied Sciences, Jyväskylä, Finland ; and
| | - Keijo Häkkinen
- Biology of Physical Activity, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Heikki Kyröläinen
- Biology of Physical Activity, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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18
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Rocha-Rodrigues S, Sousa M, Lourenço Reis P, Leão C, Cardoso-Marinho B, Massada M, Afonso J. Bidirectional Interactions between the Menstrual Cycle, Exercise Training, and Macronutrient Intake in Women: A Review. Nutrients 2021; 13:438. [PMID: 33572821 PMCID: PMC7910908 DOI: 10.3390/nu13020438] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 02/08/2023] Open
Abstract
Women have a number of specificities that differentiate them from men. In particular, the role of sex steroid hormones and the menstrual cycle (MC) significantly impact women's physiology. The literature has shown nonlinear relationships between MC, exercise, and nutritional intake. Notably, these relationships are bidirectional and less straightforward than one would suppose. For example, the theoretical implications of the MC's phases on exercise performance do not always translate into relevant practical effects. There is often a disconnect between internal measures (e.g., levels of hormone concentrations) and external performance. Furthermore, it is not entirely clear how nutritional intake varies across the MC's phases and whether these variations impact on exercise performance. Therefore, a thorough review of the existing knowledge could help in framing these complex relationships and potentially contribute to the optimization of exercise prescription and nutritional intake according to the naturally occurring phases of the MC. Throughout this review, an emerging trend is the lack of generalizability and the need to individualize interventions, since the consequences of the MC's phases and their relationships with exercise and nutritional intake seem to vary greatly from person to person. In this sense, average data are probably not relevant and could potentially be misleading.
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Affiliation(s)
- Sílvia Rocha-Rodrigues
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun’Álvares, 4900-347 Viana do Castelo, Portugal;
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), Quinta de Prados, Edifício Ciências de Desporto, 5001-801 Vila Real, Portugal
- Tumor & Microenvironment Interactions Group, i3S, Rua Alfredo Allen, 208 4200-135 Porto, Portugal
| | - Mónica Sousa
- Nutrition & Metabolism, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria, 1169-056 Lisboa, Portugal;
- CINTESIS, NOVA Medical School, NMS, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 1169-056 Lisboa, Portugal
| | - Patrícia Lourenço Reis
- Hospital da Luz Arrábida, Luz Saúde, Praceta Henrique Moreira, 150, 4400-346 Vila Nova de Gaia, Portugal;
| | - César Leão
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun’Álvares, 4900-347 Viana do Castelo, Portugal;
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), Quinta de Prados, Edifício Ciências de Desporto, 5001-801 Vila Real, Portugal
| | | | - Marta Massada
- Centre for Research, Education, Innovation and Intervention in Sport, Faculty of Sport of the University of Porto. Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal; (M.M.); (J.A.)
- St. Mary’s Hospital of Porto, Rua de Camões, 906, 4049-025 Porto, Portugal
| | - José Afonso
- Centre for Research, Education, Innovation and Intervention in Sport, Faculty of Sport of the University of Porto. Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal; (M.M.); (J.A.)
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19
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Rael B, Barba-Moreno L, Romero-Parra N, Alfaro-Magallanes VM, Castro EA, Cupeiro R, Peinado AB. Cardiorespiratory response to exercise in endurance-trained premenopausal and postmenopausal females. Eur J Appl Physiol 2021; 121:903-913. [PMID: 33389018 DOI: 10.1007/s00421-020-04574-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 11/27/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE To assess the influence of different hormonal profiles on the cardiorespiratory response to exercise in endurance-trained females. METHODS Forty-seven eumenorrheic females, 38 low-dose monophasic oral contraceptive (OC) users and 13 postmenopausal women, all of them endurance-trained, participated in this study. A DXA scan, blood sample tests and a maximal aerobic test were performed under similar low-sex hormone levels: early follicular phase for the eumenorrheic females; withdrawal phase for the OC group and at any time for postmenopausal women. Cardiorespiratory variables were measured at resting and throughout the maximal aerobic test (ventilatory threshold 1, 2 and peak values). Heart rate (HR) was continuously monitored with a 12-lead ECG. Blood pressure (BP) was measured with an auscultatory method and a calibrated mercury sphygmomanometer. Expired gases were measured breath-by-breath with the gas analyser Jaeger Oxycon Pro. RESULTS One-way ANCOVA reported a lower peak HR in postmenopausal women (172.4 ± 11.7 bpm) than in eumenorrheic females (180.9 ± 10.6 bpm) (p = 0.024). In addition, postmenopausal women exhibited lower VO2 (39.1 ± 4.9 ml/kg/min) compared to eumenorrheic females (45.1 ± 4.4 ml/kg/min) in ventilatory threshold 2 (p = 0.009). Nonetheless, respiratory variables did not show differences between groups at peak values. Finally, no differences between OC users and eumenorrheic females' cardiorespiratory response were observed in endurance-trained females. CONCLUSIONS Cardiorespiratory system is impaired in postmenopausal women due to physiological changes caused by age and sex hormones' decrement. Although these alterations appear not to be fully compensated by exercise, endurance training could effectively mitigate them. In addition, monophasic OC pills appear not to impact cardiorespiratory response to an incremental running test in endurance-trained females.
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Affiliation(s)
- Beatriz Rael
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Martín Fierro, 28040, Madrid, Spain
| | - Laura Barba-Moreno
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Martín Fierro, 28040, Madrid, Spain.
| | - Nuria Romero-Parra
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Martín Fierro, 28040, Madrid, Spain
| | - Víctor M Alfaro-Magallanes
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Martín Fierro, 28040, Madrid, Spain
| | - Eliane A Castro
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Martín Fierro, 28040, Madrid, Spain.,Department of Sports Sciences and Physical Conditioning, Faculty of Education, Universidad Católica de La Santísima Concepción, Concepción, Chile
| | - Rocío Cupeiro
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Martín Fierro, 28040, Madrid, Spain
| | - Ana B Peinado
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Martín Fierro, 28040, Madrid, Spain
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20
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Elliott-Sale KJ, McNulty KL, Ansdell P, Goodall S, Hicks KM, Thomas K, Swinton PA, Dolan E. The Effects of Oral Contraceptives on Exercise Performance in Women: A Systematic Review and Meta-analysis. Sports Med 2020; 50:1785-1812. [PMID: 32666247 PMCID: PMC7497464 DOI: 10.1007/s40279-020-01317-5] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND Oral contraceptive pills (OCPs) are double agents, which downregulate endogenous concentrations of oestradiol and progesterone whilst simultaneously providing daily supplementation of exogenous oestrogen and progestin during the OCP-taking days. This altered hormonal milieu differs significantly from that of eumenorrheic women and might impact exercise performance, due to changes in ovarian hormone-mediated physiological processes. OBJECTIVE To explore the effects of OCPs on exercise performance in women and to provide evidence-based performance recommendations to users. METHODS This review complied with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A between-group analysis was performed, wherein performance of OCP users was compared with naturally menstruating women, and a within-group analysis was conducted, wherein performance during OCP consumption was compared with OCP withdrawal. For the between-group analysis, women were phase matched in two ways: (1) OCP withdrawal versus the early follicular phase of the menstrual cycle and (2) OCP consumption versus all phases of the menstrual cycle except for the early follicular phase. Study quality was assessed using a modified Downs and Black Checklist and a strategy based on the recommendations of the Grading of Recommendations Assessment Development and Evaluation working group. All meta-analyses were conducted within a Bayesian framework to facilitate probabilistic interpretations. RESULTS 42 studies and 590 participants were included. Most studies (83%) were graded as moderate, low or very low quality, with 17% achieving high quality. For the between-group meta-analysis comparing OCP users with naturally menstruating women, posterior estimates of the pooled effect were used to calculate the probability of at least a small effect (d ≥ 0.2). Across the two between-group comparison methods, the probability of a small effect on performance favouring habitual OCP users was effectually zero (p < 0.001). In contrast, the probability of a small effect on performance favouring naturally menstruating women was moderate under comparison method (1) (d ≥ 0.2; p = 0.40) and small under comparison method (2) (d ≥ 0.2; p = 0.19). Relatively large between-study variance was identified for both between-group comparisons ([Formula: see text]0.5 = 0.16 [95% credible interval (CrI) 0.01-0.44] and [Formula: see text]0.5 = 0.22 [95% CrI 0.06-0.45]). For the within-group analysis comparing OCP consumption with withdrawal, posterior estimates of the pooled effect size identified almost zero probability of a small effect on performance in either direction (d ≥ 0.2; p ≤ 0.001). CONCLUSIONS OCP use might result in slightly inferior exercise performance on average when compared to naturally menstruating women, although any group-level effect is most likely to be trivial. Practically, as effects tended to be trivial and variable across studies, the current evidence does not warrant general guidance on OCP use compared with non-use. Therefore, when exercise performance is a priority, an individualised approach might be more appropriate. The analysis also indicated that exercise performance was consistent across the OCP cycle.
