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Ambrozy CA, Hawes NE, Hayden OL, Sortz I, Malek MH. Caffeine Expectancy Does Not Influence the Physical Working Capacity at the Fatigue Threshold. J Strength Cond Res 2024; 38:1056-1062. [PMID: 38781467 DOI: 10.1519/jsc.0000000000004742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
ABSTRACT Ambrozy, CA, Hawes, NE, Hayden, OL, Sortzi, I, and Malek, MH. Caffeine expectancy does not influence the physical working capacity at the fatigue threshold. J Strength Cond Res 38(6): 1056-1062, 2024-The placebo effect occurs when a desired outcome is experienced due to the belief that a treatment is effective, even in the absence of an active ingredient. One explanation for this effect is based on a person's expectations of a drug or supplement. Although caffeine's effects on sports performance have been studied, little is known about how expectations of caffeine affect neuromuscular fatigue during continuous muscle action. The physical working capacity at the fatigue threshold (PWCFT) can be used to assess neuromuscular fatigue noninvasively using surface electromyography. Thus, the purpose of this study was to investigate whether caffeine expectancy influences PWCFT. We hypothesized that regardless of expectancy, caffeine consumption would delay neuromuscular fatigue. The study involved 8 healthy college-aged men (mean ± SEM: age, 25.6 ± 1.0 years) who visited the laboratory on 4 occasions, each separated by 7 days. The subjects completed 4 experimental conditions, in random order, where they were told that they were consuming caffeine or placebo and either received caffeine or placebo. After consuming the drink, the subjects remained in the laboratory for an hour and then performed an incremental exercise test. The results showed that the condition where subjects were told that they were consuming caffeine and received caffeine had significantly higher mean values for maximal power output (F(3, 21) = 11.75; p < 0.001), PWCFT (F(3, 21) = 12.28; p < 0.001), PWCFT (%maximal power output; F(3, 21) = 8.75; p < 0.001), and heart rate at end exercise (%predicted; F(3, 21) = 3.83; p = 0.025) compared with the 2 conditions where placebo was received. However, no statistically significant mean differences were found from the condition where subjects were told that they were consuming placebo but consuming caffeine. This suggests that a person's expectancy and potential somatic response may serve as a cue for how an ergogenic aid or placebo could affect subsequent performance.
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Affiliation(s)
- Christina A Ambrozy
- Physical Therapy Program, Department of Health Care Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan; and
- Integrative Physiology of Exercise Laboratory, Department of Health Care Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan
| | - Nicole E Hawes
- Physical Therapy Program, Department of Health Care Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan; and
- Integrative Physiology of Exercise Laboratory, Department of Health Care Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan
| | - Olivia L Hayden
- Physical Therapy Program, Department of Health Care Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan; and
- Integrative Physiology of Exercise Laboratory, Department of Health Care Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan
| | - Isabella Sortz
- Physical Therapy Program, Department of Health Care Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan; and
- Integrative Physiology of Exercise Laboratory, Department of Health Care Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan
| | - Moh H Malek
- Physical Therapy Program, Department of Health Care Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan; and
- Integrative Physiology of Exercise Laboratory, Department of Health Care Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan
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Thompson SL, Brade CJ, Henley-Martin SR, Naylor LH, Spence AL. Vascular adaptation to exercise: a systematic review and audit of female representation. Am J Physiol Heart Circ Physiol 2024; 326:H971-H985. [PMID: 38391316 DOI: 10.1152/ajpheart.00788.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 02/24/2024]
Abstract
Biological sex is a salient factor in exercise-induced vascular adaptation. Although a male bias is apparent in the literature, the methodological quality of available studies in females is not yet known. This systematic review with narrative synthesis aimed to assess available evidence of exercise interventions on endothelial function, measured using flow-mediated dilation, in otherwise healthy individuals and athletes. A standardized audit framework was applied to quantify the representation of female participants. Using a tiered grading system, studies that met best-practice recommendations for conducting physiological research in females were identified. A total of 210 studies in 5,997 participants were included, with 18% classified as athletes. The primary exercise mode and duration were aerobic (49%) and acute (61%), respectively. Despite 53% of studies (n = 111) including at least one female, female participants accounted for only 39% of the total study population but 49% of the athlete population. Majority (49%) of studies in females were conducted in premenopausal participants. No studies in naturally menstruating, hormonal contraceptive-users or in participants experiencing menstrual irregularities met all best-practice recommendations. Very few studies (∼5%) achieved best-practice methodological guidelines for studying females and those that did were limited to menopause and pregnant cohorts. In addition to the underrepresentation of female participants in exercise-induced vascular adaptation research, there remains insufficient high-quality evidence with acceptable methodological control of ovarian hormones. To improve the overall methodological quality of evidence, adequate detail regarding menstrual status should be prioritized when including females in vascular and exercise research contexts.
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Affiliation(s)
- Sarah L Thompson
- Exercise Science, Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Carly J Brade
- Exercise Science, Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Sarah R Henley-Martin
- Exercise Science, Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Louise H Naylor
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia
| | - Angela L Spence
- Exercise Science, Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
- Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
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Saito R, Shagawa M, Sugimoto Y, Hirai T, Kato K, Sekine C, Yokota H, Hirabayashi R, Ishigaki T, Akuzawa H, Togashi R, Yamada Y, Osanami H, Edama M. Changes in the mechanical properties of the thigh and lower leg muscle-tendon units during the early follicular and early luteal phases. Front Sports Act Living 2024; 6:1323598. [PMID: 38596640 PMCID: PMC11002163 DOI: 10.3389/fspor.2024.1323598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/12/2024] [Indexed: 04/11/2024] Open
Abstract
Background This study aimed to determine changes in the muscle and tendon stiffness of the thigh and lower leg muscle-tendon units during the early follicular and early luteal phases, and check for possible relations between muscle and tendon stiffness in each phase. Methods The sample consisted of 15 female university students with regular menstrual cycles. The basal body temperature method, ovulation kit, and salivary estradiol concentration measurement were used to estimate the early follicular and early luteal phases. A portable digital palpation device measured muscle-tendon stiffness in the early follicular and early luteal phases. The measurement sites were the rectus femoris (RF), vastus medialis (VM), patellar tendon (PT), medial head of gastrocnemius muscle, soleus muscle, and Achilles tendon. Results No statistically significant differences in the thigh and lower leg muscle-tendon unit stiffness were seen between the early follicular and early luteal phases. Significant positive correlations were found between the stiffness of the RF and PT (r = 0.608, p = 0.016) and between the VM and PT (r = 0.737, p = 0.002) during the early luteal phase. Conclusion The present results suggest that the stiffness of leg muscle-tendon units of the anterior thigh and posterior lower leg do not change between the early follicular and early luteal phases and that tendons may be stiffer in those women who have stiffer anterior thigh muscles during the early luteal phase.
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Maasri RE, Jarvie JR, Karski JS, Smith LJ, Malek MH. The Influence of Cold Therapy on the Physical Working Capacity at the Electromyographic Threshold for Consecutive Exercise Sessions. Bioengineering (Basel) 2024; 11:292. [PMID: 38534566 DOI: 10.3390/bioengineering11030292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/28/2024] [Accepted: 03/15/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND The purpose of this study was to determine whether cold therapy after the first exercise test influences the physical working capacity at the fatigue threshold (PWCFT) during the second exercise test. We hypothesized that cold therapy would delay the onset of PWCFT for the second exercise test relative to the control visit (i.e., no cold therapy). METHODS Eight healthy college-aged men volunteered for the present study. For each of the two visits, subjects performed incremental, single-leg, knee-extensor ergometer, followed by either resting for 30 min (control visit) or having a cold pack applied for 15 min and then resting for 15 min (experimental visit). Then, the same exercise test was performed. The order of visits (control vs. experimental) was randomized for each subject. The exercise indices and PWCFT were determined for each of the two visits and statistically analyzed using two-way repeated measures analysis of variance. RESULTS The results indicate no significant (p > 0.05) mean differences for maximal power output, heart rate at end-exercise, and PWCFT between the control and cold therapy visits. Moreover, there were no significant (p > 0.05) mean differences between the first and second exercise workbout within each visit. CONCLUSIONS The findings of this study suggest that cold therapy did not influence neuromuscular fatigue.
