期刊
INTERNATIONAL JOURNAL OF SPORTS MEDICINE
卷 44, 期 2, 页码 81-94出版社
GEORG THIEME VERLAG KG
DOI: 10.1055/a-1909-1196
关键词
sex steroid hormones; female athletes; hyperandrogenism; testosterone; transgender woman
Various endogenous and exogenous variables affect the hormone levels and sports performance in female athletes, and differences in sex chromosome abnormalities contribute to biological, functional, and hormonal variations among athletes. Physicians need to be aware of and understand the hormone variability and related health concerns in order to support healthy, fair, and inclusive sports participation for female athletes.
In the female athletic community, there are several endogenous and exogenous variables that influence the status of the hypothalamus-pituitary-ovarian axis and serum sex steroid hormones concentrations (e. g., 17 beta-estradiol, progesterone, androgens) and their effects. Moreover, female athletes with different sex chromosome abnormalities exist (e. g., 46XX, 46XY, and mosaicism). Due to the high variability of sex steroid hormones serum concentrations and responsiveness, female athletes may have different intra- and inter-individual biological and functional characteristics, health conditions, and sports-related health risks that can influence sports performance and eligibility. Consequently, biological, functional, and/or sex steroid differences may exist in the same and in between 46XX female athletes (e. g., ovarian rhythms, treated or untreated hypogonadism and hyperandrogenism), between 46XX and 46XY female athletes (e. g., treated or untreated hyperandrogenism/disorders of sexual differentiation), and between transgender women and eugonadal cisgender athletes. From a healthcare perspective, dedicated physicians need awareness, knowledge, and an understanding of sex steroid hormones' variability and related health concerns in female athletes to support physiologically healthy, safe, fair, and inclusive sports participation. In this narrative overview, we focus on the main clinical relationships between hypothalamus-pituitary-ovarian axis function, endogenous sex steroids and health status, health risks, and sports performance in the heterogeneous female athletic community.
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