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Affiliation(s)
- Kirsty J Elliott-Sale
- Department of Sport Science, Sport Health and Performance Enhancement (SHAPE) Research Centre, Nottingham Trent University, Nottingham, UK.
| | - Kelly L McNulty
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK
| | - Paul Ansdell
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK
| | - Stuart Goodall
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK
| | - Kirsty M Hicks
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK
| | - Kevin Thomas
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK
| | - Paul A Swinton
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - Eimear Dolan
- Applied Physiology and Nutrition Research Group, Escola de Educação Física e Esporte, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
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21
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Statham G. Understanding the effects of the menstrual cycle on training and performance in elite athletes: A preliminary study. PROGRESS IN BRAIN RESEARCH 2020; 253:25-58. [PMID: 32771127 DOI: 10.1016/bs.pbr.2020.05.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
Success at an Olympic level can come down to the smallest of margins. However little research has been conducted into how the menstrual cycle affects elite athletes' performance and decision making. This study uses a combination of quantitative and qualitative research methods to explore this question. Physiological performance data was collected from eight elite athletes for 7 months and analyzed as a function of menstrual phase. The Cambridge Gambling Task (CGT) was used to test decision making and testing occurred twice in one cycle, during the early follicular phase and during the mid-luteal phase. Menstrual cycle phase was determined using menstrual cycle mapping and urine ovulation tests. In the qualitative part of this project, two elite athletes, two Olympic level athletes, and two coaches participated in semi-structured interviews. The study found that physiological performance was significantly better during the menses phase (MP) compared to the proliferative and secretory phases (PSP). There was variation in how elite athletes were individually affected however. Oral contraceptive users showed a greater performance change from MP to PSP suggesting that oral contraceptives may be detrimental to performance in some athletes. The results of the CGT showed that impulsivity is significantly affected by menstrual cycle phase. Risk taking, error rates and response times were not affected. The qualitative interviews revealed that elite athletes and their coaches understand little of the menstrual cycle. Despite this, there are preconceptions that it negatively effects performance during the menses phase. The findings suggest that the menstrual cycle can have a significant effect on an elite athlete's performance and this paper discusses how individuals can possibly improve aspects of physiological and psychological performance by understanding and monitoring their menstrual patterns.
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Affiliation(s)
- Georgia Statham
- Faculty of Health Sciences, University of Bristol, Bristol, United Kingdom.
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22
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Best R, Temm D, Hucker H, McDonald K. Repeated Menthol Mouth Swilling Affects Neither Strength nor Power Performance. Sports (Basel) 2020; 8:E90. [PMID: 32560472 PMCID: PMC7353636 DOI: 10.3390/sports8060090] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/05/2020] [Accepted: 06/16/2020] [Indexed: 01/05/2023] Open
Abstract
This study aimed to assess the effects of repeated menthol mouth swilling upon strength and power performance. Nineteen (10 male) participants completed familiarisation and experimental trials of repeated menthol mouth swilling (0.1% concentration) or control (no swill) in a randomised crossover design. Participants performed an isometric mid-thigh pull (IMTP; peak and mean force; N), vertical jump (peak; cm) and six second sprint (peak and mean power; W) under each condition. Participants completed three efforts per exercise task interspersed with three-minute recoveries. Mean best values were analysed via a two-way mixed repeated measures ANOVA, and differences reported as effect sizes ± 95% confidence intervals, with accompanying descriptors and p values. Differences in peak IMTP values were unclear between familiarisation and experimental trials, and between menthol and control conditions. Mean IMTP force differed between familiarisation and control (0.51; -0.15 to 1.14; p = 0.001) and familiarisation and menthol conditions (0.50; -0.15 to 1.14; p = 0.002) by a small degree, but were unclear between control and menthol conditions. Unclear differences were also noted on vertical jump performance compared to familiarisation and between experimental conditions, with repeated six second peak and average power performance also showing unclear effects across all comparisons. We conclude that repeated menthol mouth swilling does not improve strength or power performance.
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Affiliation(s)
- Russ Best
- Centre for Sport Science and Human Performance, Wintec, Hamilton 3200, New Zealand; (D.T.); (H.H.); (K.M.)
- School of Health and Life Sciences, Teesside University, Middlesbrough TS1 3BX, UK
| | - Dani Temm
- Centre for Sport Science and Human Performance, Wintec, Hamilton 3200, New Zealand; (D.T.); (H.H.); (K.M.)
| | - Holly Hucker
- Centre for Sport Science and Human Performance, Wintec, Hamilton 3200, New Zealand; (D.T.); (H.H.); (K.M.)
| | - Kerin McDonald
- Centre for Sport Science and Human Performance, Wintec, Hamilton 3200, New Zealand; (D.T.); (H.H.); (K.M.)
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23
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Blagrove RC, Bruinvels G, Pedlar CR. Variations in strength-related measures during the menstrual cycle in eumenorrheic women: A systematic review and meta-analysis. J Sci Med Sport 2020; 23:1220-1227. [PMID: 32456980 DOI: 10.1016/j.jsams.2020.04.022] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 03/10/2020] [Accepted: 04/30/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVES To systematically review the current body of research that has investigated changes in strength-related variables during different phases of the menstrual cycle in eumenorrheic women. DESIGN Systematic review and meta-analysis. METHODS A literature search was conducted in Pubmed, SPORTDiscus and Web of Science using search terms related to the menstrual cycle and strength-related measures. Two reviewers reached consensus that 21 studies met the criteria for inclusion. Methodological rigour was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Random effects meta-analyses were used to compare the early-follicular, ovulatory and mid-luteal phases for maximal voluntary contraction, isokinetic peak torque, and explosive strength. RESULTS The assessment of study quality showed that a high level of bias exists in specific areas of study design. Non-significant and small or trivial effect sizes (p≥0.26, Hedges g≤0.35) were identified for all strength-related variables in each comparison between phases. 95% confidence intervals for each comparison suggested the uncertainty associated with each estimate extends to a small effect on strength performance with unclear direction (-0.42≤g≤0.48). The heterogeneity for each comparison was also small (p≥0.83, I2=0%). CONCLUSIONS Strength-related measures appear to be minimally altered (g≤0.35) by the fluctuations in ovarian sex hormones that occur during the menstrual cycle. This finding should be interpreted with caution due to the methodological shortcomings identified by the quality assessment.
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Affiliation(s)
- Richard C Blagrove
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, United Kingdom.
| | - Georgie Bruinvels
- School of Sport, Health and Applied Science, St Mary's University, Twickenham, United Kingdom; Orreco Ltd, National University of Ireland Business Innovation Centre, Galway, Ireland
| | - Charles R Pedlar
- School of Sport, Health and Applied Science, St Mary's University, Twickenham, United Kingdom; Orreco Ltd, National University of Ireland Business Innovation Centre, Galway, Ireland; Division of Surgery and Interventional Science, University College London, London, United Kingdom
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24
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Driscoll RL, McCarthy DG, Palmer MS, Spriet LL. Mild dehydration impaired intermittent sprint performance and thermoregulation in females. Appl Physiol Nutr Metab 2020; 45:1045-1048. [PMID: 32392422 DOI: 10.1139/apnm-2020-0040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The effects of mild dehydration during ice hockey are well-studied in males but not females. In a randomized, crossover design, 11 female varsity hockey players drank no fluid (1.7% ± 0.3% body mass loss) or water to maintain hydration during simulated-hockey exercise. Core temperature (P < 0.01) and perceived fatigue (P = 0.02) were higher and sprint power lower (P < 0.01) when mildly dehydrated. Thus, mild dehydration may impair hockey performance and thermoregulation while increasing perceived fatigue in females. Novelty Female stop-and-go sport athletes may benefit their in-game sprint performance and thermoregulation by following personalized in-game hydration to prevent becoming mildly dehydrated.
