Circulating androgens in women: exercise-induced changes

Sleep duration has a limited impact on the prevalence of menstrual irregularities in athletes: a cross-sectional study

Background

This study aimed to investigate the relationship between the prevalence of menstrual irregularities, energy intake, and sleep deprivation among female athletes.

Methods

A total of 128 female athletes, with an average age of 19.2 ± 1.2 years, participated in the study and tracked their food intake over a three-day period. Menstrual status and sleep duration were assessed using a questionnaire, and psychological anxiety was evaluated using the State and Trait Anxiety Inventory (STAI). These were measured once during the investigation. The impact of sleep status on state anxiety and daily energy intake was examined using the T-test. A generalized linear model (GLM) with a log link function was employed to investigate the effects of sleep deprivation on the presence of menstrual irregularities.

Results

As the results of the present study, sleep deprivation significant increased both state and trait anxiety (p < 0.05), as well as affecting energy intake (p < 0.05), particularly protein and carbohydrate intakes (p < 0.05). However, GLM analysis indicated that while sleep deprivation did not directly influence the prevalence of menstrual irregularities (p > 0.05), state anxiety emerged as a significant factor impacting the prevalence of menstrual irregularities (p < 0.05).

Conclusions

The results of the present study suggest a potential pathway wherein sleep deprivation might elevate state anxiety levels, consequently indirectly contributing to an increase the probability of menstrual irregularities. In conclusion, the results of the presents study provide novels insights suggesting that sleep deprivation might directly increase state anxiety and indirectly affect the prevalence of menstrual irregularities. Hence, decreased sleep duration might be related to mental health issues and the prevalence of menstrual irregularities both significant concerns among female athletes. Future studies will play a crucial role in further elucidating how sleep patterns impact the health and well-being of female athletes.

The association of testosterone with sarcopenia and frailty in chronic liver disease

BACKGROUND

Testosterone is an important anabolic hormone responsible for maintaining body composition and muscle mass and circulates mostly albumin-bound, or sex hormone binding globulin (SHBG)-bound or free in the plasma. Of these fractions, the latter is bioactive and exerts the androgenic effects on male population. Liver cirrhosis, the advanced stage of any chronic liver disease characterized by permanent distortions to the hepatic architecture, disrupts the hypothalamic-pituitary-gonadal axis, leading to diminished levels of free testosterone and hypogonadism.

METHODS

We retrieved the PubMed database to provide a synopsis of testosterone's physiology and action and summarize the effect of sarcopenia in pre-cirrhotic and cirrhotic patients. Moreover, we scoped to provide insight into the relationship of testosterone levels with sarcopenia, frailty and survival in cirrhotic and non-cirrhotic population as well as to discuss the efficacy of exogenous testosterone supplementation on the anthropometric parameters and survival of those patients.

RESULTS

Low testosterone levels have been associated with sarcopenia, reduced body lean mass, decreased bone mineral density and frailty, thus leading to increased morbidity and mortality especially among cirrhotic patients. Furthermore, exogenous testosterone administration significantly ameliorated body composition on patients with chronic hepatic disease, without significant adverse effects. However, the current literature does not suggest any significant effect on survival of those patients. Moreover, the long-term safety of testosterone use remains an open question.

CONCLUSION

Low serum testosterone is strongly correlated with sarcopenia, frailty, higher rate of hepatic decompensation and mortality. Nonetheless, exogenous supplementation of testosterone did not ameliorate the liver-related outcomes and complications.

Investigation of irisin's role in pubertal onset physiology in female rats

OBJECTIVE

The timing of pubertal development is closely related to metabolic status and energy reserves. It is thought that irisin, which is involved in the regulation of energy metabolism and is shown to be present in the hypothalamo-pituitary-gonadal (HPG) axis, may play a role in this process. In our study, we aimed to investigate the effect of irisin administration on pubertal development and HPG axis in rats.

DESIGN-METHODS

36 female rats were included in the study were divided into 3 groups: 100 ng/kg/day irisin treatment group (irisin-100), 50 ng/kg/day irisin treatment group (irisin-50), and control group. On the 38th day, serum samples were taken to determine levels of luteinizing hormone (LH) and follicle stimulating hormone (FSH), estradiol and irisin. Brain hypothalamus samples were taken to determine levels of pulsatile gonadotropin-releasing hormone (GnRH), kisspeptin, neurokinin-B, dynorphin (Dyn), and makorin ring finger protein-3 (MKRN3).

RESULTS

Vaginal opening and estrus were seen firstly in the irisin-100 group. At the end of the study, the highest rate of vaginal patency was found in the irisin-100 group. Hypothalamic protein expression levels of GnRH, NKB and Kiss1 in homogenates; serum FSH, LH, and estradiol levels were the highest in the irisin-100 group, followed by the irisin-50 and control groups, respectively. Ovarian sizes were significantly greater in the irisin-100 group compared to the other groups. The hypothalamic protein expression levels of MKRN3 and Dyn were the lowest in the irisin-100 group.

CONCLUSIONS

In this experimental study, irisin triggered the onset of puberty in a dose-dependent manner. Irisin administration caused the excitatory system to dominate in the hypothalamic GnRH pulse generator.

Examining the Role of Physical Activity Interventions in Modulating Androgens and Cardiovascular Health in Postmenopausal Women: A Narrative Review

A growing body of literature has examined the role of physical activity (PA) in modifying the effects of estrogen withdrawal on cardiovascular health in postmenopausal women, but the impact of PA on androgens is less clear. Changes in androgen concentrations following regular PA may improve cardiovascular health. This narrative review summarizes the literature assessing the impact of PA interventions on androgens in postmenopausal women. The association between changes in androgen concentrations and cardiovascular health following PA programs is also examined. Randomized controlled trials were included if they (i) implemented a PA program of any type and duration in postmenopausal women and (ii) measured changes in androgen concentrations. Following PA interventions, no changes in androstenedione, conflicting changes in dehydroepiandrosterone/dehydroepiandrosterone-sulfate, and increases in sex hormone-binding globulin concentrations were found. Total testosterone decreased following aerobic PA but increased after resistance training. Most aerobic PA interventions led to reductions in free testosterone. A combination of caloric restriction and/or fat loss enhanced the influence of PA on most androgens. Evidence exploring the relationship between changes in androgens and cardiovascular health indicators was scarce and inconsistent. PA has shown promise in modifying the concentrations of some androgens (free and total testosterone, sex hormone-binding globulin), and remains a well-known beneficial adjuvant option for postmenopausal women to manage their cardiovascular health. Fat loss influences the effect of PA on androgens, but the synergistic role of PA and androgens on cardiovascular health merits further examination. Many research gaps remain regarding the relationship between PA, androgens, and cardiovascular disease in postmenopausal women.

