Testosterone concentrations in female athletes and ballet dancers with menstrual disorders

Abstract

Menstrual disorders are common among female athletes and ballet dancers. Endocrine changes, such as high testosterone (HT) levels and high luteinizing hormone (LH)/follicle-stimulating hormone (FSH) ratios, may suggest functional ovarian hyperandrogenism which may induce such dysfunction. The aim of this study was therefore to evaluate endocrine status in female athletes and ballet dancers with menstrual disorders. Their nutritional status and dietary habits were analysed in relation to the testosterone levels. In a cross-sectional approach, 31 female athletes (18.1 ± 2.6 years) and 21 ballerinas (17.1 ± 0.9) with menstrual disorders participated in the study. The levels of serum LH, FSH, progesterone (P), estradiol (E2), prolactin (PRL), thyroid-stimulating hormone, testosterone (T) and sex hormone-binding globulinwere measured to assess hormonal status. In addition, the free androgen index (FAI) was calculated. Nutritional status, total daily energy expenditure and nutritional habits were evaluated. Girls were assigned to one of the following groups: low testosterone (LT) level, normal testosterone level or HT level. There were significant differences between ballerinas and other female athletes in terms of testosterone levels, FAI, age at the beginning of training, length of training period and age at menarche. The PRL level was lowest in the LT group while the FAI index was highest in the HT group. Daily energy and carbohydrate intakes were significantly lower in the HT group. T levels in the study subjects were found to be associated with nutritional factors, energy availability, age at the beginning of training and frequency of training. This is the first report of HT levels being associated with the status of a female ballet dancer, the age of menarche and the length of the training history. Further research is necessary to confirm the results in a larger study group.

Sex differences in extinction to negative stimuli

“…Most (75%) women with affective disorders experience significant symptoms in the luteal phase of the menstrual cycle. [ 16 ] Compared to men, women in the luteal phase show more abnormalities in decision making and spend more attentive resources on ERPs. [ 14 , 15 ] These findings, together with our earlier report, [ 38 ] provide a sound explanation of the neural mechanism by which extinction, not acquisition, is more difficult in women than in men.…”

“…[ 14 , 15 ] Levels of estrogen and progesterone are low during menses compared to the follicular phase, which is characterized by high estradiol levels. [ 16 ] Some evidence from animal studies [ 9 , 11 , 17 ] suggest that gonadal hormones in different menstrual cycles may influence or contribute to sex differences in conditioned fear extinction, as well as the recall of conditioned fear. In the present research, women in 2 different phases of the menstrual cycle were compared to each other and to a group of men.…”

Sport, doping and female fertility

“…However, excluding subjects with hyperandrogenic disorder of sex development who are exposed to high levels of androgens from prenatal age, since the athletes often begin training before menarche, the influence of intensive training on pubertal development and menstrual function cannot be excluded. Female athletes with oligomenorrhea and hyperandrogenism show a higher frequency of delayed puberty [ 64 , 70 ]. Therefore, some authors hypothesized that hyperandrogenism may be a consequence of intensive training rather than a primitive factor influencing sports performance and, consequently, selection [ 70 ].…”

“…Female athletes with oligomenorrhea and hyperandrogenism show a higher frequency of delayed puberty [ 64 , 70 ]. Therefore, some authors hypothesized that hyperandrogenism may be a consequence of intensive training rather than a primitive factor influencing sports performance and, consequently, selection [ 70 ].…”

“…The authors excluded in all hyperandrogenic subjects the main conditions that can cause hyperandrogenism (PCOS, congenital adrenal hyperplasia, Cushing’s syndrome and androgen-secreting tumours). Interestingly, the high T group showed the lowest energy and carbohydrate intake and the lowest energy availability [ 70 ]. Therefore, the authors hypothesize that the increase in T levels could represent a sort of protective mechanism against excessive weight loss thanks to T property of stimulating the growth of lean tissue mass.…”