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Affiliation(s)
- Rachel L Driscoll
- Department of Psychology, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Devin G McCarthy
- Department of Kinesiology, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Matthew S Palmer
- Department of Human Kinetics, St. Francis Xavier University, Antigonish, NS B2G 2W5, Canada
| | - Lawrence L Spriet
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
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25
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Resistance Training and Skeletal Muscle Protein Metabolism in Eumenorrheic Females: Implications for Researchers and Practitioners. Sports Med 2020; 49:1637-1650. [PMID: 31190324 DOI: 10.1007/s40279-019-01132-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Resistance training is essential for health and performance and confers many benefits such as increasing skeletal muscle mass, increasing strength and power output, and improving metabolic health. Resistance training is a major component of the physical activity guidelines, yet research in female populations is limited. Recent increases in the promotion of, and the participation by, females in sport and exercise, highlight the need for an increase in understanding of evidence-based best practice exercise prescription for females. The aim of this review is to provide an overview of the current research regarding resistance training performance and skeletal muscle adaptation in females, with a focus on the hormonal variables that may influence resistance training outcomes. Findings suggest that the menstrual cycle phase may impact strength, but not skeletal muscle protein metabolism. In comparison, oral contraception use in females may reduce skeletal muscle protein synthesis, but not strength outcomes, when compared to non-users. Future research should investigate the role of resistance training in the maintenance of skeletal muscle protein metabolism during pregnancy, menopause and in athletes experiencing relative energy deficiency in sport. The review concludes with recommendations for researchers to assist them in the inclusion of female participants in resistance training research specifically, with commentary on the most appropriate methods of controlling for, or understanding the implications of, hormonal fluctuations. For practitioners, the current evidence suggests possible resistance training practices that could optimise performance outcomes in females, although further research is warranted.
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26
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Thompson B, Almarjawi A, Sculley D, Janse de Jonge X. The Effect of the Menstrual Cycle and Oral Contraceptives on Acute Responses and Chronic Adaptations to Resistance Training: A Systematic Review of the Literature. Sports Med 2020; 50:171-185. [PMID: 31677121 DOI: 10.1007/s40279-019-01219-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Resistance training is well known to increase strength and lean body mass, and plays a key role in many female athletic and recreational training programs. Most females train throughout their reproductive years when they are exposed to continuously changing female steroid hormone profiles due to the menstrual cycle or contraceptive use. Therefore, it is important to focus on how female hormones may affect resistance training responses. OBJECTIVE The aim of this systematic review is to identify and critically appraise current studies on the effect of the menstrual cycle and oral contraceptives on responses to resistance training. METHODS The electronic databases Embase, PubMed, SPORTDiscus and Web of Science were searched using a comprehensive list of relevant terms. Studies that investigated the effect of the menstrual cycle phase or oral contraceptive cycle on resistance training responses were included. Studies were also included if they compared resistance training responses between the natural menstrual cycle and oral contraceptive use, or if resistance training was adapted to the menstrual cycle phase or oral contraceptive phase. Studies were critically appraised with the McMasters Universities Critical Review Form for Quantitative Studies and relevant data were extracted. RESULTS Of 2007 articles found, 17 studies met the criteria and were included in this systematic review. The 17 included studies had a total of 418 participants with an age range of 18-38 years. One of the 17 studies found no significant differences in acute responses to a resistance training session over the natural menstrual cycle, while four studies did find changes. When assessing the differences in acute responses between the oral contraceptive and menstrual cycle groups, two studies reported oral contraceptives to have a positive influence, whilst four studies reported that oral contraceptive users had a delayed recovery, higher levels of markers of muscle damage, or both. For the responses to a resistance training program, three studies reported follicular phase-based training to be superior to luteal phase-based training or regular training, while one study reported no differences. In addition, one study reported no differences in strength development between oral contraceptive and menstrual cycle groups. One further study reported a greater increase in type I muscle fibre area and a trend toward a greater increase in muscle mass within low-androgenic oral contraceptive users compared with participants not taking hormonal contraceptives. Finally, one study investigated androgenicity of oral contraceptives and showed greater strength developments with high androgenic compared with anti-androgenic oral contraceptive use. CONCLUSIONS The reviewed articles reported conflicting findings, and were often limited by small participant numbers and methodological issues, but do appear to suggest female hormones may affect resistance training responses. The findings of this review highlight the need for further experimental studies on the effects of the menstrual cycle and oral contraceptives on acute and chronic responses to resistance training.
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Affiliation(s)
- Belinda Thompson
- School of Environmental and Life Sciences, Faculty of Science, The University of Newcastle, 10 Chittaway Road, PO Box 127, Ourimbah, NSW, 2258, Australia
| | - Ashley Almarjawi
- School of Environmental and Life Sciences, Faculty of Science, The University of Newcastle, 10 Chittaway Road, PO Box 127, Ourimbah, NSW, 2258, Australia
| | - Dean Sculley
- School of Environmental and Life Sciences, Faculty of Science, The University of Newcastle, 10 Chittaway Road, PO Box 127, Ourimbah, NSW, 2258, Australia
| | - Xanne Janse de Jonge
- School of Environmental and Life Sciences, Faculty of Science, The University of Newcastle, 10 Chittaway Road, PO Box 127, Ourimbah, NSW, 2258, Australia.
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27
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Barba-Moreno L, Cupeiro R, Romero-Parra N, Janse de Jonge XAK, Peinado AB. Cardiorespiratory Responses to Endurance Exercise Over the Menstrual Cycle and With Oral Contraceptive Use. J Strength Cond Res 2019; 36:392-399. [PMID: 31855928 DOI: 10.1519/jsc.0000000000003447] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Barba-Moreno, L, Cupeiro, R, Romero-Parra, N, Janse de Jonge, XA, and Peinado, AB. Cardiorespiratory Responses to Endurance Exercise Over the Menstrual Cycle and With Oral Contraceptive Use. J Strength Cond Res XX(X): 000-000, 2019-Female steroid hormone fluctuations during the menstrual cycle and exogenous hormones from oral contraceptives may have potential effects on exercise performance. The aim of this study was to investigate the effects of these fluctuations on cardiorespiratory responses during steady-state exercise in women. Twenty-three healthy endurance-trained women performed 40 minutes of running at 75% of their maximal aerobic speed during different phases of the menstrual cycle (n = 15; early follicular phase, midfollicular phase, and luteal phase) or oral contraceptive cycle (n = 8; hormonal phase and nonhormonal phase). Ventilatory parameters and heart rate (HR) were measured. Data were analyzed using a mixed linear model. For the eumenorrheic group, significantly higher oxygen uptake (p = 0.049) and percentage of maximum oxygen uptake (p = 0.035) were observed during the midfollicular phase compared with the early follicular. Heart rate (p = 0.004), oxygen ventilatory equivalent (p = 0.042), carbon dioxide ventilatory equivalent (p = 0.017), and tidal volume (p = 0.024) increased during luteal phase in comparison with midfollicular. In oral contraceptive users, ventilation (p = 0.030), breathing frequency (p = 0.018), oxygen ventilatory equivalent (p = 0.032), and carbon dioxide ventilatory equivalent (p = 0.001) increased during the hormonal phase. No significant differences were found for the rest of the parameters or phases. Both the eumenorrheic group and oral contraceptive group showed a significant increase in some ventilatory parameters during luteal and hormonal phases, respectively, suggesting lower cardiorespiratory efficiency. However, the lack of clinical meaningfulness of these differences and the nondifferences of other physiological variables, indicate that the menstrual cycle had a small impact on submaximal exercise in the current study.