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Affiliation(s)
- Rami E Maasri
- Physical Therapy Program, Department of Health Care Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
- Integrative Physiology of Exercise Laboratory, Department of Health Care Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
| | - Jonathan R Jarvie
- Physical Therapy Program, Department of Health Care Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
- Integrative Physiology of Exercise Laboratory, Department of Health Care Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
| | - Jacob S Karski
- Physical Therapy Program, Department of Health Care Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
- Integrative Physiology of Exercise Laboratory, Department of Health Care Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
| | - Logan J Smith
- Physical Therapy Program, Department of Health Care Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
- Integrative Physiology of Exercise Laboratory, Department of Health Care Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
| | - Moh H Malek
- Physical Therapy Program, Department of Health Care Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
- Integrative Physiology of Exercise Laboratory, Department of Health Care Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
- Eugene Applebaum College of Pharmacy & Health Sciences, Wayne State University, 259 Mack Avenue, Room 2248, Detroit, MI 48201, USA
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Oxfeldt M, Frederiksen LK, Gunnarson T, Hansen M. Influence of menstrual cycle phase and oral contraceptive phase on exercise performance in endurance-trained females. J Sports Med Phys Fitness 2024; 64:236-247. [PMID: 38213268 DOI: 10.23736/s0022-4707.23.15458-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
BACKGROUND Limited data exists on the influence of menstrual cycle (MC) phase and oral contraceptive (OC) phase on physical performance in endurance-trained females due to poor control regarding MC verification and differentiation. We aimed to evaluate exercise performance and the respiratory response to exercise in three distinct phases of the MC and OC cycle in endurance-trained females. METHODS Using a prospective cohort study design, we recruited trained females (Vo2max 52±4 mL O2/min/kg) who were either not using oral contraceptives (NOC) or using monophasic OCs. NOC were tested in the early and late follicular phase (FP) and the mid-luteal phase (LP). OC-users were tested in the withdrawal phase (WP) and two times in the active OC phase (OCP). The test battery included DXA scans, blood sampling, a submaximal bike test, a maximal isometric knee-extensor strength test, 4 and 20-second bike sprints, and a 6 min time trial on a bike. MC phases were verified by the use of ovulation kits and circulating sex hormone levels. RESULTS After the exclusion of four NOCs due to inadequate sex hormone levels, 11 NOC and 13 OC users were included in the final analysis. 6 min time trial performance, sprint performance, and most submaximal exercise intensity variables did not differ between MC phases and OC cycle phases. However, in NOC, ventilation (L/min) during exercise at 30% of aerobic peak power was 7.6% lower in the late FP compared to the LP (P<0.05). In OC users, muscle strength was 3.9% higher in the early OCP compared to WP (P<0.05), whereas body mass was higher in the late OCP compared to WP (P<0.05). CONCLUSIONS Collectively, our study suggests that MC phase and OCP influence exercise performance to a limited extent in endurance-trained females.
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Affiliation(s)
- Mikkel Oxfeldt
- Department of Public Health, University of Aarhus, Aarhus, Denmark
| | - Louise K Frederiksen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Gunnarson
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Mette Hansen
- Department of Public Health, University of Aarhus, Aarhus, Denmark -
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Yoon S, Cederbaum LA, Côté JN. Females show less decline in contractile function than males after repeated all-out cycling. Appl Physiol Nutr Metab 2024; 49:199-212. [PMID: 37820383 DOI: 10.1139/apnm-2023-0184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Females demonstrate greater fatigue resistance during a range of exercise modalities; however, this may be confounded by the lower mechanical work completed. Accordingly, this study examined the sex-specific peripheral and central fatigue mechanisms during repeated all-out cycling and whether they are affected by total mechanical work performed. A total of 26 healthy young adults (12 females) performed 10 × 10 s all-out cycling interspersed by 30 s passive recovery. Metabolic responses, peripheral and central fatigue, were quantified via changes in pre- to post-exercise blood lactate, potentiated quadriceps twitch force (and contractile properties) evoked via supramaximal electrical stimulation of the femoral nerve, and voluntary activation of the knee extensors, respectively. During exercise, mechanical work, vastus lateralis muscle activation (via surface electromyography), and deoxygenation (via near-infrared spectroscopy) were recorded. Sex comparison analyses were performed before and after statistically controlling for total mechanical work (via ANCOVA). Mechanical work and muscle activation plateaued at similar sprint repetition (sprint 5) and voluntary activation change (pre vs. post) was similar between the sexes. Females, however, showed lower %work decrement (i.e., fatigability; P = 0.037) and peripheral responses as evident by lower reductions in quadriceps twitch force (P < 0.001) and muscle deoxygenation (P = 0.001). Adjusting for total mechanical work did not change these sex comparison results. We show that females' greater fatigue resistance during repeated all-out cycling may not be attributed to the greater total mechanical work performed but could be mediated by lower peripheral fatigue in the knee extensor muscles.
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Affiliation(s)
- SangHoon Yoon
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, QC H2W 1S4, Canada
| | - Lauren A Cederbaum
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, QC H2W 1S4, Canada
| | - Julie N Côté
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, QC H2W 1S4, Canada
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Ekberg S, Morseth B, Larsén KB, Wikström-Frisén L. Does the Menstrual Cycle Influence Aerobic Capacity in Endurance-Trained Women? Res Q Exerc Sport 2023:1-8. [PMID: 38109660 DOI: 10.1080/02701367.2023.2291473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 11/30/2023] [Indexed: 12/20/2023]
Abstract
Purpose: The aim was to study if aerobic capacity varies during different phases of the menstrual cycle (MC) in endurance-trained female athletes. Methods: Ten endurance-trained eumenorrheic women performed a submaximal test followed by an incremental test until exhaustion three times during one MC, early follicular phase (EFP), late follicular phase (LFP), and midluteal phase (MLP). During the submaximal test, the respiratory exchange ratio (RER) and utilization of fat and carbohydrates were analyzed; and, during the incremental test, VO2 peak, maximal heart rate, utilization of fat and carbohydrates, and RER were analyzed. Lactate levels were analyzed at rest, during the submaximal test, and after the incremental test. The anaerobic threshold was determined at RER = 1. Results: No significant differences (p < .05) between the MC phases were seen in a maximal heart rate or VO2peak. Similarly, VO2, heart rate, RER, fatty acid oxidation, and carbohydrate oxidation at 70, 80, 90, and 100% of VO2peak did not differ significantly between MC phases. There were no significant differences between these phases in resting lactate before the test or during the submaximal tests, though there was a significant difference in lactate concentration 3 minutes after the incremental test between the EFP and the LFP (p = .043). Conclusion: This study did not display variations in physiological parameters between EFP, LFP, and MLP, indicating similar aerobic capacity despite hormonal variations. This knowledge may be useful when planning for competition in aerobic events.
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Barth C, Crestol A, de Lange AMG, Galea LAM. Sex steroids and the female brain across the lifespan: insights into risk of depression and Alzheimer's disease. Lancet Diabetes Endocrinol 2023; 11:926-941. [PMID: 37865102 DOI: 10.1016/s2213-8587(23)00224-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 10/23/2023]
Abstract
Despite widespread sex differences in prevalence and presentation of numerous illnesses affecting the human brain, there has been little focus on the effect of endocrine ageing. Most preclinical studies have focused on males only, and clinical studies often analyse data by covarying for sex, ignoring relevant differences between the sexes. This sex- (and gender)-neutral approach is biased and contributes to the absence of targeted treatments and services for all sexes (and genders). Female health has been historically understudied, with grave consequences for their wellbeing and health equity. In this Review, we spotlight female brain health across the lifespan by informing on the role of sex steroids, particularly oestradiol, on the female brain and on risk for diseases more prevalent in females, such as depression and Alzheimer's disease.
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Affiliation(s)
- Claudia Barth
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Arielle Crestol
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ann-Marie G de Lange
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland; Department of Psychiatry, University of Oxford, Oxford, UK; Department of Psychology, University of Oslo, Oslo, Norway
| | - Liisa A M Galea
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada
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De Martin Topranin V, Engseth TP, Hrozanova M, Taylor M, Sandbakk Ø, Noordhof DA. The Influence of Menstrual-Cycle Phase on Measures of Recovery Status in Endurance Athletes: The Female Endurance Athlete Project. Int J Sports Physiol Perform 2023; 18:1296-1303. [PMID: 37726100 DOI: 10.1123/ijspp.2022-0325] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 06/16/2023] [Accepted: 07/17/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE To investigate the influence of menstrual-cycle (MC) phase on measures of recovery status, that is, resting heart rate, perceived sleep quality, and physical and mental readiness to train, among female endurance athletes. METHODS Daily data were recorded during 1 to 4 MCs (ie, duration ≥21 and ≤35 d, ovulatory, luteal phase ≥10 d) of 41 trained-to-elite-level female endurance athletes (mean [SD]: age 27 [8] y, weekly training: 9 [3] h). Resting heart rate was assessed daily using a standardized protocol, while perceived sleep quality and physical and mental readiness to train were assessed using a visual analog scale (1-10). Four MC phases (early follicular phase [EFP], late follicular phase, ovulatory phase, and midluteal phase [MLP]) were determined using the calendar-based counting method and urinary ovulation-prediction test. Data were analyzed using linear mixed-effects models. RESULTS Resting heart rate was significantly higher in MLP (1.7 beats·min-1, P = .006) compared with EFP without significant differences between the other MC phases. Perceived sleep quality was impaired in MLP compared with late follicular phase (-0.3, P = .035). Physical readiness to train was lower both in ovulatory phase (-0.6, P = .015) and MLP (-0.5, P = .026) compared with EFP. Mental readiness to train did not show any significant differences between MC phases (P > .05). CONCLUSIONS Although significant, the findings had negligible to small effect sizes, indicating that MC phase is likely not the main determinant of changes in measures of recovery status but, rather, one of the many possible stressors.
