scholarly journals Female hyperandrogenism and elite sport

2020 ◽  
Vol 9 (4) ◽  
pp. R81-R92 ◽  
Author(s):  
Angelica Lindén Hirschberg
Keyword(s):  
Muscle Mass ◽  
Athletic Performance ◽  
Female Athletes ◽  
Polycystic Ovary ◽  
Controlled Trial ◽  
Disorders Of Sex Development ◽  
Sport Performance ◽  
Aerobic Performance ◽  
Normal Female ◽  
Testosterone Levels

Emerging evidence indicates that testosterone, which can increase muscle mass and strength, stimulates erythropoiesis, promotes competitive behaviour, and enhances the physical performance of women. Indeed, the levels of testosterone within the normal female range are related to muscle mass and athletic performance in female athletes. Furthermore, among these athletes, the prevalence of hyperandrogenic conditions, including both polycystic ovary syndrome and rare differences/disorders of sex development (DSD), which may greatly increase testosterone production, are elevated. Thus, if the androgen receptors of an individual with XY DSD are functional, her muscle mass will develop like that of a man. These findings have led to the proposal that essential hyperandrogenism is beneficial for athletic performance and plays a role in the choice by women to compete in athletic activities. Moreover, a recent randomized controlled trial demonstrated a significant increase in the lean mass and aerobic performance by young exercising women when their testosterone levels were enhanced moderately. Circulating testosterone is considered the strongest factor to explain the male advantage in sport performance, ranging between 10 and 20%. It appears to be unfair to allow female athletes with endogenous testosterone levels in the male range (i.e. 10–20 times higher than normal) to compete against those with normal female androgen levels. In 2012, this consideration led international organizations to establish eligibility regulations for the female classification in order to ensure fair and meaningful competition, but the regulations are controversial and have been challenged in court.

Female Hyperandrogenism in Elite Sports and the Athletic Triad

2021 ◽  
Author(s):  
Angelica Lindén Hirschberg
Keyword(s):  
Female Athletes ◽  
Polycystic Ovary ◽  
Disorders Of Sex Development ◽  
Normal Female ◽  
Menstrual Disorders ◽  
Mineral Density ◽  
Energy Deficiency ◽  
Sex Development ◽  
Endocrine Disturbances ◽  
Increased Risk

AbstractEssential hyperandrogenism seems to be overrepresented in female elite athletes. This applies to mild forms such as polycystic ovary syndrome, as well as rare differences/disorders of sex development (DSD). The reason is likely a selection bias since there is increasing evidence that androgens are beneficial for athletic performance by potent anabolic effects on muscle mass and bone mass, and stimulation of erythropoiesis. XY DSD may cause a greatly increased production of testosterone in the male range, that is, 10 to 20 times higher than the normal female range. The established regulations concerning the eligibility of female athletes with severe hyperandrogenism to compete in the female classification remain controversial. The most common cause of menstrual disorders in female athletes, however, is probably an acquired functional hypothalamic disturbance due to energy deficiency in relation to energy expenditure, which could lead to low bone mineral density and increased risk of injury. This condition is particularly common in endurance and esthetic sports, where a lean body composition is considered an advantage for physical performance. It is important to carefully evaluate endocrine disturbances and menstrual disorders in athletes since the management should be specific according to the underlying cause.

Athletic Performance and the Oral Contraceptive

2009 ◽  
Vol 4 (2) ◽  
pp. 151-162 ◽  
Author(s):  
Claire Rechichi ◽  
Brian Dawson ◽  
Carmel Goodman
Keyword(s):  
Oral Contraceptive ◽  
Menstrual Cycle ◽  
Athletic Performance ◽  
Female Athletes ◽  
Anaerobic Power ◽  
Anaerobic Capacity ◽  
Reproductive Hormones ◽  
Aerobic Performance ◽  
Cycle Phase ◽  
Physiological Variables

Some reports suggest variation in physiological responses and athletic performance, for female athletes at specific phases of the menstrual cycle. However, inconsistent findings are common due to the inappropriate verification of menstrual cycle phase, small subject numbers, high intra- and interindividual variability in estrogen and progesterone concentration, and the pulsatile secretion of these hormones. Therefore, the oral contraceptive (OC) cycle may provide a more stable environment in which to evaluate the acute effect of reproductive hormones on physiological variables and exercise performance. To date, most of the OC research has compared differences between OC use and nonuse, and few researchers have examined within-cycle effects of the OC. It is also apparent that OC use is becoming far more prevalent in athletes; hence the effect of the different exogenous and endogenous hormonal profiles on athletic performance should be investigated. Research to date identifies potential for variation in aerobic performance, anaerobic capacity, anaerobic power and reactive strength throughout an OC cycle. The purpose of this review is to present and evaluate the current literature on the physiology of exercise and athletic performance during the OC cycle.

scholarly journals Lack of Hirsutism in an XX Woman With History of Hyperandrogenism and Oligomenorrhea: Two Coexisting Disorders or Novel Syndrome of Androgen Insensitivity?