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Affiliation(s)
- Laura Barba-Moreno
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science, Polytechnic University of Madrid, Madrid, Spain
| | - Rocío Cupeiro
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science, Polytechnic University of Madrid, Madrid, Spain
| | - Nuria Romero-Parra
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science, Polytechnic University of Madrid, Madrid, Spain
| | - Xanne A K Janse de Jonge
- School of Environmental and Life Sciences, Faculty of Science, The University of Newcastle, Callaghan, Australia
| | - Ana B Peinado
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science, Polytechnic University of Madrid, Madrid, Spain
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28
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Pettersson S, Edin F, Bakkman L, McGawley K. Effects of supplementing with an 18% carbohydrate-hydrogel drink versus a placebo during whole-body exercise in -5 °C with elite cross-country ski athletes: a crossover study. J Int Soc Sports Nutr 2019; 16:46. [PMID: 31655603 PMCID: PMC6815417 DOI: 10.1186/s12970-019-0317-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 10/03/2019] [Indexed: 12/02/2022] Open
Abstract
Background Whilst the ergogenic effects of carbohydrate intake during prolonged exercise are well-documented, few investigations have studied the effects of carbohydrate ingestion during cross-country skiing, a mode of exercise that presents unique metabolic demands on athletes due to the combined use of large upper- and lower-body muscle masses. Moreover, no previous studies have investigated exogenous carbohydrate oxidation rates during cross-country skiing. The current study investigated the effects of a 13C-enriched 18% multiple-transportable carbohydrate solution (1:0.8 maltodextrin:fructose) with additional gelling polysaccharides (CHO-HG) on substrate utilization and gastrointestinal symptoms during prolonged cross-country skiing exercise in the cold, and subsequent double-poling time-trial performance in ~ 20 °C. Methods Twelve elite cross-country ski athletes (6 females, 6 males) performed 120-min of submaximal roller-skiing (69.3 ± 2.9% of \documentclass[12pt]{minimal}
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\begin{document}$$ \dot{\mathrm{V}} $$\end{document}V˙O2peak) in −5 °C while receiving either 2.2 g CHO-HG·min− 1 or a non-caloric placebo administered in a double-blind, randomized manner. Whole-body substrate utilization and exogenous carbohydrate oxidation was calculated for the last 60 min of the submaximal exercise. The maximal time-trial (2000 m for females, 2400 m for males) immediately followed the 120-min submaximal bout. Repeated-measures ANOVAs with univariate follow-ups were conducted, as well as independent and paired t-tests, and significance was set at P < 0.05. Data are presented as mean ± SD. Results Exogenous carbohydrate oxidation contributed 27.6 ± 6.6% to the total energy yield with CHO-HG and the peak exogenous carbohydrate oxidation rate reached 1.33 ± 0.27 g·min− 1. Compared to placebo, fat oxidation decreased by 9.5 ± 4.8% with CHO-HG, total carbohydrate oxidation increased by 9.5 ± 4.8% and endogenous carbohydrate utilization decreased by 18.1 ± 6.4% (all P < 0.05). No severe gastrointestinal symptoms were reported in either trial and euhydration was maintained in both trials. Time-trial performance (8.4 ± 0.4 min) was not improved following CHO-HG compared to placebo (− 0.8 ± 3.5 s; 95% confidence interval − 3.0 to 1.5 s; P = 0.46). No sex differences were identified in substrate utilization or relative performance. Conclusions Ingestion of an 18% multiple-transportable carbohydrate solution with gelling polysaccharides was found to be well-tolerated during 120 min of submaximal whole-body exercise, but did not improve subsequent maximal double-poling performance.
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Affiliation(s)
- Stefan Pettersson
- Center for Health and Performance, Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden. .,Swedish Olympic Committee, Stockholm, Sweden.
| | - Fredrik Edin
- Center for Health and Performance, Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | | | - Kerry McGawley
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden
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29
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Yanovich R, Ketko I, Muginshtein-Simkovitch J, Yanovich E, Eliyahu U, Fleischmann C, Atias-Varon D, Waissengrin B, Makranz C, Heled Y. Physiological Differences Between Heat Tolerant and Heat Intolerant Young Healthy Women. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2019; 90:307-317. [PMID: 31169467 DOI: 10.1080/02701367.2019.1599799] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 03/22/2019] [Indexed: 06/09/2023]
Abstract
Purpose: Heat intolerance (HI) is determined in the Israel Defense Force according to a heat tolerance test (HTT) before returning to duty after an exertional heat stroke (EHS) event. Recently, increased numbers of female combatants resulted in an increased number of EHS cases among women and a higher percentage of heat intolerance (HI) individuals. We aimed to evaluate the differences between tolerance to heat among women performing an HTT in relation to their menstrual cycle phase. Method: Thirty-three female participants were sorted into two groups: HI and heat tolerant (HT) according to two HTTs performed during both the luteal and follicular phases of the menstrual cycle or while consuming and during a break from consuming contraceptives. Results: HT women had an 18% higher maximal oxygen uptake (p < .005, 95% CI [2.6,9.8]) and 1.2% lower skin temperature in the HTT at the during and follicular phases (p < .01, 95% CI [0.12,0.77]) and 1.7% lower at the off and luteal phases (p < .001, 95% CI [0.34,0.92]). The mean sweat rate was 14% lower among the HI group only at the HTT at the during and follicular phases (p < .05, 95% CI (3,88)]). Conclusion: We found that HT can be predicted using aerobic capacity and core body temperature. Moreover, during the luteal phase, women presented altered thermoregulation that decreased the probability of being HT. This emphasizes the importance of considering the HT/HI criteria in the HTT for women, according to their aerobic ability and menstrual-cycle phase.
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Affiliation(s)
- Ran Yanovich
- a Sheba Medical Center
- b IDF Medical Corps
- c Wingate College of Physical Education and Sport Sciences
| | - Itay Ketko
- a Sheba Medical Center
- b IDF Medical Corps
| | | | - Einat Yanovich
- c Wingate College of Physical Education and Sport Sciences
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30
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Taylor BA, Parducci PM, Zaleski AL, Panza GA, Pescatello LS, Thompson PD. Venous thromboemboli associated with acute aerobic exercise: A review of case report commonalities. Scand J Med Sci Sports 2019; 29:1749-1754. [PMID: 31241786 DOI: 10.1111/sms.13505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 06/03/2019] [Accepted: 06/18/2019] [Indexed: 12/31/2022]
Abstract
Venous thromboembolic (VTE) events such as deep vein thrombosis (DVT) and pulmonary embolism (PE) have been reported in otherwise low-risk healthy athletes following acute bouts of aerobic exercise. PURPOSE To review case reports and assess the commonalities of athletic individuals with VTE, as well as return-to-play (RTP) recommendations. METHODS We reviewed 47 reports (20 DVTs, 15 PEs, and 12 DVTs/PEs, 19 women) of trained individuals who were diagnosed with DVT and/or PE following aerobic exercise. We assessed frequency of VTE risk factors, presenting symptoms, and RTP recommendations. RESULTS The age of women (24.6 ± 7.0 years) was lower (P < .01) than of men (40.6 ± 13.6 years). Of the 19 women, 14 (73.7%) used oral contraceptives. Thirteen cases (27.7%) reported a recent period of prolonged inactivity (>1 hour), and another 12 cases were found to have an antithrombin disorder following testing after diagnosis. The most frequently reported symptoms were muscle pain in 26 of 32 (81.3%) DVT or DVT/PE cases, and dyspnea in 21 of 27 (77.8%) PE or DVT/PE cases. Despite these common symptoms, the estimated time from first report of symptoms to confirmed diagnosis was 56.3 ± 118.7 days and 25 cases (53.2%) were initially misdiagnosed. Twenty-three cases (48.9%) did not report RTP recommendations, and those which did varied widely. CONCLUSIONS Thirty-two cases (~70%) had at least one of three major risk factors, suggesting that many cases of VTE in athletes may be preventable with better education and awareness. The wide variety of RTP recommendations highlights the need for standardized guidelines in this population.