Irisin: circulating levels in serum and its relation to gonadal axis

Irisin is an exercise-induced myokine/adipokine in mice and humans that plays an important role in 'browning' of white adipose tissue and has shown great potential as a treatment for some metabolic diseases, such as obesity, insulin resistance, and inflammation. The circulating irisin level is reported to be associated with exercise, obesity, diet, diseases, and exposure to different pharmacological agents. Several studies have attempted to characterize the role of irisin in PCOS and other reproductive diseases, but contradictory results have been reported. Our previous study showed that irisin may serve further functions in folliculogenesis and fertility. In this review, we present the current knowledge on the physiology of irisin and its role in gonadal axis. Firstly, we describe irisin circulating levels and speculate on the potential mechanisms involved in irisin secretion and regulation. Then, we focus on the irisin levels in PCOS, and explore the relationships between, BMI, insulin resistance, and hyperandrogenism. Finally, we present the results from animal interventional studies and in vitro experiments to investigate the relationship between irisin and gonadal axis, indicating its novel effects on reproduction and fertility.

Serum concentrations of oxytocin, DHEA and follistatin are associated with osteoporosis or sarcopenia in community-dwelling postmenopausal women

Background

Osteoporosis and sarcopenia are major health issues in postmenopausal women due to their high prevalence and association with several adverse outcomes. However, no biomarkers may be used for screening and diagnosis. The current study investigated potential biomarkers for osteoporosis and/or sarcopenia in postmenopausal women.

Methods

A cross-sectional study on 478 healthy community-dwelling postmenopausal women aged 50–90 years was performed. Osteoporosis and sarcopenia were defined according to the World Health Organization (WHO) and Asian Working Group for Sarcopenia (AWGS).

Results

Dehydroepiandrosterone (DHEA) was related to muscle strength (β = 0.19, p = 0.041) and function (β = 0.58, p = 0.004). Follistatin (β = − 0.27, p = 0.01) was related to muscle mass. Oxytocin (β = 0.59, p = 0.044) and DHEA (β = 0.51, p = 0.017) were related to bone mass. After adjusting for age, oxytocin (odds ratio (OR) 0.75; 95% confidence intervals (CI) 0.63–0.98; p = 0.019) was associated with osteoporosis, and DHEA (OR 0.73; 95% CI 0.51–0.96; p = 0.032) and follistatin (OR 1.66; 95% CI 1.19–3.57; p = 0.022) were associated with sarcopenia.

Conclusions

Postmenopausal women with sarcopenia were more likely to have lower DHEA levels and higher follistatin levels, and postmenopausal women with osteoporosis were more likely to have lower oxytocin levels.

Relationship among Nutritional Intake, Anxiety, and Menstrual Irregularity in Elite Rowers

There is evidence showing that excessive mental stress is detrimental to the menstrual period, and it is known that many elite athletes are highly susceptible to mental anxiety. This study investigated the nutritional intake and mental anxiety of 104 relatively young elite endurance athletes aged 16 to 23 years and used a multiple logistic model to examine the factors that might be related to menstrual irregularity. Calcium intake was marginally associated with the occurrence of menstrual irregularities (odds ratio = 1.004, p = 0.030), whereas there were strong associations between body mass or state anxiety and menstrual irregularities in elite athletes (odds ratio = 0.557, p = 0.035 for body mass; odds ratio = 1.094, p = 0.006 for state anxiety). These results suggested that state anxiety would be an important factor causing menstrual irregularity in elite endurance athletes. It is recommended that elite athletes are monitored for anxiety levels and develop a strategy for stress management.

Urinary Steroid Profile in Elite Female Athletes in Relation to Serum Androgens and in Comparison With Untrained Controls

Introduction

In female athletes, the interpretation of doping tests is complex due to hormonal variations during the menstrual cycle and hormonal contraceptive use, both influencing the urinary steroid profile. Exercise is suggested to affect circulating steroid hormone levels, and in women, the urinary steroid profile differs between in competition testing and out of competition testing. No previous study has investigated the relationship between amount of exercise and the urinary steroid profile in female elite athletes.

Purpose

To compare the urinary steroid profile between female Olympic athletes and age- and BMI-matched untrained controls, and to study the urinary steroid profile in relation to serum hormones and amount of exercise.

Methods

In this cross-sectional study conducted at the Women’s Health Research Unit, Karolinska University Hospital, Stockholm, 94 female elite athletes and 86 untrained controls were included. Serum estrogens and testosterone and the urinary steroid profile were analyzed by liquid chromatography–tandem mass spectrometry and gas chromatography-tandem mass spectrometry, respectively. Exercise hours/week were evaluated by questionnaire.

Results

Although serum steroid hormones were comparable between groups, the athletes demonstrated approximately 30% lower urinary steroid metabolites of testosterone, epitestosterone, androsterone, etiocholanolone, 5α-androstan-3α, 17β-diol, and 5β-androstan-3α, 17β-diol compared to the controls. The urinary steroid metabolites correlated positively with serum steroid hormones. In the athletes, urinary steroid metabolites: androsterone (r_s = −0.28, p = 0.007), epitestosterone (r_s = −0.22, p = 0.034), 5αAdiol (r_s = −0.31, p = 0.002) and testosterone (r_s = −0.24, p = 0.026), were negatively correlated with amount of training (hours per week).

Conclusion

The urinary concentrations of steroid metabolites were lower in elite athletes than in sedentary controls, although serum steroids were comparable between groups. Moreover, exercise time was negatively associated with the urinary concentrations. Our findings suggest alternative excretion routes of androgens in the athletes related to training.

Anabolic-Androgenic Steroid Use in Sports, Health, and Society

This consensus statement is an update of the 1987 American College of Sports Medicine (ACSM) position stand on the use of anabolic-androgenic steroids (AAS). Substantial data have been collected since the previous position stand, and AAS use patterns have changed significantly. The ACSM acknowledges that lawful and ethical therapeutic use of AAS is now an accepted mainstream treatment for several clinical disorders; however, there is increased recognition that AAS are commonly used illicitly to enhance performance and appearance in several segments of the population, including competitive athletes. The illicit use of AAS by competitive athletes is contrary to the rules and ethics of many sport governing bodies. Thus, the ACSM deplores the illicit use of AAS for athletic and recreational purposes. This consensus statement provides a brief history of AAS use, an update on the science of how we now understand AAS to be working metabolically/biochemically, potential side effects, the prevalence of use among athletes, and the use of AAS in clinical scenarios.

The effects of three types of exercise training on steroid hormones in physically inactive middle-aged adults: a randomized controlled trial

PURPOSE

Physical inactivity and ageing are associated with imbalances in anabolic/catabolic steroid hormones, jeopardizing health. We investigated the effects of three types of training on plasma steroid hormone levels in physically inactive, middle-aged adults.

METHODS

A 12-week randomized controlled trial was performed with a parallel-group design. A total of 67 (36 women) middle-aged adults (45-65 years old) were randomly assigned to (1) no exercise (control), (2) concurrent training based on the international physical activity recommendations (PAR), (3) high-intensity interval training (HIIT), or (4) HIIT plus whole-body electromyostimulation (HIIT + EMS). The training volume in the PAR group was 150 min/week at 60-65% of the heart rate reserve for aerobic training and ~ 60 min/week at 40-50% of the one-repetition maximum for resistance training. The training volume in the HIIT and HIIT + EMS groups was 40-65 min/week at > 95% of the maximum oxygen uptake in long interval sessions, and > 120% of the maximum oxygen uptake in short interval sessions.