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Affiliation(s)
- Virginia De Martin Topranin
- Center for Elite Sports Research, Department of Neuromedicine and Movement Science (INB), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Maria Hrozanova
- Center for Elite Sports Research, Department of Neuromedicine and Movement Science (INB), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Madison Taylor
- School of Sport Sciences, UiT Arctic University of Norway, Tromsø, Norway
| | - Øyvind Sandbakk
- Center for Elite Sports Research, Department of Neuromedicine and Movement Science (INB), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- School of Sport Sciences, UiT Arctic University of Norway, Tromsø, Norway
| | - Dionne A Noordhof
- Center for Elite Sports Research, Department of Neuromedicine and Movement Science (INB), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Dupuit M, Meignié A, Chassard T, Blanquet L, LeHeran J, Delaunay T, Bernardeau E, Toussaint JF, Duclos M, Antero J. On-Field Methodological Approach to Monitor the Menstrual Cycle and Hormonal Phases in Elite Female Athletes. Int J Sports Physiol Perform 2023; 18:1169-1178. [PMID: 37666497 DOI: 10.1123/ijspp.2022-0287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 05/17/2023] [Accepted: 06/15/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVES Currently, there are no guidelines for implementing the monitoring of menstrual status, including the natural menstrual cycle (NC) or oral contraception (OC), in a sport setting. We aimed to provide a feasible, on-field methodological approach for monitoring NC and OC in female athletes. METHODS We developed a smartphone app with daily questionnaires to monitor both NC and OC phases in 19 elite female soccer players (23.7 [4.4] y) over 7 months. Adherence and compliance were evaluated. The NC and OC phases were based on calendar data to establish an individual menstrual profile for each athlete. RESULTS The initial questionnaire revealed that the vast majority of female players (80%) were interested in monitoring their menstrual status. The online monitoring yielded high athlete adherence (87.0% [14.2%]) with a slight decrease over the winter break and at the end of the championship, which necessitated adaptations to promote compliance. Monitoring identified the specific menstrual pattern of each athlete and highlighted large interindividual variability. CONCLUSION This study assesses, for the first time, the interest of female players in monitoring their menstrual status. It provides a new methodological approach, as well as guidelines for optimizing on-field monitoring. It also anticipates some obstacles sport staff may encounter when trying to implement such follow-up. It is essential to better understand the menstrual profile of athletes and determine its potential impacts on well-being and performance.
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Affiliation(s)
- Marine Dupuit
- Laboratory of Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne (UCA), Clermont-Ferrand, France
- Institute for Research in Medicine and Epidemiology of Sports (IRMES, EA7329), INSEP, Paris, France
| | - Alice Meignié
- Institute for Research in Medicine and Epidemiology of Sports (IRMES, EA7329), INSEP, Paris, France
| | - Tom Chassard
- Institute for Research in Medicine and Epidemiology of Sports (IRMES, EA7329), INSEP, Paris, France
| | - Ludivine Blanquet
- Institute for Research in Medicine and Epidemiology of Sports (IRMES, EA7329), INSEP, Paris, France
| | | | | | | | - Jean-François Toussaint
- Institute for Research in Medicine and Epidemiology of Sports (IRMES, EA7329), INSEP, Paris, France
- CIMS, Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
- Université Paris Cité, Paris, France
| | - Martine Duclos
- Sport Medicine and Functional Explorations, University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France
- Unité de Nutrition Humaine (UNH), Université Clermont Auvergne (UCA), INRA, Clermont-Ferrand, France
| | - Juliana Antero
- Institute for Research in Medicine and Epidemiology of Sports (IRMES, EA7329), INSEP, Paris, France
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Bingzheng Z, Xinzhuo Z, Zhuo J, Xing Y, Bin L, Lunhao B. The effects of sex hormones during the menstrual cycle on knee kinematics. Front Bioeng Biotechnol 2023; 11:1209652. [PMID: 37744250 PMCID: PMC10512414 DOI: 10.3389/fbioe.2023.1209652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/28/2023] [Indexed: 09/26/2023] Open
Abstract
The effects of the menstrual cycle and sex hormones on knee kinematics remain unclear. The purpose of the study was to investigate the effects of the menstrual cycle and serum sex hormone concentrations on knee kinematic parameters of the 90°cutting in female college soccer athletes. Three female college soccer teams (53 subjects) participated in the study. During the first menstrual cycle, a three-step method was used to exclude subjects with anovulatory and luteal phase-deficient (LPD) (12 subjects). The subjects' menstrual cycle was divided into the menstrual phase, late-follicular phase, ovulatory phase, and mid-luteal phase (group 1, 2, 3, 4). In each phase of the second menstrual cycle, we used a portable motion analysis system to enter the teams and tested the sex hormones concentrations and knee kinematics parameters in three universities in turn. We found that subjects had a lower maximum knee valgus in group 4 compared with other groups. This meant that subjects had a lower biomechanical risk of non-contact anterior cruciate ligament (ACL) injury in the mid-luteal phase. There was no significant correlation between serum estrogen, progesterone concentration, and knee kinematic parameters. This meant that sex hormones did not have a protective effect. Future studies need to incorporate more factors (such as neuromuscular control, etc.) to investigate.
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Affiliation(s)
- Zhou Bingzheng
- Department of Orthopaedic Surgery and Sports Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhao Xinzhuo
- Department of Biomedical Engineering, Shenyang University of Technology, Shenyang, Liaoning, China
| | - Jin Zhuo
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Xing
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang, China
| | - Li Bin
- Department of Orthopaedic Surgery and Sports Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Bai Lunhao
- Department of Orthopaedic Surgery and Sports Medicine, Shengjing Hospital of China Medical University, Shenyang, China
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Hummel J, Benkendorff C, Fritsche L, Prystupa K, Vosseler A, Gancheva S, Trenkamp S, Birkenfeld AL, Preissl H, Roden M, Häring HU, Fritsche A, Peter A, Wagner R, Kullmann S, Heni M. Brain insulin action on peripheral insulin sensitivity in women depends on menstrual cycle phase. Nat Metab 2023; 5:1475-1482. [PMID: 37735274 PMCID: PMC10513929 DOI: 10.1038/s42255-023-00869-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 07/19/2023] [Indexed: 09/23/2023]
Abstract
Insulin action in the human brain modulates eating behaviour, whole-body metabolism and body fat distribution1,2. In particular, brain insulin action increases whole-body insulin sensitivity, but these studies were mainly performed in lean men3,4. Here we investigate metabolic and hypothalamic effects of brain insulin action in women with a focus on the impact of menstrual cycle ( ClinicalTrials.gov registration: NCT03929419 ).Eleven women underwent four hyperinsulinemic-euglycemic clamps, two in the follicular phase and two in the luteal phase. Brain insulin action was introduced using nasal insulin spray5-7 and compared to placebo spray in a fourfold crossover design with change in glucose infusion rate as the primary endpoint. Here we show that during the follicular phase, more glucose has to be infused after administration of nasal insulin than after administration of placebo. This remains significant after adjustment for blood glucose and insulin. During the luteal phase, no significant influence of brain insulin action on glucose infusion rate is detected after adjustment for blood glucose and insulin (secondary endpoint). In 15 other women, hypothalamic insulin sensitivity was assessed in a within-subject design by functional magnetic resonance imaging with intranasal insulin administration8. Hypothalamus responsivity is influenced by insulin in the follicular phase but not the luteal phase.Our study therefore highlights that brain insulin action improves peripheral insulin sensitivity also in women but only during the follicular phase. Thus, brain insulin resistance could contribute to whole-body insulin resistance in the luteal phase of the menstrual cycle.
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Affiliation(s)
- Julia Hummel
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
- Department of Internal Medicine I, Division of Endocrinology and Diabetology, University of Ulm, Ulm, Germany
| | - Charlotte Benkendorff
- Department of Internal Medicine, Division of Diabetology, Endocrinology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Louise Fritsche
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Katsiaryna Prystupa
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Andreas Vosseler
- Department of Internal Medicine, Division of Diabetology, Endocrinology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Sofiya Gancheva
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Endocrinology and Diabetology, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Sandra Trenkamp
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Andreas L Birkenfeld
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
- Department of Internal Medicine, Division of Diabetology, Endocrinology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Hubert Preissl
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
- Department of Internal Medicine, Division of Diabetology, Endocrinology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Michael Roden
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Endocrinology and Diabetology, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Hans-Ulrich Häring
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
- Department of Internal Medicine, Division of Diabetology, Endocrinology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Andreas Fritsche
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
- Department of Internal Medicine, Division of Diabetology, Endocrinology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Andreas Peter
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Department for Diagnostic Laboratory Medicine, Institute for Clinical Chemistry and Pathobiochemistry, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Robert Wagner
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Endocrinology and Diabetology, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Stephanie Kullmann
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
- Department of Internal Medicine, Division of Diabetology, Endocrinology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Martin Heni
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany.
- Department of Internal Medicine I, Division of Endocrinology and Diabetology, University of Ulm, Ulm, Germany.
- Department of Internal Medicine, Division of Diabetology, Endocrinology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany.
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany.
- Department for Diagnostic Laboratory Medicine, Institute for Clinical Chemistry and Pathobiochemistry, Eberhard Karls University Tübingen, Tübingen, Germany.