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Affiliation(s)
- Beth A Taylor
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut.,Department of Preventive Cardiology, Hartford Hospital, Hartford, Connecticut
| | - Paul M Parducci
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
| | - Amanda L Zaleski
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut.,Department of Preventive Cardiology, Hartford Hospital, Hartford, Connecticut
| | - Gregory A Panza
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut.,Department of Preventive Cardiology, Hartford Hospital, Hartford, Connecticut
| | - Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
| | - Paul D Thompson
- Department of Preventive Cardiology, Hartford Hospital, Hartford, Connecticut
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31
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Dalgaard LB, Dalgas U, Andersen JL, Rossen NB, Møller AB, Stødkilde-Jørgensen H, Jørgensen JO, Kovanen V, Couppé C, Langberg H, Kjær M, Hansen M. Influence of Oral Contraceptive Use on Adaptations to Resistance Training. Front Physiol 2019; 10:824. [PMID: 31312144 PMCID: PMC6614284 DOI: 10.3389/fphys.2019.00824] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 06/12/2019] [Indexed: 02/01/2023] Open
Abstract
Introduction: The majority of young women use oral contraceptives (OCs). Use of OCs has been associated with lower myofibrillar protein and tendon collagen synthesis rates, but it is unknown whether OCs will limit the adaptive response of myotendinous tissue to resistance training. Design and Methods: Fourteen healthy untrained young regular OC users (24 ± 1 years, fat% 32 ± 1, 35 ± 2 ml⋅min-1⋅kg-1) and 14 NOC users (non-OC, controls) (24 ± 1 years, fat% 32 ± 2, 34 ± 2 ml⋅min-1⋅kg-1) performed a 10-week supervised lower extremity progressive resistance training program. Before and after the intervention biopsies from the vastus lateralis muscle and the patellar tendon were obtained. Muscle (quadriceps) and tendon cross-sectional area (CSA) was determined by magnetic resonance imaging (MRI) scans, and muscle fiber CSA was determined by histochemistry. Maximal isometric knee extension strength was assessed by dynamometry while 1 repetition maximum (RM) was determined during knee extension. Results: Training enhanced CSA in both muscle (p < 0.001) and tendon (p < 0.01). A trend toward a greater increase in muscle CSA was observed for OC (11%) compared to NOC (8%) (interaction p = 0.06). Analysis of mean muscle fiber type CSA showed a trend toward an increase in type II muscle fiber area in both groups (p = 0.11, interaction p = 0.98), whereas type I muscle fiber CSA increased in the OC group (n = 9, 3821 ± 197 to 4490 ± 313 mm2, p < 0.05), but not in NOC (n = 7, 4020 ± 348 to 3777 ± 354 mm2, p = 0.40) (interaction p < 0.05). Post hoc analyses indicated that the effect of OCs on muscle mass increase was induced by the OC-users (n = 7), who used OCs containing 30 μg ethinyl estradiol (EE), whereas the response in users taking OCs with 20 μg EE (n = 7) did not differ from NOC. Both the OC and NOC group experienced an increase in maximal knee strength (p < 0.001) and 1RM leg extension (p < 0.001) after the training period with no difference between groups. Conclusion: Use of OCs during a 10-week supervised progressive resistance training program was associated with a trend toward a greater increase in muscle mass and a significantly greater increase in type I muscle fiber area compared to controls. Yet, use of OCs did not influence the overall increase in muscle strength related to training.
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Affiliation(s)
- Line B Dalgaard
- Section of Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Ulrik Dalgas
- Section of Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Jesper L Andersen
- Department of Orthopedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Institute of Sports Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nicklas B Rossen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.,Department of Endocrinology and Internal Medicine, Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark
| | | | | | - Jens Otto Jørgensen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.,Department of Endocrinology and Internal Medicine, Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark
| | - Vuokko Kovanen
- Faculty of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Christian Couppé
- Department of Orthopedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Institute of Sports Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henning Langberg
- Department of Orthopedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Institute of Sports Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.,CopenRehab, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Michael Kjær
- Department of Orthopedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Institute of Sports Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Hansen
- Section of Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark.,Department of Orthopedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Institute of Sports Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Cauci S, Francescato MP, Curcio F. Combined Oral Contraceptives Increase High-Sensitivity C-Reactive Protein but Not Haptoglobin in Female Athletes. Sports Med 2018; 47:175-185. [PMID: 27084393 DOI: 10.1007/s40279-016-0534-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND No studies have examined the effects of oral hormonal contraception on chronic low-grade inflammation as assessed by stratified levels of high-sensitivity C-reactive protein (hsCRP) in athletes. We explored the impact of combined oral contraceptives (OCs) on serum hsCRP, haptoglobin, triglycerides and cholesterol in white female athletes. METHODS Italian sportswomen (n = 205; mean age 24 ± 5.3 years; body mass index 21 ± 2.2 kg m-2; sport activity 8.7 ± 3.65 h week-1) were analyzed according to OC use. RESULTS Progressive hsCRP levels were evaluated in OC users (n = 53) compared to non-OC users (n = 152). Levels of hsCRP from 3.0 to <10.0 mg L-1 (at high risk of future cardiovascular events) were found in 26.4 % (14/53) of OC users and only in 2.6 % (4/153) of non-OC users (OR = 13.3, 95 % CI 4.14-42.6, P < 0.001). Risky hsCRP levels ≥1.0 mg L-1 were found in 62.3 % of OC users versus 13.2 % non-OC users (OR = 10.9, 95 % CI 5.26-22.5, P < 0.001). Protective hsCRP levels (<0.5 mg L-1) were found in 17.0 % of OC users and in 64.5 % of non-OC users (OR = 0.11, 95 % CI 0.05-0.25, P < 0.001). OC use increased serum triglycerides (P < 0.001), total cholesterol (P = 0.027) and HDL cholesterol (P = 0.018), whereas haptoglobin was unaffected. Hours of exercise week-1 had a mild inverse association with hsCRP (P = 0.048) in non-OC users only. CONCLUSIONS OC use markedly elevated chronic low-grade inflammation in athletes, which could predispose to a higher inflammatory response to physical stress and elevate cardiovascular risk. Physical activity without OC use seemed to favor low hsCRP. Further research is needed to extend our results and to elucidate the potential effects on athletic performance of chronically elevated hsCRP. Our findings would be useful for sport physicians interpreting blood tests in athletes.
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Affiliation(s)
- Sabina Cauci
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Piazzale Kolbe 4, Udine, 33100, Italy.
| | - Maria Pia Francescato
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Piazzale Kolbe 4, Udine, 33100, Italy
| | - Francesco Curcio
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Piazzale Kolbe 4, Udine, 33100, Italy.,Clinical Analysis Laboratory, Department of Laboratory Medicine, Institute of Clinical Pathology, Santa Maria della Misericordia University-Hospital, Udine, 33100, Italy
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Response of women using oral contraception to exercise in the heat. Eur J Appl Physiol 2017; 117:1383-1391. [PMID: 28477076 DOI: 10.1007/s00421-017-3628-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 04/28/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To compare the response of long-term oral contraceptive users (WomenOC; n = 8) to naturally menstruating women (WomenNM; n = 8) at rest and during exercise in temperate (TEMP; 22 °C) and hot (HEAT; 35 °C) conditions. METHODS Participants performed a three-stage cycling trial in each condition at 90, 135, and 180% of lactate threshold 1 (total = 52.5 min). Heart rate (HR) and core temperature (T c) were recorded continuously, whereas blood pressure (BP), ratings of perceived exertion (RPE), blood lactate [La-], and skin blood flow (BFsk) were recorded every 7.5 min. RESULTS Baseline T c was higher in WomenOC (37.5 ± 0.2, 37.6 ± 0.3 °C) than WomenNM (37.2 ± 0.2, 37.0 ± 0.4 °C) before the TEMP (p = 0.03) and HEAT (p < 0.01) trials, respectively. This difference remained for 22.5 min into both trials (p ≤ 0.05), after which time no between-group differences were found (p > 0.05). BFsk measured in WomenNM plateaued from 7.5 min in the HEAT, whereas BFsk measured in WomenOC increased for 15.0 min (p = 0.02) before plateauing. There were no between-group differences in HR, BP, or blood [La-] before or throughout either trial (p > 0.05). WomenOC had higher (p ≤ 0.04) RPE values than WomenNM in the HEAT, reporting 8 ± 1 and 6 ± 2 at the end of Stage 3, respectively. CONCLUSIONS WomenOC concluded both trials with a comparable T c to WomenNM, but had a prolonged BFsk response and elevated RPE in the HEAT. Changes to BFsk and RPE observed in women using OC may have implications for exercise tolerance in hot conditions.