RESULTS

Compared to the control group, dehydroepiandrosterone sulfate increased in the PAR, HIIT, and HIIT + EMS groups (~ 14%, ~ 14%, and ~ 20%, respectively; all P < 0.01). Cortisol decreased in the PAR, HIIT, and HIIT + EMS groups (~ - 17%, ~ - 10%, and ~ - 23%, respectively; all P ≤ 0.05). Testosterone increased in the HIIT and HIIT + EMS groups (~ 28%, and ~ 16%, respectively; all P ≤ 0.01). Free testosterone increased in the HIIT and HIIT + EMS groups (~ 30% and ~ 18% respectively; all P ≤ 0.01). No significant increase in sex hormone-binding globulin was observed (P = 0.869).

CONCLUSION

Our findings suggest that HIIT, with or without whole-body EMS, can significantly enhance steroid hormones status in previously physically inactive middle-aged adults. The PAR program led to slight improvements than the HIIT and HIIT + EMS groups despite the application of a higher training volume.

CLINICAL TRIAL REGISTRY

NCT03334357 (ClinicalTrials.gov). November 7, 2017 retrospectively registered.

Chronic irisin exposure decreases sexual incentive motivation in female rats

Irisin is a novel myokine/adipokine that is released into the circulation in response to types of exercise and increases energy expenditure. Disorders in the endocrine system related to reproduction, which occur due to the chronic or excessive exercise, cause a decrease in women's sexual desire. However, the role of irisin hormone on sexual desire in women has not been elucidated. We hypothesized that chronic irisin exposure would decrease sexual incentive motivation for male partners by affecting the endocrine system in female rats. We tested this by quantifying and comparing of both sexual incentive motivation and active investigation for sexual partner, and also changes in the serum hormone levels in chronically irisin-treated female rats. As a result, chronic irisin exposure decreased the time spent near the male rat, male preference ratio, and male investigation preference ratio. Furthermore, serum testosterone and progesterone levels significantly decreased and estradiol levels increased while kisspeptin-1 levels were not changed by chronic irisin exposure in female rats. These data indicate that chronic irisin exposure may cause low sexual incentive motivation for opposite-sex partners in female rats via changes in reproductive hormones. The results suggest that irisin hormone may play a role in decreased sexual desire due to long-term exercise in women.

Dietary intake and menstrual cycle changes in international level young athletes

BACKGROUND

Few studies have examined the influence of nutritional status and mental stress on menstrual cycle characteristics. The purpose of this study was to describe the impact of low energy availability (EA) and mental health problems on the menstrual cycles of elite female rowing competitors during a survey period.

METHODS

We enrolled sixteen subjects (16-18 years old) who were elite female rowing competitors preparing for an international competition. This study provides the first long-term assessment of dietary intake, body mass/composition, state of anxiety, and menstrual cycle in international level female athletes.

RESULTS

Dietary energy intake increased significantly during the investigation period (P<0.001). CHO intake increased significantly during the investigation period (P<0.005). EA significantly increased during the investigation period (P<0.01). The percentage of athletes with menstrual dysfunction was 20.0% in April 2018 (2 of 10), but none of the athletes reported menstrual dysfunction in October 2019. The mental status measured by state anxiety index (STAI) did not change significantly during this survey period (P>0.05).

CONCLUSIONS

There was no athlete who has menstrual disfunction after sufficient CHO intake during this survey period. These findings of this study suggest that adequate EA levels and sufficient CHO intake might lead to improved menstrual function. In addition, the impact of psychological factors on menstrual dysfunction at normal levels may be less than the effects of nutritional status.

Variations in strength-related measures during the menstrual cycle in eumenorrheic women: A systematic review and meta-analysis

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.

Growth Hormone(s), Testosterone, Insulin-Like Growth Factors, and Cortisol: Roles and Integration for Cellular Development and Growth With Exercise

Hormones are largely responsible for the integrated communication of several physiological systems responsible for modulating cellular growth and development. Although the specific hormonal influence must be considered within the context of the entire endocrine system and its relationship with other physiological systems, three key hormones are considered the "anabolic giants" in cellular growth and repair: testosterone, the growth hormone superfamily, and the insulin-like growth factor (IGF) superfamily. In addition to these anabolic hormones, glucocorticoids, mainly cortisol must also be considered because of their profound opposing influence on human skeletal muscle anabolism in many instances. This review presents emerging research on: (1) Testosterone signaling pathways, responses, and adaptations to resistance training; (2) Growth hormone: presents new complexity with exercise stress; (3) Current perspectives on IGF-I and physiological adaptations and complexity these hormones as related to training; and (4) Glucocorticoid roles in integrated communication for anabolic/catabolic signaling. Specifically, the review describes (1) Testosterone as the primary anabolic hormone, with an anabolic influence largely dictated primarily by genomic and possible non-genomic signaling, satellite cell activation, interaction with other anabolic signaling pathways, upregulation or downregulation of the androgen receptor, and potential roles in co-activators and transcriptional activity; (2) Differential influences of growth hormones depending on the "type" of the hormone being assayed and the magnitude of the physiological stress; (3) The exquisite regulation of IGF-1 by a family of binding proteins (IGFBPs 1-6), which can either stimulate or inhibit biological action depending on binding; and (4) Circadian patterning and newly discovered variants of glucocorticoid isoforms largely dictating glucocorticoid sensitivity and catabolic, muscle sparing, or pathological influence. The downstream integrated anabolic and catabolic mechanisms of these hormones not only affect the ability of skeletal muscle to generate force; they also have implications for pharmaceutical treatments, aging, and prevalent chronic conditions such as metabolic syndrome, insulin resistance, and hypertension. Thus, advances in our understanding of hormones that impact anabolic: catabolic processes have relevance for athletes and the general population, alike.

Dehydroepiandrosterone Sulfate and Free Testosterone but not Estradiol are Related to Muscle Strength and Bone Microarchitecture in Older Adults

The study aimed to elucidate the relationship between sex steroids and muscle mass, muscle strength, and trabecular bone score (TBS) in a community-dwelling aged population. We analyzed 922 men > 60 years of age and 1244 postmenopausal women. Weak muscle strength was defined as hand grip strength < 26 kg for men and < 18 kg for women, whereas degraded bone microarchitecture was defined as a TBS ≤ 1.2. The mean age was 70.2 ± 6.8 years for men and 71.2 ± 6.7 years for women. Participants within higher dehydroepiandrosterone sulfate (DHEAS) and free testosterone (FT) tertiles were likely to be younger, have greater muscle mass, and have stronger hand grip strength. Based on logistic regression models, men within the lowest FT tertile had weaker muscle strength compared to those in the highest tertile (adjusted odds ratio [OR] 2.28; 95% confidence interval [CI] 1.33-3.91). Women within the lowest DHEAS and FT tertile had weaker muscle strength compared to those in the highest tertile (adjusted OR for DHEAS 1.42; 95% CI 1.02-1.99; adjusted OR for FT 1.77, 95% CI 1.26-2.48). Moreover, men within the lowest FT tertile exhibited degraded bone microarchitecture compared to those in the highest tertile (adjusted OR 2.57, 95% CI 1.46-4.51). However, estradiol was not related to muscle strength or bone microarchitecture in both sexes. In conclusion, in aged men, serum FT was closely associated with muscle strength and bone microarchitecture and in postmenopausal women, serum DHEAS and FT were related to muscle strength.