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Recacha-Ponce P, Collado-Boira E, Suarez-Alcazar P, Montesinos-Ruiz M, Hernando-Domingo C. Is It Necessary to Adapt Training According to the Menstrual Cycle? Influence of Contraception and Physical Fitness Variables. Life (Basel) 2023; 13:1764. [PMID: 37629621 PMCID: PMC10455893 DOI: 10.3390/life13081764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/07/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
(1) Background: The influence of the menstrual cycle on physical fitness in athletes is controversial in the scientific literature. There is a marked fluctuation of sex hormones at three key points of the menstrual cycle, where estrogen and progesterone vary significantly. Hormonal contraception induces hormonal levels different from the natural menstrual cycle, requiring specific study in relation to physical fitness. (2) Method: Women aged 18 to 40 years with regular natural menstrual cycles and women using hormonal contraception were recruited, creating two study groups. All participants needed to be athletes classified as level II-III, based on training volume/physical activity metrics, among other variables. To assess their physical fitness, cardiorespiratory fitness (measured by V˙O2max), high-speed strength, hand grip strength, and flexibility were evaluated. Blood samples were taken to determine the menstrual cycle phase through analysis of sex hormone levels. Additionally, urine tests for ovulation detection were performed for the natural menstrual cycle group. Neurosensory stimulation tests were incorporated to measure sensory thresholds and pain thresholds in each phase. Body composition in each phase and its relationship with the other variables were also taken into account. (3) Results: Athletes in the natural cycling group showed differences in V˙O2max (mL·kg-1·min-1) (phase I = 41.75 vs. phase II = 43.85 and (p = 0.004) and phase I vs. phase III = 43.25 mL·kg-1·min-1 (p = 0.043)), as well as in body weight (phase I = 63.23 vs. phase III = 62.48 kg; p = 0.006), first pain threshold (phase I = 1.34 vs. phase II = 1.69 (p = 0.027) and phase III = 1.59 mA (p = 0.011)), and sensitive threshold (phase I = 0.64 vs. phase II = 0.76 mA (p = 0.017)). The pain threshold was found to be an important covariate in relation to V˙O2max, explaining 31.9% of the variance in phase I (p = 0.006). These findings were not observed between the two phases of contraceptive cycling. (4) Conclusion: The natural menstrual cycle will cause significant changes in the physical fitness of athletes. The use of hormonal contraception is not innocuous. Women with natural cycles show an increase in cardiorespiratory fitness in phases II and III, which is a factor to be considered in relation to training level and workload.
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Affiliation(s)
| | - Eladio Collado-Boira
- Faculty of Health Sciences, Jaime I University, 12071 Castello de la Plana, Spain; (P.R.-P.); (P.S.-A.); (M.M.-R.); (C.H.-D.)
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14
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de Carvalho Rotoly G, Papoti M, Foresti YF, de Oliveira Guirro EC, Guirro RRJ. Influence of photobiomodulation therapy on the physical performance of women during the follicular phase of the menstrual cycle: A double-blind Sham-controlled randomized clinical trial. Lasers Med Sci 2023; 38:173. [PMID: 37530880 DOI: 10.1007/s10103-023-03840-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 07/25/2023] [Indexed: 08/03/2023]
Abstract
To evaluate the effects of photobiomodulation on the physical performance of healthy women, considering the menstrual cycle. 27 physically active healthy women (age 25.68 ± 3.99 years; mass 63.76 ± 12.77 kg; height 1.65 ± 0.59 cm) during the initial follicular phase (FF1 and FF2) of the menstrual cycle underwent performance evaluations, through a supramaximal test, subjective perception of exertion, blood lactate, and evaluations in the isokinetic dynamometer. Photobiomodulation (PBM) (200J) and Sham (0J) therapy were applied 10 min before the performance evaluations on the quadriceps femoris, hamstrings, and triceps surae muscles. A significance level of 5% was adopted and the effect size was calculated by Cohen's d. It was not possible to observe a significant difference (p > 0.05) in any of the performance variables evaluated in the comparison between groups, only small effects for total distance, final subjective perception of exertion, lactate peak and lactate delta in the PBM group. PBM did not improve muscle performance, resistance to fatigue, perceived exertion, and blood lactate concentrations during a predominantly anaerobic test in healthy women during the FF of the menstrual cycle.
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Affiliation(s)
- Gabriela de Carvalho Rotoly
- Post-Graduate Program in Rehabilitation and Functional Performance, Department of Health Sciences, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Marcelo Papoti
- Post-Graduate Program in Physical Education and Sport, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Yan Figueiredo Foresti
- Post-Graduate Program in Physical Education and Sport, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Elaine Caldeira de Oliveira Guirro
- Post-Graduate Program in Rehabilitation and Functional Performance, Department of Health Sciences, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Rinaldo Roberto Jesus Guirro
- Post-Graduate Program in Rehabilitation and Functional Performance, Department of Health Sciences, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
- Departamento de Ciências da Saúde, Faculdade de Medicina de Ribeirão Preto, Avenida Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil.
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15
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Siedler MR, De Souza MJ, Albracht-Schulte K, Sekiguchi Y, Tinsley GM. The Influence of Energy Balance and Availability on Resting Metabolic Rate: Implications for Assessment and Future Research Directions. Sports Med 2023; 53:1507-1526. [PMID: 37213050 DOI: 10.1007/s40279-023-01856-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 05/23/2023]
Abstract
Resting metabolic rate (RMR) is a significant contributor to an individual's total energy expenditure. As such, RMR plays an important role in body weight regulation across populations ranging from inactive individuals to athletes. In addition, RMR may also be used to screen for low energy availability and energy deficiency in athletes, and thus may be useful in identifying individuals at risk for the deleterious consequences of chronic energy deficiency. Given its importance in both clinical and research settings within the fields of exercise physiology, dietetics, and sports medicine, the valid assessment of RMR is critical. However, factors including varying states of energy balance (both short- and long-term energy deficit or surplus), energy availability, and prior food intake or exercise may influence resulting RMR measures, potentially introducing error into observed values. The purpose of this review is to summarize the relationships between short- and long-term changes in energetic status and resulting RMR measures, consider these findings in the context of relevant recommendations for RMR assessment, and provide suggestions for future research.
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Affiliation(s)
- Madelin R Siedler
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Mary Jane De Souza
- Departments of Kinesiology and Physiology, Pennsylvania State University, University Park, PA, USA
| | | | - Yasuki Sekiguchi
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Grant M Tinsley
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA.
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16
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Badenhorst CE, Govus AD, Mündel T. Does chronic oral contraceptive use detrimentally affect C-reactive protein or iron status for endurance-trained women? Physiol Rep 2023; 11:e15777. [PMID: 37487629 PMCID: PMC10365947 DOI: 10.14814/phy2.15777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/26/2023] Open
Abstract
PURPOSE Chronic use of the oral contraceptive pill (OCP) is reported to increase C-reactive protein (CRP) levels and increase the risk of cardiovascular disease in premenopausal females. METHODS A secondary analysis of data from two research studies in eumenorrheic (n = 8) and OCP (n = 8) female athletes. Basal CRP and iron parameters were included in the analysis. Sample collection occurred following a standardized exercise and nutritional control for 24 h. Eumenorrheic females were tested in the early-follicular and mid-luteal phases, and the OCP users were tested in quasi-follicular and quasi-luteal phases (both active pill periods). RESULTS A main effect for group (p < 0.01) indicated that average CRP concentration was higher in OCP users compared with eumenorrheic females, regardless of the day of measurement within the cycle. Results demonstrate a degree of iron parameters moderation throughout the menstrual cycle that is influenced by basal CRP levels; however, no linear relationship with CRP, serum iron, and ferritin was observed. CONCLUSIONS Basal CRP values were consistently higher in the OCP group despite participants being in a rested state. These results may indicate a potential risk of cardiovascular disease in prolonged users of the OCP when compared to eumenorrheic female athletes.
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Affiliation(s)
- C. E. Badenhorst
- School of Sport, Exercise and NutritionMassey UniversityPalmerston NorthNew Zealand
| | - A. D. Govus
- Discipline of Sport and Exercise ScienceLa Trobe UniversityMelbourneVictoriaAustralia
| | - T. Mündel
- School of Sport, Exercise and NutritionMassey UniversityPalmerston NorthNew Zealand
- Department of KinesiologyBrock UniversitySt. CatharinesCanada
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17
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de Carvalho G, Papoti M, Rodrigues MCD, Foresti YF, de Oliveira Guirro EC, de Jesus Guirro RR. Interaction predictors of self-perception menstrual symptoms and influence of the menstrual cycle on physical performance of physically active women. Eur J Appl Physiol 2023; 123:601-7. [PMID: 36371725 DOI: 10.1007/s00421-022-05086-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 11/01/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To analyze the physical performance, self-perception menstrual symptoms, of physically active eumenorrheic women with endogenous ovarian cycle in two phases of the menstrual cycle. METHODS Twenty-six women participated in the study (age 25.8 ± 3.9 years; height 1.64 ± 0.58 m; mass 64 ± 12.32 kg; menarche 11.69 ± 1.28 years). Assessments were performed in two phases of the menstrual cycle (MC), Early-Follicular Phase (FP) and Mid-Luteal Phase (LP), performance was assessed through total time to exhaustion (TTE), complete stages (CE), and final speed (FE), through a graded exercise test (GXT). Information on the participants' menstrual symptoms and their perceptions of the influence of MC on their performance were also collected. Data normality was assessed using the Shapiro-Wilk test. Paired analyses were conducted (t test or Wilcoxon) to examine the responses between the menstrual phases. The interaction analysis of symptom predictors was performed by multiple linear regression, with a significance level of p ≤ 0.05. RESULTS There was no significant difference in physical performance between the phases during the GXT in TTE (mean difference 8.50; 95% CI - 11.99 to 42; p = 0.36). During FP, women with heavy flow had shorter performance in the GXT (t = - 2.5; p = 0.01), demonstrating an r2 = 0.32. In LP, for the women who reported not having the perception of the influence of the menstrual cycle on exercise, the total test time was longer (t = 2.55; p = 0.01), with an r2 = 0.45. CONCLUSION There was no difference in physical performance between FP and LP. However, menstrual flow intensity and perception of cycle interference demonstrated a decrease in TTE.