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Cauci S, Buligan C, Marangone M, Francescato MP. Oxidative Stress in Female Athletes Using Combined Oral Contraceptives. SPORTS MEDICINE-OPEN 2016; 2:40. [PMID: 27747795 PMCID: PMC5031583 DOI: 10.1186/s40798-016-0064-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 09/13/2016] [Indexed: 12/21/2022]
Abstract
Background Oxidative stress in female athletes is understudied. We investigated oxidative stress in sportswomen of different disciplines according to combined oral contraceptive (OC) use and lifestyle/alimentary habits. Methods Italian sportswomen (n = 144; mean age 23.4 ± 4.2 years; body mass index 21.2 ± 2.2 kg m−2; sport activity 9.2 ± 4.1 h week−1) were analyzed; 48 % were volleyball players, 12.5 % soccer players, 10.4 % track-and-field sports, and followed by other disciplines’ athletes. Oxidative stress was evaluated by free oxygen radical test (FORT) assessing blood hydroperoxides and free oxygen radical defense (FORD) assay evaluating antioxidant capacity in OC users (n = 42) compared to non-OC users. Results Elevated oxidative stress levels (≥310 FORT units) were found in 92.9 % of OC users and in 23.5 % of non-OC users (crude OR = 42, 95 % CI 12–149, p < 0.001; adjusted OR = 60, 95 % CI 11–322, p < 0.001). Continuous values of hydroperoxides were twofold higher in OC users versus non-OC users (median 484 versus 270 FORT units, p < 0.001) and were inversely related to FORD units in OC users (p = 0.01). Hydroperoxides were not associated with weekly hours of exercise. In OC users, lifestyle/alimentary habits were not correlated to hydroperoxides. In non-OC users only, hydroperoxide values were positively correlated with weight and BMI and inversely correlated with chocolate and fish consumption. Conclusions The markedly elevated oxidative stress we revealed in OC-user athletes could be detrimental to physical activity and elevate cardiovascular risk (as thromboembolism). Further research is needed to extend our results, to clarify the biochemical pathways leading to increased hydroperoxides (mainly lipid peroxides) and reduced antioxidant defense, and to elucidate the potential effects on athletic performance. OC use should be considered when developing gender-focused strategies against oxidative stress.
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Affiliation(s)
- Sabina Cauci
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Piazzale Kolbe 4, Udine, 33100, Italy.
| | - Cinzia Buligan
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Piazzale Kolbe 4, Udine, 33100, Italy
| | - Micaela Marangone
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Piazzale Kolbe 4, Udine, 33100, Italy
| | - Maria Pia Francescato
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Piazzale Kolbe 4, Udine, 33100, Italy
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Shultz SJ, Schmitz RJ, Benjaminse A, Collins M, Ford K, Kulas AS. ACL Research Retreat VII: An Update on Anterior Cruciate Ligament Injury Risk Factor Identification, Screening, and Prevention. J Athl Train 2015; 50:1076-93. [PMID: 26340613 PMCID: PMC4641546 DOI: 10.4085/1062-6050-50.10.06] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Sandra J. Shultz
- Department of Kinesiology, University of North Carolina at Greensboro
| | - Randy J. Schmitz
- Department of Kinesiology, University of North Carolina at Greensboro
| | - Anne Benjaminse
- The Department of Human Movement Sciences, University of Groningen, and The School of Sports Studies, Hanze University, Groningen, The Netherlands
| | - Malcolm Collins
- Department of Human Biology, University of Cape Town, South Africa
| | - Kevin Ford
- Human Biomechanics and Physiology Laboratory, Department of Physical Therapy, High Point University, NC
| | - Anthony S. Kulas
- Department of Health Education and Promotion, Eastern Carolina University, Greenville, NC
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Hayashida H, Dolan NJ, Hounsome C, Alajmi N, Bishop NC. Salivary SIgA responses to acute moderate-vigorous exercise in monophasic oral contraceptive users. Appl Physiol Nutr Metab 2015; 40:863-7. [PMID: 26300012 DOI: 10.1139/apnm-2014-0468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to examine the effect of oral contraceptive (OC) use on salivary secretory immunoglobulin A (SIgA) levels at rest and in response to an acute bout of moderate-vigorous exercise during 2 phases of the 4-week OC cycle corresponding to different phases of the synthetic menstrual cycle. Ten healthy active females completed a cycling at 70% peak oxygen uptake for 45 min at 2 time points of an OC cycle: during the equivalent in time to the mid-follicular phase (day 8 ± 2) and the mid-luteal phase (day 20 ± 2). Timed unstimulated saliva samples were obtained before, immediately postexercise, and 1 h postexercise and analyzed for salivary SIgA. Salivary SIgA secretion rate was 26% (95% confidence limits (CI) 6-46) lower at postexercise compared with pre-exercise during the synthetic follicular phase (p = 0.019) but no differences were observed during the synthetic luteal trial. Saliva flow rate was 11% (95% CI, 8-30) lower at postexercise compared with pre-exercise (main effect for time; p = 0.025). In conclusion, the pattern of salivary SIgA secretion rate response to moderate-vigorous exercise varies across the early and late phases of a monophasic OC cycle, with a transient reduction in salivary SIgA responses during the synthetic follicular phase. These findings indicate that monophasic OC use should be considered when assessing mucosal immune responses to acute exercise.
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Affiliation(s)
- Harumi Hayashida
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Nicola J Dolan
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Charlotte Hounsome
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Nawal Alajmi
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Nicolette C Bishop
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Casto KV, Edwards DA. Before, During, and After: How Phases of Competition Differentially Affect Testosterone, Cortisol, and Estradiol Levels in Women Athletes. ADAPTIVE HUMAN BEHAVIOR AND PHYSIOLOGY 2015. [DOI: 10.1007/s40750-015-0028-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Deldicque L, Francaux M. Recommendations for Healthy Nutrition in Female Endurance Runners: An Update. Front Nutr 2015; 2:17. [PMID: 26075206 PMCID: PMC4443719 DOI: 10.3389/fnut.2015.00017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 05/12/2015] [Indexed: 01/01/2023] Open
Abstract
The purpose of this review is to present the basic principles of a healthy nutrition in female endurance runner enriched by the latest scientific recommendations. Female endurance runners are a specific population of athletes who need to take specifically care of daily nutrition due to the high load of training and the necessity to keep a rather low body mass. This paradoxical situation can create some nutritional imbalances and deficiencies. Female endurance athletes should pay attention to their total energy intake, which is often lower than their energy requirement. The minimal energy requirement has been set to 45 kcal/kg fat free mass/day plus the amount of energy needed for physical activity. The usual recommended amount of 1.2–1.4 g protein/kg/day has recently been questioned by new findings suggesting that 1.6 g/kg/day would be more appropriate for female athletes. Although a bit less sensitive to carbohydrate loading than their male counterparts, female athletes can benefit from this nutritional strategy before a race if the amount of carbohydrates reaches 8 g/kg/day and if their daily total energy intake is sufficient. A poor iron status is a common issue in female endurance runners but iron-enriched food as well as iron supplementation may help to counterbalance this poor status. Finally, they should also be aware that they may be at risk for low calcium and vitamin D levels.