The resistance training effects of different weight level during menstrual cycle in female

We examined the different effects of body mass index (BMI) level on resistance training during menstrual cycle. Thirty-six female subjects performed resistance training and subjects were divided into three groups: BMIunder, BMInorm, BMIover. Subjects completed 12 weeks of sub-maximal resistance training with 3 sets of 8–12 repetitions. Maximum isometric force test was measured before and after training in the follicular phase (FP) and the luteal phase (LP). Maximum isometric force of whole groups (BMIunder, BMInorm, BMIover) was significantly increased both FP and LP after 12-week resistance training. Maximum isometric force after training and absolute increase value in BMInorm and BMIover were no significantly different between FP and LP. However, significant different of maximum isometric force after training (FP, 79.08±11.60; LP, 84.05±12.38) and absolute increase value (FP, 9.63±5.47; LP, 15.13±6.06) were found between FP and LP just by BMIunder. We suggest that if muscle strength is measured in the FP (LP) before training and then they should be measured same phase, such as FP and LP after training and BMIunder can be influenced muscle strength in LP.

The digit ratio (2D:4D) relationship with testosterone is moderated by physical training: Evidence of prenatal organizational influences on activational patterns of adult testosterone in physically-active women

BACKGROUND

The 2nd to 4th digit ratio (2D:4D) is regarded as a sexually dimorphic trait governed by prenatal testosterone (T) and estradiol exposure. However, relationships between the 2D:4D and adult sex hormone concentrations are inconsistent in females. Environmental contingencies (e.g., physical training) may provide a stronger basis for establishing these linkages, particularly if the relationships are plastic and not fixed.

AIMS

To investigate associations between 2D:4D, training hours and salivary T (sal-T) measures in physically-active women.

STUDY DESIGN

Descriptive and quasi-experimental monitoring across the follicular (day 7), ovulatory (day 14) and luteal (day 21) phases of three menstrual cycles.

SUBJECTS

35 naturally-cycling women training regularly for sport (range 3-12 h a week).

OUTCOME MEASURES

Morning sal-T concentrations and changes in sal-T to a physical and psychological stimulus (~10 min) were measured.

RESULTS

Both 2D:4D and training hours were related to morning sal-T concentrations in all three menstrual phases (p < 0.01) and their interaction was significant during ovulation. Follow-up testing revealed a negative 2D:4D and sal-T association in women reporting high, but not low, training hours each week. Participant 2D:4D was also related to sal-T changes under physical and/or psychological challenge across each menstrual phase (p < 0.01), whereas training hours and its interaction with 2D:4D were not significant predictors of these outcomes.

CONCLUSIONS

2D:4D linkages with basal and challenge-induced sal-T changes were identified in women undertaking regular physical training. Training hours also moderated the 2D:4D link to morning sal-T, but with some menstrual-phase dependency. These complexities and environmental relationships may help reconcile conflicting results.

Exercise, or exercise and diet for the management of polycystic ovary syndrome: a systematic review and meta-analysis

BACKGROUND

Typically, management of PCOS focuses on lifestyle changes (exercise and diet), aiming to alleviate symptoms, and lower the associated risk of type 2 diabetes and cardiovascular disease. Our objective was to analyse evidence on the effectiveness of exercise in the management of PCOS, when compared to (i) usual care, (ii) diet alone, and (iii) exercise combined with diet, and also exercise combined with diet, compared to (i) control or usual care and (ii) diet alone.

METHODS

Relevant databases were searched (June 2017) with no time limit for trial inclusion. Eligible trials employed a randomised or quasi-randomised design to measure the chronic effects of exercise, or exercise and diet in women with PCOS.

RESULTS

Searches returned 2390 articles; of those, 27 papers from 18 trials were included. Results are presented as mean difference (MD) and 95% confidence intervals (95% CI). Compared with control, exercise had a statistical effect on change from baseline fasting insulin (MD - 2.44 μIU/mL, 95% CIs - 4.24 to - 0.64; very low-quality evidence), HOMA-IR (- 0.57, - 0.99 to - 0.14; very low-quality evidence), total cholesterol (- 5.88 mg/dL, - 9.92 to - 1.83; low-quality evidence), LDL cholesterol (- 7.39 mg/dL, - 9.83 to - 4.95; low-quality evidence), and triglycerides (- 4.78 mg/dL, - 7.52 to - 2.05; low-quality evidence). Exercise also improved VO₂ max (3.84 ml/kg/min, 2.87 to 4.81), waist circumference (- 2.62 cm, - 4.13 to - 1.11), and body fat percentage (- 1.39%, - 2.61 to - 0.18) when compared with usual care. No effect was found for change value systolic/diastolic blood pressure, fasting glucose, HDL cholesterol (all low-quality evidence), or waist-to-hip ratio. Many favourable change score findings were supported by post-intervention value analyses: fasting insulin (- 2.11 μIU/mL, - 3.49 to - 0.73), total cholesterol (- 6.66 mg/dL, - 11.14 to - 2.17), LDL cholesterol (- 6.91 mg/dL, - 12.02 to - 1.80), and VO₂ max (5.01 ml/kg/min, 3.48 to 6.54). Statistically lower BMI (- 1.02 kg/m², - 1.81 to - 0.23) and resting heart rate (- 3.26 beats/min - 4.93 to - 1.59) were also revealed in post-intervention analysis. Subgroup analyses revealed the greatest improvements in overweight/obese participants, and more outcomes improved when interventions were supervised, aerobic in nature, or of a shorter duration. Based on limited data, we found no differences for any outcome between the effects of exercise and diet combined, and diet alone. It was not possible to compare exercise vs diet or exercise and diet combined vs diet.

CONCLUSION

Statistically beneficial effects of exercise were found for a range of metabolic, anthropometric, and cardiorespiratory fitness-related outcomes. However, caution should be adopted when interpreting these findings since many outcomes present modest effects and wide CIs, and statistical effects in many analyses are sensitive to the addition/removal of individual trials. Future work should focus on rigorously designed, well-reported trials that make comparisons involving both exercise and diet.

SYSTEMATIC REVIEW REGISTRATION

This systematic review was prospectively registered on the Prospero International Prospective Register of Systematic Reviews ( CRD42017062576 ).

Caffeine Improves Triathlon Performance: A Field Study in Males and Females

The ergogenic effect of caffeine on endurance exercise is commonly accepted. We aimed to elucidate realistically the effect of caffeine on triathlon event performance using a field study design, while allowing investigation into potential mechanisms at play. A double-blind, randomized, crossover field trial was conducted. Twenty-six triathletes (14 males and 12 females; mean ± SD: age = 37.8 ± 10.6 years, habitual caffeine intake = 413 ± 505 mg/day, percentage body fat = 14.5 ± 7.2%, and training/week = 12.8 ± 4.5 hr) participated in this study. Microencapsulated caffeine (6 mg/kg body weight) was supplemented 60 min pretrial. Performance data included time to completion, rating of perceived exertion, and profile of mood states. Blood samples taken before, during, and postrace were analyzed for cortisol, testosterone, and full blood count. Capillary blood lactate concentrations were assessed prerace, during transitions, and 3, 6, 9, 12, and 15 min after triathlons. Caffeine supplementation resulted in a 3.7% reduction in swim time (33.5 ± 7.0 vs. 34.8 ± 8.1 min, p < .05) and a 1.3% reduction in time to completion (149.6 ± 19.8 vs. 151.5 ± 18.6 min, p < .05) for the whole group. Gender differences and individual responses are also presented. Caffeine did not alter the rating of perceived exertion significantly, but better performance after caffeine supplementation suggests a central effect resulting in greater overall exercise intensity at the same rating of perceived exertion. Caffeine supplementation was associated with higher postexercise cortisol levels (665 ± 200 vs. 543 ± 169 nmol/L, p < .0001) and facilitated greater peak blood lactate accumulation (analysis of variance main effect, p < .05). We recommend that triathlon athletes with relatively low habitual caffeine intake may ingest 6 mg/kg body weight caffeine, 45-60 min before the start of Olympic-distance triathlon to improve their performance.