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A781-A782
Author(s):  
Masako Ueda ◽  
Louis F Amorosa
Keyword(s):  
Clinical Features ◽  
Polycystic Ovary ◽  
Bone Age ◽  
Androgen Insensitivity Syndrome ◽  
Laboratory Evaluation ◽  
Normal Female ◽  
Oral Contraceptive Pills ◽  
Androgen Insensitivity ◽  
Testosterone Levels ◽  
Menstrual Irregularities

Abstract Polycystic ovary syndrome (PCOS) is one of the most common causes of infertility in women, and its etiologies have not been clearly elucidated. Non-classical congenital adrenal hyperplasia (NC-CAH) with mild to moderate enzyme deficiency of 21-hydroxylase due to bi-allelic mutations in its gene (CYP21A2) is a cause of secondary PCOS that should always be considered. Common clinical features of NC-CAH include menstrual irregularities, hirsutism, acne, advanced bone age with accelerated linear growth, and short stature, associated with hyperandrogenism. Androgen insensitivity syndrome (AIS) is another cause of hyperandrogenism due to lack of response to androgen typically in genetic male (XY) presenting with female physical characteristics, most commonly due to a mutation in the androgen receptor (AR) gene on the X chromosome. Here, we present a 61 years old woman, with a diagnosis of PCOS based on oligomenorrhea and high testosterone ~90 pg/mL at age 18, meeting both NIH and Rotterdam PCOS diagnostic criteria. She took oral contraceptive pills only for one year, despite continued menstrual irregularities. After age 42, her menstrual cycles became and remained regular without further intervention until menopause at age 51, while her testosterone levels fluctuated between 80 and 250 pg/mL. After menopause, her testosterone levels drastically increased to >350 pg/mL. The patient has been recommended, but reluctant to undergo oophorectomy for enlarged non-cystic ovaries. Other potentially related clinical features include the presence of a pituitary adenoma, and a thyroid nodule. She has no notable adrenal mass or myelolipoma. Patient is lean and well-fit, at 5’11” and 151 lb. The most puzzling feature has been a lack of virilization and hirsutism. During laboratory evaluation, high 17-hydroxyprogesterone was identified, and NC-CAH became a potential etiology of PCOS, but this did not explain the lack of apparent virilization. The finding of unimpressive levels of DHEA implied that this pathway probably was unlikely the major cause of high testosterone. Investigation for hyperandrogenism focusing on AIS revealed normal female karyotype XX, and no identifiable mutations or abnormal copy number in AR. The findings thus far have provided no unifying diagnosis for her clinical features, especially for androgen insensitivity, and additional studies are being performed. Assessment of other genes recently reported to be associated with AIS is being performed as well as genetic confirmation of NC-CAH by analyzing CYP21A2. Steroid 5-alpha reductase 2 (SRD5A2), whose mutations and polymorphism interestingly are associated with AIS and PCOS, respectively, and nuclear receptor subfamily 5, group A, member 1 (NR5A1) is another gene associated with AIS. It remains to be determined whether she has AIS as a coexisting disorder with NC-CAH or a novel syndrome with a feature of androgen insensitivity.

Exploring Relations of Wellness and Athletic Coping Skills of Collegiate Athletes: Implications for Sport Performance

2007 ◽  
Vol 101 (3_suppl) ◽  
pp. 1043-1049 ◽  
Author(s):  
Shannon Von Guenthner ◽  
Jon Hammermeister
Keyword(s):  
Goal Setting ◽  
Athletic Performance ◽  
Female Athletes ◽  
Coping Skills ◽  
Collegiate Athletes ◽  
Well Being ◽  
Sport Performance ◽  
Self Report ◽  
Psychological Variables ◽  
Mental Preparation

In exploring the relationship between wellness and athletic performance, this study assessed the link between wellness, as defined by a high score on five wellness dimensions of emotional, social, spiritual, intellectual, and physical well-being, with psychological variables thought to be related to athletic performance as measured by athletes' self-report of specific athletic coping skills. 142 collegiate athletes completed a survey composed of the Optimal Living Profile to measure wellness dimensions and the Athletic Coping Skills Inventory to measure specific psychological variables. Analysis indicated that athletes scoring higher on the dimensions of wellness also scored significantly higher on athletic coping skills. Specifically, male athletes who scored higher on wellness also reported higher scores on coachability, concentration, goal setting/mental preparation, and peaking under pressure, and female athletes who scored higher on wellness also reported higher scores in coping with adversity, coachability, concentration, goal setting/mental preparation, and freedom from worry. Various dimensions of wellness seem related to better performance by involving the athletic coping skills of intercollegiate athletes. Implications for coaches and sport psychologists are also discussed.