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Affiliation(s)
- Louise Deldicque
- Exercise Physiology Research Group, Department of Kinesiology, Faber, KU Leuven , Leuven , Belgium
| | - Marc Francaux
- Institute of Neuroscience, Université catholique de Louvain , Louvain-la-Neuve , Belgium
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Rahr-Wagner L, Thillemann TM, Mehnert F, Pedersen AB, Lind M. Is the use of oral contraceptives associated with operatively treated anterior cruciate ligament injury? A case-control study from the Danish Knee Ligament Reconstruction Registry. Am J Sports Med 2014; 42:2897-905. [PMID: 25428957 DOI: 10.1177/0363546514557240] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The incidence of anterior cruciate ligament (ACL) injuries is 2 to 9 times higher in women than in men. In addition, in vitro studies have demonstrated that ACL is an estrogen target tissue, and some studies have therefore suggested a protective association between oral contraceptives (OC) and the likelihood of sustaining ACL injury. HYPOTHESIS There is a protective association between OC use and the likelihood of operatively treated ACL injury. STUDY DESIGN Case-control study; Level of evidence, 3. METHODS The study population included 4497 women with an operatively treated ACL injury registered in the Danish Knee Ligament Reconstruction Registry for the 2005 to 2011 period and 8858 age-matched controls with no ACL injury. The study evaluated exposure to OC use at the time of ACL injury (index date) and in the 5 previous years ("ever user") or no OC use ("never user"). Ever users were further classified as either new users (patients who redeemed their first prescription within the first year before the index date), long-term users (redeemed additional prescriptions 1 to 5 years before the index date), or recent users (redeemed their most recent prescription >1 year before the index date). Finally, a dose-response analysis of OC use was performed. Conditional logistic regression was used to calculate the relative risk (RR) with a 95% CI of sustaining an operatively treated ACL injury according to OC use. RESULTS The adjusted RR associating OC with ACL injury was 0.82 (95% CI, 0.75-0.90) between ever users and never users. Furthermore, there was a decreased RR of sustaining ACL injury of 0.80 (95% CI, 0.74-0.91) in long-term users and 0.81 (95% CI, 0.72-0.89) in recent users. Using OC for more than 4 years did not seem to alter the likelihood of sustaining an operatively treated ACL injury. CONCLUSION This population-based pharmacoepidemiological study including 13,355 women indicates that a protective association exists between OC use and the likelihood of sustaining an operatively treated ACL injury. Although this study does indicate a protective association of OC use, OC should not be used as a prophylactic measure before additional clinical studies have further clarified the biological and causal association between OC use and the likelihood of sustaining operatively treated ACL injury.
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Affiliation(s)
- Lene Rahr-Wagner
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark Division of Sports Trauma, Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | | | - Frank Mehnert
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Alma Becic Pedersen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Martin Lind
- Division of Sports Trauma, Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
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Lundsgaard AM, Kiens B. Gender differences in skeletal muscle substrate metabolism - molecular mechanisms and insulin sensitivity. Front Endocrinol (Lausanne) 2014; 5:195. [PMID: 25431568 PMCID: PMC4230199 DOI: 10.3389/fendo.2014.00195] [Citation(s) in RCA: 162] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 10/30/2014] [Indexed: 12/23/2022] Open
Abstract
It has become increasingly apparent that substrate metabolism is subject to gender-specific regulation, and the aim of this review is to outline the available evidence of molecular gender differences in glucose and lipid metabolism of skeletal muscle. Female sex has been suggested to have a favorable effect on glucose homeostasis, and the available evidence from hyperinsulinemic-euglycemic clamp studies is summarized to delineate whether there is a gender difference in whole-body insulin sensitivity and in particular insulin-stimulated glucose uptake of skeletal muscle. Whether an eventual higher insulin sensitivity of female skeletal muscle can be related to gender-specific regulation of molecular metabolism will be topic for discussion. Gender differences in muscle fiber type distribution and substrate availability to and in skeletal muscle are highly relevant for substrate metabolism in men and women. In particular, the molecular machinery for glucose and fatty acid oxidative and storage capacities in skeletal muscle and its implications for substrate utilization during metabolic situations of daily living are discussed, emphasizing their relevance for substrate choice in the fed and fasted state, and during periods of physical activity and recovery. Together, handling of carbohydrate and lipids and regulation of their utilization in skeletal muscle have implications for whole-body glucose homeostasis in men and women. 17-β estradiol is the most important female sex hormone, and the identification of estradiol receptors in skeletal muscle has opened for a role in regulation of substrate metabolism. Also, higher levels of circulating adipokines as adiponectin and leptin in women and their implications for muscle metabolism will be considered.
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Affiliation(s)
- Anne-Marie Lundsgaard
- Section of Molecular Physiology, Department of Nutrition, Exercise and Sports, August Krogh Centre, University of Copenhagen, Copenhagen, Denmark
| | - Bente Kiens
- Section of Molecular Physiology, Department of Nutrition, Exercise and Sports, August Krogh Centre, University of Copenhagen, Copenhagen, Denmark
- *Correspondence: Bente Kiens, Section of Molecular Physiology, Department of Nutrition, Exercise and Sports, August Krogh Centre, University of Copenhagen, Universitetsparken 13, Copenhagen 2100, Denmark e-mail:
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Elliott-Sale KJ, Smith S, Bacon J, Clayton D, McPhilimey M, Goutianos G, Hampson J, Sale C. Examining the role of oral contraceptive users as an experimental and/or control group in athletic performance studies. Contraception 2013; 88:408-12. [DOI: 10.1016/j.contraception.2012.11.023] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 11/30/2012] [Accepted: 11/30/2012] [Indexed: 11/30/2022]
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Joyce S, Sabapathy S, Bulmer A, Minahan C. Effect of Long-Term Oral Contraceptive Use on Determinants of Endurance Performance. J Strength Cond Res 2013; 27:1891-6. [DOI: 10.1519/jsc.0b013e3182736935] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Shultz SJ, Schmitz RJ, Benjaminse A, Chaudhari AM, Collins M, Padua DA. ACL Research Retreat VI: an update on ACL injury risk and prevention. J Athl Train 2013; 47:591-603. [PMID: 23068597 DOI: 10.4085/1062-6050-47.5.13] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Sandra J Shultz
- Applied Neuromechanics Research Laboratory, University of North Carolina at Greensboro, Greensboro, NC, USA.
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Landesberg WH. Pulmonary embolism in a female collegiate cross-country runner presenting as nonspecific back pain. J Chiropr Med 2013; 11:215-20. [PMID: 23449383 DOI: 10.1016/j.jcm.2011.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Revised: 06/21/2011] [Accepted: 08/17/2011] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE The purpose of this case report is to describe a female athlete with back and right scapular pain due to pulmonary embolism. CLINICAL FEATURES A 20-year-old female collegiate cross-country runner presented to a chiropractic clinic with pain in the right scapular area that was severe, stabbing, and worsened with respiration. She had a cough and experienced difficulty lying on her right side. She had an elevated d-dimer. Chest radiograph demonstrated pleural effusion, prompting a thoracic computed tomographic angiogram that showed a large right lower lobe embolus and pulmonary infarct. INTERVENTION AND OUTCOME The patient was hospitalized, prescribed anticoagulant therapy, and monitored for 6 months. She was able to return to competitive running 8 months later. CONCLUSION This case raises awareness of the occurrence of birth control medication for the purpose of enhanced performance in female athletes and the associated risks of using this medication for enhanced performance.
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Shultz SJ, Wideman L, Montgomery MM, Beasley KN, Nindl BC. Changes in serum collagen markers, IGF-I, and knee joint laxity across the menstrual cycle. J Orthop Res 2012; 30:1405-12. [PMID: 22389002 PMCID: PMC3371148 DOI: 10.1002/jor.22093] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Accepted: 02/02/2012] [Indexed: 02/04/2023]
Abstract
Variations in serum markers of collagen production (CICP) and degradation (ICTP), insulin-like growth factor I (IGF-I) and anterior knee laxity (AKL) were measured in 20 women [10 with spontaneous cycles (eumenorrheic), 10 using oral contraceptives] over 5 consecutive days at menses (M1-M5, 1st pill week), the initial estrogen rise near ovulation (O1-O5, 2nd pill week), the initial progesterone rise of the early luteal phase (EL1-EL5, 3rd pill week) and post-progesterone peak of the late luteal phase (LL1-LL5, 4th pill week). ICTP was higher in oral contraceptive women (5.3 ± 1.7 vs. 3.7 ± 1.3 µg/L; p = 0.030), primarily during days near ovulation and the early luteal phase when concentrations decreased in eumenorrheic women (p = 0.04). IGF-I concentrations increased during menses then decreased and remained lower during the early and late luteal phase in oral contraceptive women, resulting in lower concentrations compared to eumenorrheic women at EL2 and LL1 (p = 0.03). CICP decreased in early and late luteal days (p <0.01), and there was a trend toward lower concentrations in eumenorrheic versus oral contraceptive women (85.7 ± 35.7 ng/ml vs. 123.2 ± 49.8 ng/ml; p = 0.07). Lower CICP and greater IGF-I concentrations predicted greater AKL across the 20 cycle days in both groups (R(2) = 0.310 and 0.400). Sex hormone concentration changes across the menstrual cycle are of sufficient magnitude to influence collagen metabolism, and may indirectly influence knee structure and function.