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James JJ, Leach OK, Young AM, Newman AN, Mpongo KL, Quirante JM, Wardell DB, Ahmadi M, Gifford JR. The exercise power-duration relationship is equally reproducible in eumenorrheic female and male humans. J Appl Physiol (1985) 2023; 134:230-241. [PMID: 36548510 DOI: 10.1152/japplphysiol.00416.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
This study aims to investigate the effect of the menstrual cycle (MC) on exercise performance across the power-duration relationship (PDR). We hypothesized females would exhibit greater variability in the PDR across the MC than males across a similar timespan, with critical power (CP) and work-prime (W') being lower during the early follicular phase than the late follicular and midluteal phases. Seven eumenorrheic, endurance-trained female adults performed multiple constant-load-to-task-failure and maximum-power tests at three timepoints across the MC (early follicular, late follicular, and midluteal phases). Ten endurance-trained male adults performed the same tests approximately 10 days apart. No differences across the PDR were observed between MC phases (CP: 186.74 ± 31.00 W, P = 0.955, CV = 0.81 ± 0.65%) (W': 7,961.81 ± 2,537.68 J, P = 0.476, CV = 10.48 ± 3.06%). CP was similar for male and female subjects (11.82 ± 1.42 W·kg-1 vs. 11.56 ± 1.51 W·kg-1, respectively) when controlling for leg lean mass. However, W' was larger (P = 0.047) for male subjects (617.28 ± 130.10 J·kg-1) than female subjects (490.03 ± 136.70 J·kg-1) when controlling for leg lean mass. MC phase does not need to be controlled when conducting aerobic endurance performance research on eumenorrheic female subjects without menstrual dysfunction. Nevertheless, several sex differences in the power-duration relationship exist, even after normalizing for body composition. Therefore, previous studies describing the physiology of exercise performance in male subjects may not perfectly describe that of female subjects.NEW & NOTEWORTHY Females are often excluded from exercise performance research due to experimental challenges in controlling for the menstrual cycle (MC), causing uncertainty regarding how the MC impacts female performance. The present study examined the influences that biological sex and the MC have on the power-duration relationship (PDR) by comparing critical power (CP), Work-prime (W'), and maximum power output (PMAX) in males and females. Our data provide evidence that the MC does not influence the PDR and that females exhibit similar reproducibility as males. Thus, when conducting aerobic endurance exercise research on eumenorrheic females without menstrual dysfunction, the phase of the MC does not need to be controlled. Although differences in body composition account for some differences between the sexes, sex differences in W' and PMAX persisted even after normalizing for different metrics of body composition. These data highlight the necessity and feasibility of examining sex differences in performance, as previously generated male-only data within the literature may not apply to female subjects.
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Affiliation(s)
- Jessica J James
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Olivia K Leach
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Arianna M Young
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Audrey N Newman
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Kiese L Mpongo
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Jaron M Quirante
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Devon B Wardell
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Mohadeseh Ahmadi
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Jayson R Gifford
- Department of Exercise Sciences, Brigham Young University, Provo, Utah.,Program of Gerontology, Brigham Young University, Provo, Utah
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Dobashi K, Katagiri A, Fujii N, Nishiyasu T. Combined Effects of Hypocapnic Hyperventilation and Hypoxia on Exercise Performance and Metabolic Responses During the Wingate Anaerobic Test. Int J Sports Physiol Perform 2023; 18:69-76. [PMID: 36521190 DOI: 10.1123/ijspp.2022-0121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 08/25/2022] [Accepted: 09/13/2022] [Indexed: 12/23/2022]
Abstract
Hypoxia during supramaximal exercise reduces aerobic metabolism with a compensatory increase in anaerobic metabolism without affecting exercise performance. A similar response is elicited by preexercise voluntary hypocapnic hyperventilation, but it remains unclear whether hypocapnic hyperventilation and hypoxia additively reduce aerobic metabolism and increase anaerobic metabolism during supramaximal exercise. To address that issue, 12 healthy subjects (8 males and 4 females) performed the 30-second Wingate anaerobic test (WAnT) after (1) spontaneous breathing in normoxia (control, ∼21% fraction of inspired O2 [FiO2]), (2) voluntary hypocapnic hyperventilation in normoxia (hypocapnia, ∼21% FiO2), (3) spontaneous breathing in hypoxia (hypoxia, ∼11% FiO2), or (4) voluntary hypocapnic hyperventilation in hypoxia (combined, ∼11% FiO2). Mean power output during the 30-second WAnT was similar among the control (561 [133] W), hypocapnia (563 [140] W), hypoxia (558 [131] W), and combined (560 [133] W) trials (P = .778). Oxygen uptake during the 30-second WAnT was lower in the hypocapnia (1523 [318] mL/min), hypoxia (1567 [300] mL/min), and combined (1203 [318] mL/min) trials than in the control (1935 [250] mL/min) trial, and the uptake in the combined trial was lower than in the hypocapnia or hypoxia trial (all P < .001). Oxygen deficit, an index of anaerobic metabolism, was higher in the hypocapnia (38.4 [7.3] mL/kg), hypoxia (37.8 [6.8] mL/kg), and combined (40.7 [6.9] mL/kg) trials than in the control (35.0 [6.8] mL/kg) trial, and the debt was greater in the combined trial than in the hypocapnia or hypoxia trial (all P < .003). Our results suggest that voluntary hypocapnic hyperventilation and hypoxia additively reduce aerobic metabolism and increase anaerobic metabolism without affecting exercise performance during the 30-second WAnT.
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Antero J, Golovkine S, Niffoi L, Meignié A, Chassard T, Delarochelambert Q, Duclos M, Maitre C, Maciejewski H, Diry A, Toussaint JF. Menstrual cycle and hormonal contraceptive phases' effect on elite rowers' training, performance and wellness. Front Physiol 2023; 14:1110526. [PMID: 36875020 PMCID: PMC9981658 DOI: 10.3389/fphys.2023.1110526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/02/2023] [Indexed: 02/19/2023] Open
Abstract
Objectives: To investigate the effect of menstrual cycle (MC) and hormonal contraception (HC) phases in elite rowers training, performance and wellness monitoring. Methods: Twelve French elite rowers were follow-up for 4,2 cycles on average in their final preparation for the Olympics and Paralympics Games in Tokyo 2021 through an on-site longitudinal study based on repeated measures. Daily self-reported evaluation using Likert rating scales of wellness (sleep quality, fitness, mood, injuries' pain), menstrual symptoms and training parameters (perceived exertion and self-assessment of performance) were collected (n = 1,281) in parallel to a coach evaluation of rowers' performance (n = 136), blinded to theirs MC and HC phases. Salivary samples of estradiol and progesterone were collected in each cycle to help to classify the MC into 6 phases and HC into 2-3 phases depending on the pills' hormone concentration. A chi-square test normalized by each rower was used to compare the upper quintile scores of each studied variable across phases. A Bayesian ordinal logistic regression was applied to model the rowers' self-reported performance. Results: Rowers with a natural cycle, n = 6 ( + 1 amenorrhea) evaluate their performance and wellness with significant higher score indices at the middle of their cycle. Top assessments are rarer at the premenstrual and menses phases, when they more frequently experience menstrual symptoms which are negatively correlated with their performance. The HC rowers, n = 5, also better evaluate their performance when taking the pills and more frequently experience menstrual symptoms during the pill withdrawal. The athletes self-reported performance is correlated with their coach's evaluation. Conclusion: It seems important to integrate MC and HC data in the wellness and training monitoring of female athletes since these parameters vary across hormonal phases affecting training perception of both athlete and coach.