Sex-related differences in fuel utilization and hormonal response to exercise: implications for individuals with type 1 diabetes

Sex-related differences in metabolic and neuroendocrine response to exercise in individuals without diabetes have been well established. Men and women differ in fuel selection during exercise, in which women rely to a greater extent on fat oxidation, whereas males rely mostly on carbohydrate oxidation for energy production. The difference in fuel selection appears to be mediated by sex-related differences in hormonal (including catecholamines, growth hormone, and estrogen) response to different types and intensities of exercise. In general, men exhibit an amplified counter-regulatory response to exercise, with elevated levels of catecholamines compared with women. However, women exhibit greater sensitivity to the lipolytic action of the catecholamines and deplete less of their glycogen stores than men during exercise, which suggests that women may experience a greater defense in blood glucose control after exercise than men. Conversely, little is known about sex-related differences in response to exercise in individuals with type 1 diabetes (T1D). A single study investigating sex-related differences in response to moderate aerobic exercise in individuals with T1D found sex-related differences in catecholamine response and fuel selection, but changes in blood glucose were not measured. To our knowledge, there are no studies investigating sex-related differences in blood glucose responses to different types and intensities of exercise in individuals with T1D. This review summarizes sex-related differences in exercise responses that could potentially impact blood glucose levels during exercise in individuals with T1D and highlights the need for further research.

Borderline personality disorder and polycystic ovary syndrome: A review of the literature

OBJECTIVE

This review examines the existing evidence for the relationship between borderline personality disorder and polycystic ovary syndrome, and to identify commonalities in etiological mechanisms of borderline personality disorder and polycystic ovary syndrome that might explain the relationship between these seemingly disparate disorders.

METHODS

A search of Medline, EMBASE and Cochrane Central was undertaken on 5 December 2016 to identify studies investigating women with borderline personality disorder and polycystic ovary syndrome (or symptoms and markers specific to polycystic ovary syndrome).

RESULTS

Nine studies were identified, including three cross-sectional studies investigating symptoms of polycystic ovary syndrome in women with borderline personality disorder, two cross-sectional and one cohort study examining the prevalence of psychiatric diagnoses in women with polycystic ovary syndrome and three case reports of comorbid borderline personality disorder and polycystic ovary syndrome.

CONCLUSION

Overall, the literature shows women with borderline personality disorder to have higher than expected serum androgen levels and incidence of polycystic ovaries, which can be key features of polycystic ovary syndrome. However, this research is still in its infancy, which limits our understanding of this potential comorbid phenomenon. Given the emerging anecdotal and empirical evidence to date, a theoretical discussion of the potential psychoneuroendocrinological mechanism underlying the borderline personality disorder and polycystic ovary syndrome comorbidity is provided. Further rigorous studies using standardized diagnostic criteria for polycystic ovary syndrome are warranted. Specifically, the use of prospective controlled cohort studies may be able to determine the causality and temporality of observed comorbid borderline personality disorder and polycystic ovary syndrome.

Serum complexed and free prostate specific antigen levels are lower in female elite athletes in comparison to control women

BACKGROUND

We hypothesize that prostate specific antigen (PSA), a protein that it is under regulation by androgens, may be differentially expressed in female elite athletes in comparison to control women.

METHODS

We conducted a cross-sectional study of 106 female athletes and 114 sedentary age-matched controls.  Serum from these women was analyzed for complexed prostate specific antigen (cPSA) and free prostate specific antigen (fPSA), by fifth generation assays with limits of detection of around 6 and 140 fg/mL, respectively.  A panel of estrogens, androgens and progesterone in the same serum was also quantified by tandem mass spectrometry.  Results: Both components of serum PSA (cPSA and fPSA) were lower in the elite athletes vs the control group (P=0.033 and 0.013, respectively).  Furthermore, estrone (p=0.003) and estradiol (p=0.004) were significantly lower, and dehydroepiandrosterone  (p=0.095) and 5-androstene-3β, 17β-diol (p=0.084) tended to be higher in the athletes vs controls. Oral contraceptive use was similar between groups and significantly associated with increased cPSA and fPSA in athletes (p= 0.046 and 0.009, respectively).  PSA fractions were not significantly associated with progesterone changes. The Spearman correlation between cPSA and fPSA in both athletes and controls was 0.75 (P < 0.0001) and 0.64 (P < 0.0001), respectively.  Conclusions: Elite athletes have lower complexed and free PSA, higher levels of androgen precursors and lower levels of estrogen in their serum than sedentary control women.

ABBREVIATIONS

cPSA, complexed PSA; fPSA, free PSA; PCOS, polycystic ovarian syndrome; E1, estrone; E2, estradiol; DHEA, dehydroepiandrosterone, Testo, testosterone; DHT, dihydrotestosterone; PROG, progesterone; Delta 4, androstenedione; Delta 5, androst-5-ene-3β, 17β-diol; BMD, body mineral density; LLOQ, lower limit of quantification; ULOQ, upper limit of quantification; LOD, limit of detection; ACT, α ₁-antichymotrypsin.

Different DHEA-S Levels and Response Patterns in Individuals with Chronic Neck Pain, Compared with a Pain Free Group-a Pilot Study

Objective

To test, in this pilot study, whether DHEA-S (Dehydroepiandrosterone, sulfated form) plasma levels are lower among persons with chronic neck pain, compared to control persons, and to investigate the DHEA-S response after a physical exercise.

Subjects

Included were 12 persons with chronic neck pain and eight controls without present pain, all 18 and 65 years of age. Exclusion criteria for both groups were articular diseases or tendinosis, fibromyalgia, systemic inflammatory and neuromuscular diseases, pain conditions due to trauma, or severe psychiatric diseases.

Design and methods

The participants arm-cycled on an ergometer for 30 minutes. Blood samples were taken before, 60 minutes, and 150 minutes after this standardized physical exercise.

Results

The estimated plasma DHEA-S levels at baseline were 2.0 µmol/L (95% confidence interval [CI] 1.00; 4.01) in the pain group and 4.1 µmol/L (95% CI2.0; 8.6) in the control group, adjusted for sex, age, body mass index (BMI), and Shirom-Melamed Burnout Questionnaire (SMBQ), with a ratio of 0.48 ( P  = 0.094).

