Hyperandrogenism May Explain Reproductive Dysfunction in Olympic Athletes

Hagmar, Magnus; Berglund, Bo; Brismar, Kerstin; Hirschberg, Angelica Lindén

doi:10.1249/mss.0b013e318195a21a

Cited by 96 publications

(76 citation statements)

References 31 publications

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“…Thus, the higher LH/FSH ratio in our swimmers compared with control subjects reinforces the hypothesis of a PCO-like syndrome. A profile of PCO-like syndrome was previously observed in endurance athletes (23) and power athletes (47), suggesting the hypothesis of an alternative mechanism underlying functional ovarian hyperandrogenism. However, the PCO phenotype may be attenuated by frequent exercise and effective weight control (47)(48)(49).…”

Section: Discussionmentioning

confidence: 70%

Polycystic ovary–like syndrome in adolescent competitive swimmers

Coste

Paris

Galtier

et al. 2011

Fertility and Sterility

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Section: Discussionmentioning

confidence: 70%

Polycystic ovary–like syndrome in adolescent competitive swimmers

Coste

Paris

Galtier

et al. 2011

Fertility and Sterility

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“…Nine of the remaining 839 athletes had T concentration above 3 nmol/L; all had oligo/amenorrhea [59]. Testosterone levels differed among the various types of athletic events – throwers, sprinters and to a lesser extent, jumpers had higher T levels than the distance runners, in agreement with the anabolic (with reference to energy balance) phenotype discussed by Hagmar et al [57]. The T concentration had a geometric mean of 1.78 nmol/L, compared to a similar normal population (1.6; 95% CI 1.046–1.72), but a mean of 2.68 nmol/L because of a few, very significant outliers.…”

Section: Athletes and Hyperandrogenemiamentioning

confidence: 56%

“…Hagmar et al [57] noted enhanced diurnal secretion of testosterone and LH, low circulating levels of SHBG and a high frequency of polycystic ovarian morphology on ultrasound examination. A subset of Olympic athletes had anabolic body compositions and hormone profiles consistent with those in women with PCOS: an increased ratio of LH to FSH and higher T levels [57]. These findings were highest among power athletes such as runners and throwers and least frequent in technical sport such as archers and shooters.…”

Section: Athletes and Hyperandrogenemiamentioning

confidence: 99%

The Interconnected Histories of Endocrinology and Eligibility in Women’s Sport

Rogol

Pieper

2018

Horm Res Paediatr

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This report illustrates the links between history, sport, endocrinology, and genetics to show the ways in which historical context is key to understanding the current conversations and controversies about who may compete in the female category in elite sport. The International Association of Athletics Federations (IAAF) introduced hyperandrogenemia regulations for women’s competitions in 2011, followed by the International Olympic Committee (IOC) for the 2012 Olympics. The policies concern female athletes who naturally produce higher-than-average levels of testosterone and want to compete in the women’s category. Hyperandrogenemia guidelines are the current effort in a long series of attempts to determine women’s eligibility scientifically. Scientific endeavors to control who may participate as a woman illustrate the impossibility of neatly classifying competitors by sex and discriminate against women with differences of sex development (also called intersex by some).

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“…34 Nonetheless, in athletes whose body mass was within reference range, amenorrhea and oligomenorrhea have also been associated with polycystic ovarian syndrome and hyperandrogenism. 35 With these hormone physiology factors in mind, we developed the following hypotheses: Hypothesis 1. The estradiol-progesterone profile of high school girls participating in training, conditioning, and competition will differ from that of physically inactive, age-matched girls throughout a 3-month period.…”

Section: Endocrinology Of Physical Activity and Menstrual Cyclicitymentioning

confidence: 99%

Athletic Activity and Hormone Concentrations in High School Female Athletes

Wojtys¹,

Jannausch²,

Kreinbrink

et al. 2015

Journal of Athletic Training

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Context: Physical activity may affect the concentrations of circulating endogenous hormones in female athletes. Understanding the relationship between athletic and physical activity and circulating female hormone concentrations is critical.Objective: To test the hypotheses that (1) the estradiolprogesterone profile of high school adolescent girls participating in training, conditioning, and competition would differ from that of physically inactive, age-matched adolescent girls throughout a 3-month period; and (2) athletic training and conditioning would alter body composition (muscle, bone), leading to an increasingly greater lean-body-mass to fat-body-mass ratio with accompanying hormonal changes.Design: Cohort study. Settings: Laboratory and participants' homes. Patients or Other Participants: A total of 106 adolescent girls, ages 14-18 years, who had experienced at least 3 menstrual cycles in their lifetime.Main Outcome Measure(s): Participants were prospectively monitored throughout a 13-week period, with weekly physical activity assessments and 15 urine samples for estrogen, luteinizing hormone, creatinine, and progesterone concentrations. Each girl underwent body-composition measurements before and after the study period.Results: Seventy-four of the 98 girls (76%) who completed the study classified themselves as athletes. Body mass index, body mass, and fat measures remained stable, and 17 teenagers had no complete menstrual cycle during the observation period. Mean concentrations of log(estrogen/creatinine) were slightly greater in nonathletes who had cycles of ,24 or .35 days. Mean log(progesterone/creatinine) concentrations in nonathletes were less in the first half and greater in the second half of the cycle, but the differences were not statistically significant.Conclusions: A moderate level of athletic or physical activity did not influence urine concentrations of estrogen, progesterone, or luteinizing hormones. However, none of the participants achieved high levels of physical activity. A significant number (17%) of girls in both activity groups were amenorrheic during the 3-month study period.Key Words: menstrual cycle, estrogen, anterior cruciate ligament, exercise physiology Key PointsUrine concentrations of estrogen and progesterone in high school females were not altered by level of physical or athletic activity. A significant number of both athletic and nonathletic young women were amenorrheic and probably anovulatory during the 3-month study period. Athletic training and conditioning did not alter body composition over the course of the study.

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Hyperandrogenism May Explain Reproductive Dysfunction in Olympic Athletes

Cited by 96 publications

References 31 publications

Polycystic ovary–like syndrome in adolescent competitive swimmers

Polycystic ovary–like syndrome in adolescent competitive swimmers

The Interconnected Histories of Endocrinology and Eligibility in Women’s Sport

Athletic Activity and Hormone Concentrations in High School Female Athletes

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