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Affiliation(s)
- Juliana Antero
- Institute for Research in BioMedicine and Epidemiology of Sport, IRMES at INSEP (Institut National du Sport, de l'Expertise et de la Performance), Paris, France
| | - Steven Golovkine
- Institute for Research in BioMedicine and Epidemiology of Sport, IRMES at INSEP (Institut National du Sport, de l'Expertise et de la Performance), Paris, France
| | - Louis Niffoi
- Institute for Research in BioMedicine and Epidemiology of Sport, IRMES at INSEP (Institut National du Sport, de l'Expertise et de la Performance), Paris, France
| | - Alice Meignié
- Institute for Research in BioMedicine and Epidemiology of Sport, IRMES at INSEP (Institut National du Sport, de l'Expertise et de la Performance), Paris, France
| | - Tom Chassard
- Institute for Research in BioMedicine and Epidemiology of Sport, IRMES at INSEP (Institut National du Sport, de l'Expertise et de la Performance), Paris, France
| | - Quentin Delarochelambert
- Institute for Research in BioMedicine and Epidemiology of Sport, IRMES at INSEP (Institut National du Sport, de l'Expertise et de la Performance), Paris, France
| | - Martine Duclos
- Department of Sport Medicine and Functional Exploration, University Hospital CHU G. Montpied, INRAE, UNH, CRNH Auvergne, Clermont Auvergne University, Clermont-Ferrand, France
| | - Carole Maitre
- Medical Department at INSEP (Institut National du Sport, de l'Expertise et de la Performance), Paris, France
| | | | - Allison Diry
- French Rowing Federation, Nogent-sur-Marne, France
| | - Jean-François Toussaint
- Institute for Research in BioMedicine and Epidemiology of Sport, IRMES at INSEP (Institut National du Sport, de l'Expertise et de la Performance), Paris, France.,URP 7329, Université Paris Cité, Paris, France.,Center for Investigation in Sport Medicine, CIMS Hôtel-Dieu, Assistance Publique-Hopitaux de Paris, Paris, France
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21
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Alfaro-Magallanes VM, Barba-Moreno L, Romero-Parra N, Rael B, Benito PJ, Swinkels DW, Laarakkers CM, Díaz ÁE, Peinado AB; IronFEMME Study Group. Menstrual cycle affects iron homeostasis and hepcidin following interval running exercise in endurance-trained women. Eur J Appl Physiol 2022. [PMID: 36129579 DOI: 10.1007/s00421-022-05048-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 09/10/2022] [Indexed: 11/30/2022]
Abstract
Purpose Menstrual cycle phase affects resting hepcidin levels, but such effects on the hepcidin response to exercise are still unclear. Thus, we investigated the hepcidin response to running during three different menstrual cycle phases. Methods Twenty-one endurance-trained eumenorrheic women performed three identical interval running protocols during the early-follicular phase (EFP), late-follicular phase (LFP), and mid-luteal phase (MLP). The protocol consisted of 8 × 3 min bouts at 85% of the maximal aerobic speed, with 90-s recovery. Blood samples were collected pre-exercise and at 0 h, 3 h and 24 h post-exercise. Results Data presented as mean ± SD. Ferritin were lower in the EFP than the LFP (34.82 ± 16.44 vs 40.90 ± 23.91 ng/ml, p = 0.003), while iron and transferrin saturation were lower during the EFP (58.04 ± 19.70 µg/dl, 14.71 ± 5.47%) compared to the LFP (88.67 ± 36.38 µg/dl, 22.22 ± 9.54%; p < 0.001) and the MLP (80.20 ± 42.05 µg/dl, 19.87 ± 10.37%; p = 0.024 and p = 0.045, respectively). Hepcidin was not affected by menstrual cycle (p = 0.052) or menstrual cycle*time interaction (p = 0.075). However, when comparing hepcidin at 3 h post-exercise, a moderate and meaningful effect size showed that hepcidin was higher in the LFP compared to the EFP (3.01 ± 4.16 vs 1.26 ± 1.25 nMol/l; d = 0.57, CI = 0.07–1.08). No effect of time on hepcidin during the EFP was found either (p = 0.426). Conclusion The decrease in iron, ferritin and TSAT levels during the EFP may mislead the determination of iron status in eumenorrheic athletes. However, although the hepcidin response to exercise appears to be reduced in the EFP, it shows no clear differences between the phases of the menstrual cycle (clinicaltrials.gov: NCT04458662). Supplementary Information The online version contains supplementary material available at 10.1007/s00421-022-05048-5.
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22
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Costa RJS, Young P, Gill SK, Snipe RMJ, Gaskell S, Russo I, Burke LM. Assessment of Exercise-Associated Gastrointestinal Perturbations in Research and Practical Settings: Methodological Concerns and Recommendations for Best Practice. Int J Sport Nutr Exerc Metab 2022; 32:387-418. [PMID: 35963615 DOI: 10.1123/ijsnem.2022-0048] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/26/2022] [Accepted: 07/07/2022] [Indexed: 12/14/2022]
Abstract
Strenuous exercise is synonymous with disturbing gastrointestinal integrity and function, subsequently prompting systemic immune responses and exercise-associated gastrointestinal symptoms, a condition established as "exercise-induced gastrointestinal syndrome." When exercise stress and aligned exacerbation factors (i.e., extrinsic and intrinsic) are of substantial magnitude, these exercise-associated gastrointestinal perturbations can cause performance decrements and health implications of clinical significance. This potentially explains the exponential growth in exploratory, mechanistic, and interventional research in exercise gastroenterology to understand, accurately measure and interpret, and prevent or attenuate the performance debilitating and health consequences of exercise-induced gastrointestinal syndrome. Considering the recent advancement in exercise gastroenterology research, it has been highlighted that published literature in the area is consistently affected by substantial experimental limitations that may affect the accuracy of translating study outcomes into practical application/s and/or design of future research. This perspective methodological review attempts to highlight these concerns and provides guidance to improve the validity, reliability, and robustness of the next generation of exercise gastroenterology research. These methodological concerns include participant screening and description, exertional and exertional heat stress load, dietary control, hydration status, food and fluid provisions, circadian variation, biological sex differences, comprehensive assessment of established markers of exercise-induced gastrointestinal syndrome, validity of gastrointestinal symptoms assessment tool, and data reporting and presentation. Standardized experimental procedures are needed for the accurate interpretation of research findings, avoiding misinterpreted (e.g., pathological relevance of response magnitude) and overstated conclusions (e.g., clinical and practical relevance of intervention research outcomes), which will support more accurate translation into safe practice guidelines.
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23
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Flood TR, Kuennen MR, Blacker SD, Myers SD, Walker EF, Lee BJ. The effect of sex, menstrual cycle phase and oral contraceptive use on intestinal permeability and ex-vivo monocyte TNFα release following treatment with lipopolysaccharide and hyperthermia. Cytokine 2022; 158:155991. [PMID: 35944412 DOI: 10.1016/j.cyto.2022.155991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/22/2022] [Accepted: 08/01/2022] [Indexed: 11/15/2022]
Abstract
PURPOSE Investigate the impact of sex, menstrual cycle phase and oral contraceptive use on intestinal permeability and ex-vivo tumour necrosis factor alpha (TNFα) release following treatment with lipopolysaccharide (LPS) and hyperthermia. METHODS Twenty-seven participants (9 men, 9 eumenorrheic women (MC) and 9 women taking an oral contraceptive pill (OC)) completed three trials. Men were tested on 3 occasions over 6 weeks; MC during early-follicular, ovulation, and mid-luteal phases; OC during the pill and pill-free phase. Intestinal permeability was assessed following a 4-hour dual sugar absorption test (lactulose: rhamnose). Venous blood was collected each trial and stimulated with 100 μg·mL-1 LPS before incubation at 37 °C and 40 °C and analysed for TNFα via ELISA. RESULTS L:R ratio was higher in OC than MC (+0.003, p = 0.061) and men (+0.005, p = 0.007). Men had higher TNFα responses than both MC (+53 %, p = 0.004) and OC (+61 %, p = 0.003). TNFα release was greater at 40 °C than 37 °C (+23 %, p < 0.001). CONCLUSIONS Men present with lower resting intestinal barrier permeability relative to women regardless of OC use and displayed greater monocyte TNFα release following whole blood treatment with LPS and hyperthermia. Oral contraceptive users had highest intestinal permeability however, neither permeability or TNFα release were impacted by the pill cycle. Although no statistical effect was seen in the menstrual cycle, intestinal permeability and TNFα release were more variable across the phases.
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Affiliation(s)
- Tessa R Flood
- Occupational Performance Research Group, University of Chichester UK
| | - Matthew R Kuennen
- Department of Exercise Science, High Point University, High Point, NC, USA
| | - Sam D Blacker
- Occupational Performance Research Group, University of Chichester UK
| | - Stephen D Myers
- Occupational Performance Research Group, University of Chichester UK
| | | | - Ben J Lee
- Occupational and Environmental Physiology Group, Coventry University, UK.
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24
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Matsuda T, Takahashi H, Nakamura M, Kanno M, Ogata H, Ishikawa A, Yamada M, Kamemoto K, Sakamaki-Sunaga M. Influence of menstrual cycle on muscle glycogen utilization during high-intensity intermittent exercise until exhaustion in healthy women. Appl Physiol Nutr Metab 2022; 47:671-680. [PMID: 35856390 DOI: 10.1139/apnm-2021-0532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
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. In total, 11 women with regular menstrual cycles completed three tests, which comprised the early follicular phase (E-FP), late follicular phase (L-FP), and luteal phase (LP) of the menstrual cycle. High-intensity intermittent exercise until exhaustion was performed on each test day. Evaluation of muscle glycogen concentration by 13C-magnetic resonance spectroscopy and measurement of estradiol, progesterone, blood glucose, lactate, free fatty acids (FFA), and insulin concentrations were conducted before exercise (Pre) and immediately after exercise (Post). Muscle glycogen concentrations from thigh muscles at Pre and Post were not significantly different between menstrual cycle phases (P = 0.57). Muscle glycogen decreases by exercise were significantly greater in L-FP (59.0 ± 12.4 mM) than in E-FP (48.3 ± 14.4 mM, P < 0.05). Nonetheless, blood glucose, blood lactate, serum FFA, serum insulin concentrations, and exercise time until exhaustion in E-FP, L-FP, and LP were similar. The study results suggest that although exercise time does not change according to the menstrual cycle, the menstrual cycle influences muscle glycogen utilization during high-intensity intermittent exercise until exhaustion in women with habitual exercise activity. Novelty: This study compared changes in muscle glycogen concentration across the menstrual cycle during high-intensity intermittent exercise until exhaustion using 13C-magnetic resonance spectroscopy. Our results highlight the influence of the menstrual cycle on muscle glycogen during high-intensity intermittent exercise in healthy women.