Conclusions

In this pilot study, the plasma DHEA-S levels appeared to be lower among the persons with chronic neck pain, compared with the control group. It was indicated that DHEA-S decreased during the physical exercise in the control group, and either increased or was unaffected in the chronic pain group.

Walking training and cortisol to DHEA-S ratio in postmenopause: An intervention study

The literature indicates that the plasma cortisol-to-dehydroepiandrosterone-sulfate (DHEA-S) ratio is a marker of health status after menopause, when a decline in both estrogen and DHEA-S and an increase in cortisol occur. An increase in the cortisol-to-DHEA-S ratio has been positively correlated with metabolic syndrome, all-cause mortality, cancer, and other diseases. The aim of this study was to investigate the effects of a walking program on the plasma cortisol-to-DHEA-S ratio in postmenopausal women. Fifty-one postmenopausal women participated in a 13-week supervised walking program, in the metropolitan area of Pescara (Italy), from June to September 2013. Participants were evaluated in April-May and September-October of the same year. The linear mixed model showed that the variation of the log₁₀Cortisol-to-log₁₀DHEA-S ratio was associated with the volume of exercise (p = .03). Participants having lower adherence to the walking program did not have a significantly modified log₁₀Cortisol or log₁₀DHEA-S, while those having the highest adherence had a significant reduction in log₁₀Cortisol (p = .016) and a nearly significant increase in log₁₀DHEA-S (p = .084). Walking training appeared to reduce the plasma log₁₀Cortisol-to-log₁₀DHEA-S ratio, although a minimum level of training was necessary to achieve this significant reduction.

Resistance Exercise Impacts Lean Muscle Mass in Women with Polycystic Ovary Syndrome

PURPOSE

This study investigated the effects of progressive resistance training (PRT) on lean muscle mass (LMM) in women with or without polycystic ovary syndrome (PCOS) and its effects on metabolic factors and concentrations of related steroid hormones.

DESIGN

This was a nonrandomized, therapeutic, open, single-arm study.

PARTICIPANTS

All in all, 45 sedentary women with PCOS and 52 without (non-PCOS), 18-37 yr of age, with body mass indexes (BMI) of 18-39.9 kg·m(-2) of all races and social status, performed PRT three times a week for 4 months. Before and after PRT, the concentrations of hormones and metabolic factors and waist circumference were measured. LMM and total body fat percentage were determined using dual-energy x-ray absorptiometry. Clinical characteristics, LMM, and fasting glucose were adjusted for confounding covariables and compared using general linear mixed models. Each patient's menstrual history was taken before study enrollment and after PRT.

RESULTS

PRT resulted in reduced plasma testosterone and fasting glucose levels. After PRT, the androstenedione concentration increased and the sex hormone-binding globulin concentration decreased in women with PCOS. The waist circumference was reduced (P < 0.01) and the muscle mass index, lean mass (LM)/height2, increased in women with PCOS (P = 0.04). Women with PCOS showed increased muscle mass indexes of appendicular LM/height2 (P = 0.03) and LM/height2 (P < 0.01) compared with the baseline. Total LM and trunk LM were elevated in women with PCOS (P = 0.01) at the baseline and after PRT.

CONCLUSION

To our knowledge, this is the first report to show that resistance exercise alone can improve hyperandrogenism, reproductive function, and body composition by decreasing visceral fat and increasing LMM, but it has no metabolic impact on women with PCOS.

Dietary Intake, Body Composition, and Menstrual Cycle Changes during Competition Preparation and Recovery in a Drug-Free Figure Competitor: A Case Study

Physique competitions are events in which competitors are judged on muscular appearance and symmetry. The purpose of this retrospective case study was to describe changes in dietary intake, body mass/composition, and the menstrual cycle during the 20-week competition preparation (PREP) and 20-week post competition recovery (REC) periods of a drug-free amateur female figure competitor (age = 26–27, BMI = 19.5 kg/m²). Dietary intake (via weighed food records) and body mass were assessed daily and averaged weekly. Body composition was estimated via Dual-energy X-ray absorptiometry (DXA) and 7-site skinfold measurements. Energy intake, body mass and composition, and energy availability decreased during the 20-week PREP period (changes of ~298 kcals, 5.1 kg, 6.5% body fat, and 5.4 kcal/kg fat free mass, respectively) and returned to baseline values by end of the 20-week REC period. Menstrual cycle irregularity was reported within the first month of PREP and the last menstruation was reported at week 11 of PREP. Given the potentially adverse health outcomes associated with caloric restriction, future, prospective cohort studies on the physiological response to PREP and REC are warranted in drug-free, female physique competitors.

A Nonrandomized Trial of Progressive Resistance Training Intervention in Women With Polycystic Ovary Syndrome and Its Implications in Telomere Content

BACKGROUND

Physical activity is known to relieve the metabolic complications of polycystic ovary syndrome (PCOS), and exercise is also associated with telomere biology. We investigated the changes induced by progressive resistance training (PRT) in telomere content and metabolic disorder in women with PCOS and controls.

PARTICIPANTS AND METHODS

Forty-five women with PCOS and 52 healthy women aged 18 to 37 years were submitted to PRT. A linear periodization of PRT was prepared based on a trend of decreasing volume and intensity throughout the training period. The volunteers performed PRT 3 times a week for 4 months. The participants' physical characteristics and hormonal concentrations were measured before and after PRT, as telomere content that was measured using quantitative real-time polymerase chain reaction.

RESULTS

Briefly, Progressive resistance training reduced waist circumference, body fat percentage, plasma testosterone and sex hormone-binding globulin concentrations, glycemia, and free androgen index. Fasting insulin and insulin resistance index were greater in women with PCOS. Androstenedione and homocysteine increased after PRT. There were no differences in telomere content between controls (0.96 ± 0.3 before vs 0.85 ± 0.21 after) and women with PCOS (0.94 ± 0.33 before vs 0.88 ± 0.39 after). Adjusted analysis showed telomere shortening after PRT in all women (0.95 ± 0.31 before vs 0.86 ± 0.31 after; P = .03). In women with PCOS, increased homocysteine levels were related to telomere reduction and increased androstenedione was positively correlated with telomere content after PRT.

CONCLUSIONS

Progressive resistance training had positive effects on the hormonal and physical characteristics of women with PCOS and controls, but telomere content was reduced and homocysteine level increased in all participants.

The Effects of 17 Weeks of Ballet Training on the Autonomic Modulation, Hormonal and General Biochemical Profile of Female Adolescents

This study aimed to examine the alterations in physiological and biochemical markers, after 17 weeks of ballet training in high level ballet dancers. Twenty four female ballet dancers from 12 to 15 years old took part in the study. The study followed 17 weeks of ballet training and analyzed changes in body composition, the autonomic nervous system and biochemical variables before and after (post) training. The internal training load was obtained using the session rating of perceived exertion (session-RPE) method, calculated as the mean weekly session-RPE, monotony and strain. After 17 weeks of training there were significant increases in body mass, height, lean body mass, total protein, urea, hemoglobin concentration, testosterone and thyroxine. During this period, decreases in relative body fat, uric acid, red blood cells, C-reactive protein, and ferritin were also found. After the training period, the autonomic modulation demonstrated significant positive alterations, such as increases in parasympathetic related indices. Based on the results obtained we concluded that ballet training led to improvements in body composition and autonomic modulation. In general hematological and biochemical variables demonstrated that the training did not have adverse effects on the health state of the adolescents.