scholarly journals Psychological Resilience in Young Female Athletes

2021 ◽  
Vol 18 (16) ◽  
pp. 8668
Author(s):  
Kimberly H. McManama O’Brien ◽  
Miriam Rowan ◽  
Kyra Willoughby ◽  
Kelsey Griffith ◽  
Melissa A. Christino
Keyword(s):  
Personal Growth ◽  
Athletic Performance ◽  
Life Skills ◽  
Mental Distress ◽  
Female Athletes ◽  
Sport Performance ◽  
Young Female ◽  
Psychological Resilience ◽  
Positive Adaptation ◽  
Body Image Issues

Psychological resilience is an important construct that can enhance athletic performance and foster valuable life skills. Through positive adaptation to adversity and stressors in the athletic arena, athletes are able to cultivate their ability to effectively respond to negative stimuli, ultimately evolving to personal growth. For young female athletes, development of resilience may be particularly important. Young female athletes face distinct challenges in sport including sport inequity, body image issues, eating disorders, increased mental distress, and internalization of emotions. The aim of this review is to define and describe the construct of resilience and discuss the implications and applications relevant to young female athletes. By understanding how to foster resilience strategies in this population, we can enhance sport performance and enjoyment, as well as bolster valuable life skills that facilitate personal growth.

Sex Differences on Use of Associative and Dissociative Cognitive Strategies among Male and Female Athletes

2005 ◽  
Vol 101 (2) ◽  
pp. 440-444 ◽  
Author(s):  
Roberta Antonini Philippe ◽  
Roland Seiler
Keyword(s):  
Athletic Performance ◽  
Pain Perception ◽  
Female Athletes ◽  
Cognitive Strategies ◽  
International Competition ◽  
Close Attention ◽  
Men And Women ◽  
Sensory Inputs ◽  
Method Of Measurement ◽  
High Level

This study assessed whether men and women differed in using associative and dissociative cognitive strategies during athletic performance. Athletes (31 men, M age = 23.2 yr., SD = 3.9 and 29 women, M age = 22.9 yr., SD = 4.3) who practiced endurance activities (running, swimming, and cycling) were considered high-level performers because they participated in national or international competition. The athletes were interviewed, and Schomer's 1986 method of measurement was used to evaluate and quantify two cognitive strategies. Most specifically, categories of association concerned the way the athlete paid close attention to bodily signals, and categories of dissociation described how the athlete shunned sensory inputs. Analysis of variance and the t test showed that women tend to be more dissociative than men and men more associative than women. The results suggest that pain perception in these sports may be a function of sex.

scholarly journals Urinary and anal incontinence among female gymnasts and cheerleaders—bother and associated factors. A cross-sectional study

2021 ◽  
Author(s):  
Kristina Lindquist Skaug ◽  
Marie Ellström Engh ◽  
Helena Frawley ◽  
Kari Bø
Keyword(s):  
Pelvic Floor ◽  
Anal Incontinence ◽  
Female Athletes ◽  
Cross Sectional Study ◽  
Sport Performance ◽  
Sports Performance ◽  
International Consensus ◽  
Cross Sectional ◽  
Negative Effect ◽  
Female Gymnasts

Abstract Introduction and hypothesis Artistic gymnastics, team gymnastics and cheerleading are sports including high-impact activities. It is presumed that the athletes’ pelvic floor must be functioning well to prevent urinary (UI) and anal incontinence (AI) during sports. The aim of this study was to investigate the prevalence and risk factors for UI and AI in female artistic gymnasts, team gymnasts and cheerleaders; the influence of UI and AI on daily living and sport performance; and the athletes’ knowledge about the pelvic floor muscles (PFM). Methods All female athletes ≥ 12 years of age competing in ≥ 1 National Championship in artistic gymnastics, team gymnastics or cheerleading in 2018/2019 were invited. International Consensus on Incontinence Questionnaires were used to assess the prevalence/bother of UI and AI. Results Among the 319 gymnasts and cheerleaders who participated, the prevalence of UI and AI was 67% and 84%, respectively. Age, training ≥ 4 days/week and straining to void were significantly associated with stress urinary incontinence (SUI) and years of training with AI. Eighty-three percent of athletes with SUI reported a negative effect on sports performance, 22% would occasionally avoid training or specific exercises because of leakage, and 28% used pads for protection. Forty-one percent of the athletes had never heard about the PFM, and 74% reported an interest in PFM training to prevent/treat UI or AI. Conclusions UI and AI were prevalent in female gymnasts and cheerleaders, and SUI negatively influenced sport performance. The athletes’ knowledge about the PFM was limited.

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