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Affiliation(s)
- Tomoka Matsuda
- Graduate School of Health and Sport Science, Nippon Sport Science University, Tokyo, Japan.,Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Hideyuki Takahashi
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Mariko Nakamura
- Department of Sport Science, Japan Institute of Sports Sciences, Tokyo, Japan
| | - Moe Kanno
- Graduate School of Health and Sport Science, Nippon Sport Science University, Tokyo, Japan
| | - Hazuki Ogata
- Department of Exercise Physiology, Nippon Sport Science University, Tokyo, Japan
| | - Akira Ishikawa
- Graduate School of Health and Sport Science, Nippon Sport Science University, Tokyo, Japan
| | - Mizuki Yamada
- Department of Exercise Physiology, Nippon Sport Science University, Tokyo, Japan
| | - Kayoko Kamemoto
- Waseda Institute for Sport Sciences, Waseda University, Saitama, Japan
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25
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Zheng H, Badenhorst CE, Lei TH, Che Muhamed AM, Liao YH, Fujii N, Kondo N, Mündel T. Do E 2 and P 4 contribute to the explained variance in core temperature response for trained women during exertional heat stress when metabolic rates are very high? Eur J Appl Physiol 2022; 122:2201-2212. [PMID: 35796828 PMCID: PMC9463225 DOI: 10.1007/s00421-022-04996-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/17/2022] [Indexed: 12/02/2022]
Abstract
Purpose Women remain underrepresented in the exercise thermoregulation literature despite their participation in leisure-time and occupational physical activity in heat-stressful environments continuing to increase. Here, we determined the relative contribution of the primary ovarian hormones (estrogen [E2] and progesterone [P4]) alongside other morphological (e.g., body mass), physiological (e.g., sweat rates), functional (e.g., aerobic fitness) and environmental (e.g., vapor pressure) factors in explaining the individual variation in core temperature responses for trained women working at very high metabolic rates, specifically peak core temperature (Tpeak) and work output (mean power output). Methods Thirty-six trained women (32 ± 9 year, 53 ± 9 ml·kg−1·min−1), distinguished by intra-participant (early follicular and mid-luteal phases) or inter-participant (ovulatory vs. anovulatory vs. oral contraceptive pill user) differences in their endogenous E2 and P4 concentrations, completed a self-paced 30-min cycling work trial in warm–dry (2.2 ± 0.2 kPa, 34.1 ± 0.2 °C, 41.4 ± 3.4% RH) and/or warm–humid (3.4 ± 0.1 kPa, 30.2 ± 1.2 °C, 79.8 ± 3.7% RH) conditions that yielded 115 separate trials. Stepwise linear regression was used to explain the variance of the dependent variables. Results Models were able to account for 60% of the variance in Tpeak (\documentclass[12pt]{minimal}
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\begin{document}$$\overline{R }$$\end{document}R¯2: 4% [E2]) and 44% of the variance in mean power output (\documentclass[12pt]{minimal}
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\begin{document}$$\overline{R }$$\end{document}R¯2: 9% perceived exertion). Conclusion E2 contributes a small amount toward the core temperature response in trained women, whereby starting core temperature and peak aerobic power explain the greatest variance in Tpeak and work output, respectively.
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Affiliation(s)
- Huixin Zheng
- School of Sport Exercise and Nutrition, Massey University, Palmerston North, New Zealand
| | - Claire E Badenhorst
- School of Sport Exercise, Nutrition, Massey University, Auckland, New Zealand
| | - Tze-Huan Lei
- College of Physical Education, Hubei Normal University, Huangshi, China
| | | | - Yi-Hung Liao
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Naoto Fujii
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Narihiko Kondo
- Laboratory for Applied Human Physiology, Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| | - Toby Mündel
- School of Sport Exercise and Nutrition, Massey University, Palmerston North, New Zealand.
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Xu M, Chen D, Li H, Wang H, Yang LZ. The Cycling Brain in the Workplace: Does Workload Modulate the Menstrual Cycle Effect on Cognition? Front Behav Neurosci 2022; 16:856276. [PMID: 35722191 PMCID: PMC9201761 DOI: 10.3389/fnbeh.2022.856276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/06/2022] [Indexed: 11/24/2022] Open
Abstract
Recent decades have witnessed increased research efforts to clarify how the menstrual cycle influence females’ cognitive and emotional functions. Despite noticeable progress, the research field faces the challenges of inconsistency and low generalizability of research findings. Females of reproductive ages are a heterogeneous population. Generalizing the results of female undergraduates to women in the workplace might be problematic. Furthermore, the critical cognitive processes for daily life and work deserve additional research efforts for improved ecological validity. Thus, this study investigates cognitive performance across the menstrual cycle using a sample of young nurses with similar duties. We developed a mini-computerized cognitive battery to assess four mental skills critical for nursing work: cognitive flexibility, divided attention, response inhibition, and working memory. Participants completed the cognitive battery at menses, late-follicular, and mid-luteal phases. In addition, they were classified into low- and high workload groups according to their subjective workload ratings. Our results demonstrate a general mid-luteal cognitive advantage. Besides, this study reveals preliminary evidence that workload modulates the menstrual cycle effect on cognition. Only females of low workload manifest the mid-luteal cognitive advantage on divided attention and response inhibition, implying that a suitable workload threshold might be necessary for regular neuro-steroid interactions. Thus, this study advocates the significance of research focusing on the cycling brain under workloads.
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Affiliation(s)
- Min Xu
- Bengbu Medical College, Bengbu, China
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, China
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
| | - Dandan Chen
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, China
| | - Hai Li
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, China
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
| | - Hongzhi Wang
- Bengbu Medical College, Bengbu, China
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, China
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
- *Correspondence: Hongzhi Wang,
| | - Li-Zhuang Yang
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, China
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
- Li-Zhuang Yang,
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Abou Sawan S, Hodson N, Malowany JM, West DWD, Tinline-Goodfellow C, Brook MS, Smith K, Atherton PJ, Kumbhare D, Moore DR. Trained Integrated Postexercise Myofibrillar Protein Synthesis Rates Correlate with Hypertrophy in Young Males and Females. Med Sci Sports Exerc 2022; 54:953-964. [PMID: 35081094 DOI: 10.1249/mss.0000000000002878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Resistance training induces skeletal muscle hypertrophy via the summated effects of postexercise elevations in myofibrillar protein synthesis (MyoPS) that persist for up to 48 h, although research in females is currently lacking. MyoPS is regulated by mTOR translocation and colocalization; however, the effects of resistance training on these intracellular processes are unknown. We hypothesized that MyoPS would correlate with hypertrophy only after training in both sexes and would be associated with intracellular redistribution of mTOR. METHODS Recreationally active males and females (n = 10 each) underwent 8 wk of whole-body resistance exercise three times a week. Fasted muscle biopsies were obtained immediately before (REST) and 24 and 48 h after acute resistance exercise in the untrained (UT) and trained (T) states to determine integrated MyoPS over 48 h (D2O ingestion) and intracellular mTOR colocalization (immunofluorescence microscopy). RESULTS Training increased (P < 0.01) muscle strength (~20%-126%), muscle thickness (~8%-11%), and average fiber cross-sectional area (~15%-20%). MyoPS increased above REST in UT (P = 0.032) and T (P < 0.01), but to a greater extent in males (~23%; P = 0.023), and was positively (P < 0.01) associated with muscle thickness and fiber cross-sectional area at T only in both males and females. mTOR colocalization with the cell periphery increased (P < 0.01) in T, irrespective of sex or acute exercise. Training increased (P ≤ 0.043) total mTOR, LAMP2 (lysosomal marker), and their colocalization (P < 0.01), although their colocalization was greater in males at 24 and 48 h independent of training status (P < 0.01). CONCLUSIONS MyoPS during prolonged recovery from exercise is greater in males but related to muscle hypertrophy regardless of sex only in the trained state, which may be underpinned by altered mTOR localization.