Effects of a single bout of maximal aerobic exercise on BDNF in bipolar disorder: A gender-based response

Acute exercise increases brain-derived neurotrophic factor (BDNF) serum levels in majorly depressed and anxious patients. However, to the best of our knowledge, no study has evaluated the acute effects of exercise on BDNF serum levels in Bipolar Disorder (BD). The objective of the present study was to evaluate the peripheral BDNF serum response to a single maximum session of exercise in BD participants and age- and gender-matched healthy participants. BD participants (n=18) and age- and gender-matched healthy participants (n=18) were recruited to perform a single bout of maximal exercise on a cycle ergometer. Blood samples were collected prior to and immediately after the exercise protocol. There was a significant group effect and a significant group x time x gender interaction. BD participants presented significantly higher BDNF serum levels when compared to their healthy control counterparts. Exercise increases the BDNF levels of BD women, but not men.

Association between circulating endogenous androgens and insulin sensitivity changes with exercise training in midlife women

OBJECTIVE

Aging induces a shift in circulating hormones in women, accompanied by weight gain during the late reproductive, menopausal transition, and postmenopausal years. Exercise has been shown to counter weight gain; however, it might increase circulating androgens. A 6-month aerobic and resistance training exercise regimen was implemented to examine interrelationships between circulating sex hormones, body composition, aerobic capacity, insulin sensitivity, and insulin resistance.

METHODS

Twenty-eight women, aged 42 to 52 years, completed the 6-month intervention study. They were randomly assigned to either a control (CON; n = 10) group-and maintained their sedentary lifestyle-or an exercise intervention (EXE; n = 18) group. The exercise intervention consisted of combined aerobic and resistance workouts scheduled 6 days/week for 60 minutes/day. Body weight, composition, VO2 peak, plasma insulin, glucose, lipid profile, estradiol, testosterone, progesterone, dehydroepiandrosterone, and dehydroepiandrosterone sulfate (DHEAS) were measured at baseline and on month 6. Insulin sensitivity was estimated using the insulin sensitivity index and the quantitative insulin sensitivity check index, whereas insulin resistance was estimated using the homeostatic model for insulin resistance.

RESULTS

There was a trend toward increased DHEAS in both groups (P < 0.1), but not as a function of the intervention. Insulin sensitivity index increased in the EXE group compared with the CON group (P < 0.01). Multiple linear regression indicated that, at 6 months, DHEAS was a negative contributor to insulin sensitivity in the EXE group, but not in the CON group.

CONCLUSIONS

In midlife women, an increase in circulating DHEAS, such as that previously reported during the menopausal transition, is associated with higher insulin resistance, but exercise can mitigate this risk by improving insulin sensitivity, thereby countering the effects of DHEAS.

Effects of follicular versus luteal phase-based strength training in young women

Hormonal variations during the menstrual cycle (MC) may influence trainability of strength. We investigated the effects of a follicular phase-based strength training (FT) on muscle strength, muscle volume and microscopic parameters, comparing it to a luteal phase-based training (LT). Eumenorrheic women without oral contraception (OC) (N = 20, age: 25.9 ± 4.5 yr, height: 164.2 ± 5.5 cm, weight: 60.6 ± 7.8 kg) completed strength training on a leg press for three MC, and 9 of them participated in muscle biopsies. One leg had eight training sessions in the follicular phases (FP) and only two sessions in the luteal phases (LP) for follicular phase-based training (FT), while the other leg had eight training sessions in LP and only two sessions in FP for luteal phase-based training (LT). Estradiol (E2), progesterone (P4), total testosterone (T), free testosterone (free T) and DHEA-s were analysed once during FP (around day 11) and once during LP (around day 25). Maximum isometric force (Fmax), muscle diameter (Mdm), muscle fibre composition (No), fibre diameter (Fdm) and cell nuclei-to-fibre ratio (N/F) were analysed before and after the training intervention. T and free T were higher in FP compared to LP prior to the training intervention (P < 0.05). The increase in Fmax after FT was higher compared to LT (P <0.05). FT also showed a higher increase in Mdm than LT (P < 0.05). Moreover, we found significant increases in Fdm of fibre type ΙΙ and in N/F only after FT; however, there was no significant difference from LT. With regard to change in fibre composition, no differences were observed between FT and LT. FT showed a higher gain in muscle strength and muscle diameter than LT. As a result, we recommend that eumenorrheic females without OC should base the periodization of their strength training on their individual MC.

Serum androgen levels in elite female athletes

OBJECTIVE

Prior to the implementation of the blood steroidal module of the Athlete Biological Passport, we measured the serum androgen levels among a large population of high-level female athletes as well as the prevalence of biochemical hyperandrogenism and some disorders of sex development (DSD).

METHODS AND RESULTS

In 849 elite female athletes, serum T, dehydroepiandrosterone sulphate, androstenedione, SHBG, and gonadotrophins were measured by liquid chromatography-mass spectrometry high resolution or immunoassay. Free T was calculated. The sampling hour, age, and type of athletic event only had a small influence on T concentration, whereas ethnicity had not. Among the 85.5% that did not use oral contraceptives, 168 of 717 athletes were oligo- or amenorrhoic. The oral contraceptive users showed the lowest serum androgen and gonadotrophin and the highest SHBG concentrations. After having removed five doped athletes and five DSD women from our population, median T and free T values were close to those reported in sedentary young women. The 99th percentile for T concentration was calculated at 3.08 nmol/L, which is below the 10 nmol/L threshold used for competition eligibility of hyperandrogenic women with normal androgen sensitivity. Prevalence of hyperandrogenic 46 XY DSD in our athletic population is approximately 7 per 1000, which is 140 times higher than expected in the general population.

CONCLUSION

This is the first study to establish normative serum androgens values in elite female athletes, while taking into account the possible influence of menstrual status, oral contraceptive use, type of athletic event, and ethnicity. These findings should help to develop the blood steroidal module of the Athlete Biological Passport and to refine more evidence-based fair policies and recommendations concerning hyperandrogenism in female athletes.

Physical activity in different periods of life, sedentary behavior, and the risk of ovarian cancer in the NIH-AARP diet and health study

BACKGROUND

Physical activity and sedentary behavior may influence ovarian cancer risk, but clear evidence is lacking.

METHODS

We prospectively investigated the relations of self-reported physical activity and sedentary behavior to ovarian cancer incidence in a cohort of 148,892 U.S. women ages 50-71 years at baseline (1995-1996), who were followed through 2006. Multivariate Cox proportional hazard models were used to estimate relative risks (RR) and 95% confidence intervals (CI). We also conducted analysis by hormone use, body mass index (BMI), and cancer subtype.

RESULTS

We identified 753 incident epithelial ovarian cancers. Overall, neither physical activity nor sedentary behavior at baseline was associated with ovarian cancer risk. Compared with women who never or rarely engaged in vigorous physical activity in the past year, women who reported more than 5 times/week of vigorous physical activity had an RR of 1.05 (95% CI, 0.84-1.32). Women who sat 7+ hours/day had an RR of 1.05 (95% CI, 0.80-1.37) compared with those reporting <3 hours of sitting. The associations were not modified by hormone use or BMI and were similar for both serous and non-serous subtypes.

