4.4 Review

Understanding the female athlete: molecular mechanisms underpinning menstrual phase differences in exercise metabolism

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Influence of the Menstrual Cycle on Muscle Glycogen Repletion After Exhaustive Exercise in Eumenorrheic Women

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Summary: This study aimed to investigate the impact of the menstrual cycle on muscle glycogen repletion postexercise. The findings suggest that the menstrual cycle does not influence muscle glycogen repletion after exercise.

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Summary: This study found that genetic polymorphisms in CYP19A1 influence serum estradiol levels in men, and genetic polymorphisms in CYP19A1 and ESR1 are associated with serum CK activity in men. Male subjects with the TT genotype of the CYP19A1 polymorphism exhibited higher serum estradiol levels.

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Summary: The study explored sex-based differences in energy substrate utilization during moderate-intensity aerobic exercise, with men displaying greater reliance on carbohydrates while women rely more on lipids. Interestingly, no significant differences were observed in athletes, and further mechanistically driven research is needed, especially for protein sources, which are less investigated.

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Summary: Various studies have shown that sex steroids play a crucial role in the differences in body composition and energy substrate storage between men and women. Women tend to rely more on fat and less on carbohydrates during exercise at the same relative intensity. Specifically, 17-beta oestradiol is identified as a key hormone in regulating body composition and substrate metabolism.

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Tomoka Matsuda et al.

Summary: The present study investigated the effects of the menstrual cycle on muscle glycogen and circulating substrates during high-intensity intermittent exercise until exhaustion in healthy women who habitually exercised. The results showed that although exercise time does not change with the menstrual cycle, the menstrual cycle influences the utilization of muscle glycogen.

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Influence of Menstrual Cycle on Leukocyte Response Following Exercise-Induced Muscle Damage

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Physiological interindividual variability in endogenous estradiol concentration does not influence adipose tissue and hepatic lipid kinetics in women

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Summary: This study aimed to investigate the influence of physiological variation in endogenous estradiol on VLDL-Triglyceride (TG) and VLDL-apoB-100 metabolism and free fatty acid (FFA) release in premenopausal women. The results showed that plasma estradiol concentration is not an important correlate of basal plasma FFA, VLDL-TG, and VLDL-apoB-100 kinetics in premenopausal women.

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Contraction-Mediated Glucose Transport in Skeletal Muscle Is Regulated by a Framework of AMPK, TBC1D1/4, and Rac1

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Exercise-Induced Muscle Damage During the Menstrual Cycle: A Systematic Review and Meta-Analysis

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Summary: This study identified differences in delayed onset muscle soreness and strength loss during different phases of the menstrual cycle, suggesting that hormone fluctuations may affect exercise-induced muscle damage. Lower training loads or longer recovery periods may be considered during the early follicular phase, while strength conditioning loads could be enhanced during the midluteal phase.

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Summary: Progesterone hormone acts through classical and non-classical receptors in the female reproductive system, affecting menstrual cycle, pregnancy, and parturition. These receptors regulate cell responses through different signaling pathways, playing a crucial role in female reproductive tissues.

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Estrogen and Glycemic Homeostasis: The Fundamental Role of Nuclear Estrogen Receptors ESR1/ESR2 in Glucose Transporter GLUT4 Regulation

Karen Cristina Rego Gregorio et al.

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Resting skeletal muscle PNPLA2 (ATGL) and CPT1B are associated with peak fat oxidation rates in men and women but do not explain observed sex differences

Oliver J. Chrzanowski-Smith et al.

Summary: This study found that proteins in skeletal muscle related to triglyceride hydrolysis and mitochondrial lipid transport are more strongly associated with peak fat oxidation rates than proteins in adipose tissue. Despite females having higher fat oxidation rates than males, this difference is not explained by the proteins measured in this study, suggesting other factors are involved. Overall, muscle proteins play a more significant role in regulating peak fat oxidation compared to adipose tissue proteins, and sex differences in fat metabolism are likely influenced by factors beyond these measured proteins.

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Hui-Ying Luk et al.

Summary: The study aimed to investigate the impact of resistance exercise-induced hormonal changes on intramuscular cytokine gene expression after muscle damage in untrained men and women. Results showed that men had a stronger response to factors like TGFB, IL-10, and TNFA compared to women, suggesting a gender difference in intramuscular cytokine response to muscle damage.

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Oxidative Stress Is Increased in Combined Oral Contraceptives Users and Is Positively Associated with High-Sensitivity C-Reactive Protein

Sabina Cauci et al.

Summary: This study found that oral contraceptive users had significantly elevated oxidative stress and increased levels of serum hsCRP, indicating signs of low-grade chronic inflammation. Additionally, there was a strong positive correlation between oxidative stress and hsCRP, which is significant in assessing the risk for future cardiovascular diseases.

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J. Frandsen et al.

Summary: This study found that women under the age of 45 had a significantly higher maximal fat oxidation rate (MFO) compared to men, but this sex-related difference disappeared after the age of 45.

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Sirtuin 1 is not required for contraction-stimulated glucose uptake in mouse skeletal muscle

Ji H. Kang et al.

Summary: This study found that the loss of SIRT1 deacetylase function in muscle does not affect glucose uptake in response to ex vivo contractions, regardless of sex or muscle type. However, it was demonstrated that, similar to insulin-stimulated glucose uptake, contraction-stimulated glucose uptake is significantly higher in female compared to male skeletal muscle. This study is the first to show sex-based differences in contraction-stimulated glucose uptake in skeletal muscle.

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Carbohydrate improves exercise capacity but does not affect subcellular lipid droplet morphology, AMPK and p53 signalling in human skeletal muscle

J. Marc Fell et al.

Summary: Muscle glycogen and intramuscular triglycerides are important energy substrates during prolonged exercise. Exercise-induced changes in lipid droplet morphology have been found to be influenced by exercise and CHO feeding in trained males. CHO feeding did not affect glycogen or IMTG utilization in muscle fibres. Moreover, CHO feeding did not attenuate cell signalling pathways related to mitochondrial biogenesis during exercise.

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Carbohydrate-Restricted Exercise With Protein Increases Self-Selected Training Intensity in Female Cyclists but Not Male Runners and Cyclists

Tanja Oosthuyse et al.

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Methodological Considerations for Studies in Sport and Exercise Science with Women as Participants: A Working Guide for Standards of Practice for Research on Women

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Temporal changes in blood oxidative stress biomarkers across the menstrual cycle and with oral contraceptive use in active women

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A. T. Hulton et al.

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Menstrual Cycle Hormonal Changes and Energy Substrate Metabolism in Exercising Women: A Perspective Comment

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Influence of Menstrual Cycle Estradiol-β-17 Fluctuations on Energy Substrate Utilization-Oxidation during Aerobic, Endurance Exercise

Hannah N. Willett et al.

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Sex differences in hormone-sensitive lipase expression, activity, and phosphorylation in skeletal muscle at rest and during exercise

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Menstrual cycle phase and sex influence muscle glycogen utilization and glucose turnover during moderate-intensity endurance exercise

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Michael J. Toth et al.

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No effect of menstrual cycle on myofibrillar and connective tissue protein synthesis in contracting skeletal muscle

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Influence of estrogen on skeletal muscle damage, inflammation, and repair

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Effect of menstrual phase on the acetate correction factor used in metabolic tracer studies

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Effect of the ovarian hormones on GLUT4 expression and contraction-stimulated glucose uptake

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Estrogen attenuates postexercise HSP70 expression in skeletal muscle

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Myocellular triacylglycerol breakdown in females but not in males during exercise

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