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Affiliation(s)
| | | | | | - Kathleen N. Beasley
- Military Performance Division, The U.S. Army Research Institute of Environmental Medicine
| | - Bradley C. Nindl
- Military Performance Division, The U.S. Army Research Institute of Environmental Medicine
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Rechichi C, Dawson B. Oral contraceptive cycle phase does not affect 200-m swim time trial performance. J Strength Cond Res 2012; 26:961-7. [PMID: 22446669 DOI: 10.1519/jsc.0b013e31822dfb8b] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The purpose of this study was to examine whether swimming performance was affected by acute hormonal fluctuation within a monophasic oral contraceptive (OC) cycle. Six competitive swimmers and water polo players completed a 200-m time trial at 3 time points of a single OC cycle: during the consumption phase (CONS), early (WITH1), and late in the withdrawal phase (WITH2). Split times and stroke rate were recorded during the time trial, and heart rate, blood lactate, glucose, and pH were measured after each performance test. Resting endogenous serum estradiol and progesterone concentrations were also assessed. No significant differences were observed between phases for body composition, 200-m swim time, mean stroke rate, peak heart rate, or blood glucose (p > 0.05). The mean peak blood lactate was significantly lower during WITH2 (9.9 ± 3.0 mmol·L(-1)) compared with that of CONS (12.5 ± 3.0 mmol·L(-1)) and mean pH higher during WITH2 (7.183 ± 0.111) compared with that of CONS (7.144 ± 0.092). Serum estradiol levels were significantly greater during WITH2 compared with that during WITH1 and CONS, but there was no difference in serum progesterone levels. These results demonstrate that for monophasic OC users, cycle phase does not impact the 200-m swimming performance. There was a reduction in blood lactate and an increase in pH during the withdrawal phase, possibly because of an increase in fluid retention, plasma volume, and cellular alkalosis. Therefore, female 200-m swimmers taking a monophasic OC need not be concerned by the phase of their cycle with regard to competition and optimizing performance. However, coaches and scientists should exercise caution when interpreting blood lactate results obtained from swimming tests and consider controlling for cycle phase for athletes taking an OC.
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Affiliation(s)
- Claire Rechichi
- School of Sports Science, Exercise and Health, The University of Western Australia, Crawley, Australia.
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Isacco L, Duché P, Boisseau N. Influence of hormonal status on substrate utilization at rest and during exercise in the female population. Sports Med 2012; 42:327-42. [PMID: 22380007 DOI: 10.2165/11598900-000000000-00000] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
During exercise, substrate utilization plays a major role in performance and disease prevention. The contribution of fat and carbohydrates to energy expenditure during exercise is modulated by several factors, including intensity and duration of exercise, age, training and diet, but also gender. Because sex hormone levels change throughout a woman's lifetime (in connection with puberty, the menstrual cycle, use of oral contraceptives and menopause), the female population has to be considered specifically in terms of substrate utilization, and metabolic and hormonal responses to exercise. Before puberty, there is no difference between males and females when it comes to substrate oxidation during exercise. This is not the case during adulthood, since women are known to rely more on fat than men for the same relative intensity of exercise. Among adult women, the menstrual cycle and use of oral contraceptives may influence substrate oxidation. While some authors have noted that the luteal phase of the menstrual cycle is connected with greater lipid oxidation, compared with the follicular stage, other authors have found no difference. Among oral contraceptive users, fat oxidation is sometimes increased during prolonged exercise with a concomitant rise in lipolytic hormones, as well as growth hormone. If this result is not always observed, the type of oral contraceptive (monophasic vs triphasic) and hormone doses may be implicated. Menopause represents a hormonal transition in a woman's life, leading to a decline in ovarian hormone production. A decrease in fat oxidation is consequently observed, and some studies have demonstrated a similar respiratory exchange ratio during prolonged exercise in postmenopausal women and in men. As is the case during puberty, no sex difference should thus appear after menopause in the absence of hormonal replacement therapy (HRT). Results concerning women who take HRT remain conflicting. HRT may act on fat loss by increasing lipid metabolism, but this depends on how the treatment is administered (orally vs transdermally). To better understand the role of ovarian hormones in substrate oxidation, studies have made use of animal protocols to investigate cellular mechanisms. Estradiol and progesterone seem to have opposite effects, with greater lipid oxidation when estradiol is used alone. However, the concentrations used (physiological levels or pharmacological doses) may considerably modify fuel selection. In cases where conflicting data are observed in studies of substrate utilization and prolonged exercise in women, methodological reasons must be called into question. Too many parameters, which oftentimes are not specified, may modulate substrate utilization and metabolic and hormonal responses to prolonged exercise. Although information is generally provided about the type of exercise, its duration and the subjects' training level, detailed information is not always given about the subjects' nutritional state and, more specifically, the hormonal status of female subjects. The primary purpose of this review was to identify the impact of hormonal status on substrate oxidation among female subjects at rest and during exercise. A second aim was to describe gender differences in substrate utilization during exercise.
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Affiliation(s)
- Laurie Isacco
- Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions, Clermont University, Blaise Pascal University, Aubière, France
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Isacco L, Thivel D, Pelle AM, Zouhal H, Duclos M, Duche P, Boisseau N. Oral contraception and energy intake in women: impact on substrate oxidation during exercise. Appl Physiol Nutr Metab 2012; 37:646-56. [PMID: 22607658 DOI: 10.1139/h2012-031] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Oral contraception (OC) and energy intake may play a role in fuel selection during exercise. The aim of this study was to investigate the effect of OCs (OC+ vs. OC-) in fed and fasting conditions on substrate oxidation and metabolic and hormonal responses in women during exercise. Substrate oxidation (respiratory exchange ratio and lipid and carbohydrates oxidation rates), metabolic (glycerol, free fatty acids (FFA), and glucose), and hormonal (insulin, adrenaline, and noradrenaline) responses were determined in 21 women: 10 regularly menstruating women (OC-) and 11 women using OCs (OC+: low-dose monophasic pill; ethinyl estradiol ≤ 30 µg) during 45 min at 65% of maximal oxygen consumption in fasting and postprandial states. At rest, OC+ presented higher low-density lipoprotein cholesterol, total cholesterol, and triglyceride plasma concentrations as compared with OC-. OC status had no influence on substrate oxidation and metabolic and hormonal responses during exercise. In the fasting state, whatever the OC status, women exhibited greater reliance on fat than in postprandial condition. This occurred in the presence of lower plasma insulin concentrations and higher plasma FFA and glycerol levels. The results indicated that the use of low-dose monophasic combined with OCs did not modify fuel selection and metabolic and hormonal responses during exercise in women. The fasting condition, compared with the fed condition, decreased carbohydrate oxidation during exercise, leading to a greater lipid mobilization and utilization whatever the OC status. Thus, in women, the realization of an exercise in either the fed or fasting conditions had a greater impact on substrate oxidation than OC status.
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Affiliation(s)
- Laurie Isacco
- Clermont Université, Université Blaise Pascal, Clermont-Ferrand, France
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Oosthuyse T, Bosch AN. Oestrogen's regulation of fat metabolism during exercise and gender specific effects. Curr Opin Pharmacol 2012; 12:363-71. [PMID: 22398320 DOI: 10.1016/j.coph.2012.02.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 02/03/2012] [Accepted: 02/13/2012] [Indexed: 12/01/2022]
Abstract
Early animal, menstrual phase and gender comparative studies inconsistently support an oestrogen-induced increase in fat oxidation during exercise. Recent advances from studies of cellular signalling and gene expression provide evidence for inter-tissue and intramuscular mechanisms that demonstrate oestrogen's promotion of skeletal muscle fat oxidative capacity. Oestrogen or oestrogen-analogues act mainly through oestrogen receptor-alpha in skeletal muscle to stimulate the genomic expression of certain other nuclear hormone receptors and downstream targets to promote long chain fatty acid (LCFA) uptake, mitochondrial shuttling and β oxidation. Oestrogen increases the availability of LCFA substrate by enhancing adipocyte lipolysis and expression of genes promoting intramyocellular lipid storage. Oestrogen acts by non-genomic means to increase the activation of AMPK that may reinforce some direct genomic actions.
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Affiliation(s)
- Tanja Oosthuyse
- Exercise Laboratory, School of Physiology, Faculty of Health Science, University of Witwatersrand, Medical School, Johannesburg, South Africa.
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