CONCLUSIONS

Physical activity and sedentary behavior in middle and older ages were not associated with ovarian cancer risk.

IMPACT

We found no clear support for a role of physical activity and sedentary behavior in ovarian cancer risk.

Response of testosterone to prolonged aerobic exercise during different phases of the menstrual cycle

PURPOSE

To examine the androgen response to exercise in women under conditions of high (H) and low (L) estrogen (E2) levels.

METHODS

Ten exercise trained eumenorrheic women (mean ± SD: 20.0 ± 2.2 years, 58.7 ± 8.3 kg, 22.3 ± 4.9 % body fat, VO2max = 50.7 ± 9.0 mL/kg/min) completed a 60 min treadmill run at ~70 % of VO2max during both the mid-follicular (L-E2, 69.7 ± 7.3 % VO2max) and mid-luteal (H-E2, 67.6 ± 7.9 % VO2max) phases of their menstrual cycle. Blood samples were taken pre-exercise (PRE), immediately post (POST), and 30 min into recovery (30R) from exercise and analyzed for total testosterone using ELISA assays. Results were analyzed using repeated measures ANOVA.

RESULTS

Testosterone responses were (mean ± SD: L-E2, pre = 1.41 ± 0.21, post = 1.86 ± 0.21, 30R = 1.75 ± 0.32 nmol/L; H-E2, pre = 1.27 ± 0.23, post = 2.43 ± 0.56, 30R = 1.69 ± 0.34 nmol/L). Statistical analysis indicated no significant interaction existed between high and low estrogen conditions across the blood sampling times (p = 0.138). However, a main effect occurred for exercise (p < 0.004) with the post-testosterone concentration being greater than pre, although pre vs. 30R was not different (p > 0.05). All testosterone hormonal concentrations immediately post-exercise greatly exceeded the level of hemoconcentration observed during the L-E2 and H-E2 exercise sessions.

CONCLUSIONS

Prolonged aerobic exercise induces short-term elevations in testosterone in trained eumenorrheic women, which appears unrelated to estrogen levels and menstrual cycle phase. These increases may occur due to either increased androgen production and/or decreased degradation rates of the hormone, and are not solely the result of plasma fluid shifts from the exercise.

Women's intercollegiate athletic competition: cortisol, testosterone, and the dual-hormone hypothesis as it relates to status among teammates

Recent research suggests that testosterone and cortisol jointly regulate dominance motivation and, perhaps, the status relationships that are affected by it. For this article, the results of six different studies of women's intercollegiate athletic competition were combined to give a sample size of almost ninety women for whom we had before- and after-competition values for salivary cortisol and testosterone for at least one and sometimes two competitions. For many of these women, we had surveys that allowed us to assess their status with teammates. In no matter what sport (soccer, softball, volleyball, and tennis) levels of salivary cortisol and testosterone increased when women participated in athletic competition. Salivary levels of C and T appear to rise in parallel during competition and increases in levels of one hormone are significantly related to increases in the other. Salivary levels of these hormones typically decreased for teammates who did not play but watched the competition from the sidelines. For women who played in two competitions, individual differences in the positive effect of competition on cortisol and testosterone were conserved from one competition to the next, affirming the personal consistency of endocrine responses to competition. Status with teammates was positively related to before-competition levels of testosterone, but only for women with relatively low before-competition levels of cortisol. This result provides novel support for the "dual-hormone hypothesis" as it relates to predicting social status in women's athletic teams - natural social groups of individuals who know each other and whose social hierarchy has evolved over the course of practice and play for at least one and, in some cases, several years of intercollegiate athletic competition.

Marriage and motherhood are associated with lower testosterone concentrations in women

Testosterone has been hypothesized to modulate the trade-off between mating and parenting effort in males. Indeed, evidence from humans and other pair-bonded species suggests that fathers and men in committed relationships have lower testosterone levels than single men and men with no children. To date, only one published study has examined testosterone in relation to motherhood, finding that mothers of young children have lower testosterone than non-mothers. Here, we examine this question in 195 reproductive-age Norwegian women. Testosterone was measured in morning serum samples taken during the early follicular phase of the menstrual cycle, and marital and maternal status were assessed by questionnaire. Mothers of young children (age ≤3) had 14% lower testosterone than childless women and 19% lower testosterone than women who only had children over age 3. Among mothers, age of the youngest child strongly predicted testosterone levels. There was a trend towards lower testosterone among married women compared to unmarried women. All analyses controlled for body mass index (BMI), age, type of testosterone assay, and time of serum sample collection. This is the first study to look at testosterone concentrations in relation to marriage and motherhood in Western women, and it suggests that testosterone may differ with marital and maternal status in women, providing further corroboration of previous findings in both sexes.

Strength training effects on urinary steroid profile across the menstrual cycle in healthy women

Some studies suggest that performing strength training may cause alterations on the hypothalamic pituitary axis, resulting in steroid hormone variations. Intense training has been associated to slow the concentrations of estrogens and progesterone in women. The main purpose of this study was to evaluate the effects of strength training on the urinary steroid concentrations across the menstrual cycle phases. Twenty healthy women, regularly menstruating and not using pharmacologic contraceptives, performed a strength training during 8 weeks. Participants worked out 3 sets × 10 repetitions, with 2 min recovery time between sets, at 70-75 % of one maximum strength repetition. Urine samples were taken in three different phases of the menstrual cycle (menstrual, follicular and luteal) and they were collected both before and after training. Testosterone, DHEA, cortisol, cortisone, estradiol and progesterone concentrations were determined by gas chromatography-mass spectrometry. The results showed a significant decline after training in the urinary excretion of estradiol, during the menstrual and follicular phase, and progesterone, during the menstrual and luteal phase. No significant difference was observed for other steroid hormones. These data demonstrated that strength training can play an important role in the estrogen and progesterone metabolism in women, decreasing their levels across the menstrual cycle.

Comparison of baseline free testosterone and cortisol concentrations between elite and non-elite female athletes

OBJECTIVES

To compare the baseline free testosterone (T) and cortisol (C) concentrations of elite and non-elite female athletes.

METHODS

Eighteen females from different sports (track and field, netball, cycling, swimming, bob skeleton) were monitored over a 12-week period. Baseline measures of salivary free T and C concentrations were taken weekly prior to any training. The elites (n = 9) and non-elites (n = 9) were classified as international and national level competitors, respectively, with both groups matched by sport.

RESULTS

The pooled free T concentrations of the elites (87 pg/ml) were significantly higher than the non-elites (41 pg/ml) and consistently so across all weekly time points (P < 0.001). Pooled free C concentrations were also greater in the elite group (2.90 ng/ml) than the non-elites (2.32 ng/ml) (P < 0.01).

CONCLUSIONS

The pooled baseline T and C measures were higher in elite female athletes than non-elites. Higher free T and C concentrations could indicate a greater capacity for physical performance at higher work rates, which is commensurate with the demands of elite sport. Speculatively, the T differences observed could influence female behavior and thereby help to regulate sporting potential.