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Affiliation(s)
- Sidney Abou Sawan
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, CANADA
| | - Nathan Hodson
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, CANADA
| | - Julia M Malowany
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, CANADA
| | | | | | - Matthew S Brook
- School of Life Sciences, University of Nottingham, Nottingham, UNITED KINGDOM
| | - Kenneth Smith
- School of Medicine, University of Nottingham, Derby Medical School, Derby, UNITED KINGDOM
| | - Philip J Atherton
- School of Medicine, University of Nottingham, Derby Medical School, Derby, UNITED KINGDOM
| | | | - Daniel R Moore
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, CANADA
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28
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Tan B, Philipp MC, Che Muhamed AM, Mundel T. Hypohydration but not Menstrual Phase Influences Pain Perception in Healthy Women. J Appl Physiol (1985) 2022; 132:611-621. [DOI: 10.1152/japplphysiol.00402.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Chronic pain is a pervasive health problem and is associated with tremendous socioeconomic costs. However, current pain treatments are often ineffective due, in part, to the multi-factorial nature of pain. Mild hypohydration was shown to increase experimental pain sensitivity in men, but whether this also occurs in women has not been examined. Fluctuations in ovarian hormones (i.e., 17ß-oestradiol and progesterone) throughout the menstrual cycle may influence a woman's pain sensitivity, as well as hydration levels, suggesting possible interactions between hypohydration and menstrual phase on pain. We investigated the effects of mild hypohydration (HYPO, 24 hr of fluid restriction) on ischaemic pain sensitivity in 14 eumenorrheic women during the early follicular (EF) and mid-luteal (ML) phases of their menstrual cycle. We also examined whether acute water ingestion could reverse the negative effects of hypohydration. Elevated serum osmolality, plasma copeptin, and urine specific gravity indicated mild hypohydration. Compared to euhydration, HYPO reduced pain tolerance (by 34 ± 46 s; P = 0.02, ηp2 = 0.37) and increased ratings of pain intensity (by 0.7 ± 0.7 cm; P = 0.004; ηp2 = 0.55) and unpleasantness (by 0.7 ± 0.9 cm; P = 0.02; ηp2 = 0.40); these results were not influenced by menstrual phase. Water ingestion reduced thirst perception (Visual Analogue Scale, by 2.3 ± 0.9 cm; P < 0.001, ηp2 = 0.88) but did not reduce pain sensitivity. Therefore, hypohydration increases pain sensitivity in women with no influence of menstrual phase.
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Affiliation(s)
- Beverly Tan
- School of Sport Exercise and Nutrition, Massey University, Palmerston North, New Zealand
| | | | | | - Toby Mundel
- School of Sport Exercise and Nutrition, Massey University, Palmerston North, New Zealand
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29
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Baranauskas MN, Freemas JA, Tan R, Carter SJ. Moving beyond inclusion: Methodological considerations for the menstrual cycle and menopause in research evaluating effects of dietary nitrate on vascular function. Nitric Oxide 2021; 118:39-48. [PMID: 34774755 DOI: 10.1016/j.niox.2021.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/18/2021] [Accepted: 11/08/2021] [Indexed: 12/13/2022]
Abstract
Recent reports have acknowledged the underrepresentation of women in the field of dietary nitrate (NO3-) research. Undoubtedly, greater participation from women is warranted to clarify potential sex differences in the responses to dietary NO3- interventions. However, careful consideration for the effects of sex hormones - principally 17β-estradiol - on endogenous nitric oxide (NO) synthesis and dietary NO3- reductase capacity is necessary for improved interpretation and reproducibility of such investigations. From available literature, we present a narrative review describing how hormonal variations across the menstrual cycle, as well as with menopause, may impact NO biosynthesis catalyzed by NO synthase enzymes and NO3- reduction via the enterosalivary pathway. In doing so, we address methodological considerations related to the menstrual cycle and hormonal contraceptive use relevant for the inclusion of premenopausal women along with factors to consider when testing postmenopausal women. Adherence to such methodological practices may explicate the utility of dietary NO3- supplementation as a means to improve vascular function among women across the lifespan.
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Affiliation(s)
- Marissa N Baranauskas
- Department of Kinesiology, School of Public Health - Bloomington, Bloomington, Indiana University, 47405, USA.
| | - Jessica A Freemas
- Department of Kinesiology, School of Public Health - Bloomington, Bloomington, Indiana University, 47405, USA
| | - Rachel Tan
- Department of Natural Science, Seaver College, Pepperdine University, 90263, USA
| | - Stephen J Carter
- Department of Kinesiology, School of Public Health - Bloomington, Bloomington, Indiana University, 47405, USA; Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, 46202, USA
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Abou Sawan S, Hodson N, Tinline-Goodfellow C, West DWD, Malowany JM, Kumbhare D, Moore DR. Incorporation of Dietary Amino Acids Into Myofibrillar and Sarcoplasmic Proteins in Free-Living Adults Is Influenced by Sex, Resistance Exercise, and Training Status. J Nutr 2021; 151:3350-3360. [PMID: 34486662 DOI: 10.1093/jn/nxab261] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/25/2021] [Accepted: 07/15/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Acute exercise increases the incorporation of dietary amino acids into de novo myofibrillar proteins after a single meal in controlled laboratory studies in males. It is unclear whether this extends to free-living settings or is influenced by training or sex. OBJECTIVES We determined the effects of exercise, training status, and sex on 24-hour free-living dietary phenylalanine incorporation into skeletal muscle proteins. METHODS In a parallel group design, recreationally active males (mean ± SD age, 23 ± 3 years; BMI. 23.4 ± 2.9 kg/m2; n = 10) and females (age 24 ± 5 years; BMI, 23.1 ± 3.9 kg/m2; n = 9) underwent 8 weeks of whole-body resistance exercise 3 times a week. Controlled diets containing 1.6 g/kg-1/d-1 (amino acids modelled after egg), enriched to 10% with [13C6] or [2H5]phenylalanine, were consumed before and after an acute bout of resistance exercise. Fasted muscle biopsies were obtained before [untrained, pre-exercise condition (REST ] and 24 hours after an acute bout of resistance exercise in untrained (UT) and trained (T) states to determine dietary phenylalanine incorporation into myofibrillar (ΔMyo) and sarcoplasmic (ΔSarc) proteins, intracellular mechanistic target of rapamycin (mTOR) colocalization with ulex europaeus agglutinin-1 (UEA-1; capillary marker; immunofluorescence), and amino acid transporter expression (Western blotting). RESULTS The ΔMyo values were ∼62% greater (P < 0.01) in females than males at REST. The ΔMyo values increased above REST by ∼51% during UT and ∼30% in T (both P < 0.01) in males, remained unchanged in females during UT, and were ∼33% lower at T when compared to UT (P = 0.013). Irrespective of sex, ΔMyo and ΔSarc were decreased at T compared to UT (P ≤ 0.026). Resistance training increased mTOR colocalization with UEA-1 (P = 0.004), while L amino acid transporter 1, which was greater in males (P < 0.01), and sodium-coupled neutral amino acid transporter 2 protein expression were not affected by acute exercise (P ≥ 0.33) or training (P ≥ 0.45). CONCLUSIONS The exercise-induced incorporation of dietary phenylalanine into myofibrillar and sarcoplasmic proteins is attenuated after training regardless of sex, suggesting a reduced reliance on dietary amino acids for postexercise skeletal muscle remodeling in the T state.
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Affiliation(s)
- Sidney Abou Sawan
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Nathan Hodson
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | | | - Daniel W D West
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada.,Toronto Rehabilitation Institute, Toronto, Canada
| | - Julia M Malowany
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | | | - Daniel R Moore
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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Zheng H, Badenhorst CE, Lei TH, Che Muhamed AM, Liao YH, Amano T, Fujii N, Nishiyasu T, Kondo N, Mündel T. Measurement error of self-paced exercise performance in athletic women is not affected by ovulatory status or ambient environment. J Appl Physiol (1985) 2021; 131:1496-1504. [PMID: 34590913 DOI: 10.1152/japplphysiol.00342.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Measurement error(s) of exercise tests for women are severely lacking in the literature. The purpose of this investigation was to 1) determine whether ovulatory status or ambient environment were moderating variables when completing a 30-min self-paced work trial and 2) provide test-retest norms specific to athletic women. A retrospective analysis of three heat stress studies was completed using 33 female participants (31 ± 9 yr, 54 ± 10 mL·min-1·kg-1) that yielded 130 separate trials. Participants were classified as ovulatory (n = 19), anovulatory (n = 4), and oral contraceptive pill users (n = 10). Participants completed trials ∼2 wk apart in their (quasi-) early follicular and midluteal phases in two of moderate (1.3 ± 0.1 kPa, 20.5 ± 0.5°C, 18 trials), warm-dry (2.2 ± 0.2 kPa, 34.1 ± 0.2°C, 46 trials), or warm-humid (3.4 ± 0.1 kPa, 30.2 ± 1.1°C, 66 trials) environments. We quantified reliability using limits of agreement, intraclass correlation coefficient (ICC), standard error of measurement (SEM), and coefficient of variation (CV). Test-retest reliability was high, clinically valid (ICC = 0.90, P < 0.01), and acceptable with a mean CV of 4.7%, SEM of 3.8 kJ (2.1 W), and reliable bias of -2.1 kJ (-1.2 W). The various ovulatory status and contrasting ambient conditions had no appreciable effect on reliability. These results indicate that athletic women can perform 30-min self-paced work trials ∼2 wk apart with an acceptable and low variability irrespective of their hormonal status or heat-stressful environments.NEW & NOTEWORTHY This study highlights that aerobically trained women perform 30-min self-paced work trials ∼2 wk apart with acceptably low variability and their hormonal/ovulatory status and the introduction of greater ambient heat and humidity do not moderate this measurement error.
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Affiliation(s)
- Huixin Zheng
- School of Sport Exercise and Nutrition, Massey University, Palmerston North, New Zealand
| | - Claire E Badenhorst
- School of Sport Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Tze-Huan Lei
- College of Physical Education, Hubei Normal University, Huangshi, China
| | - Ahmad Munir Che Muhamed
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Pulau Pinang, Malaysia
| | - Yi-Hung Liao
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Tatsuro Amano
- Faculty of Education, Niigata University, Niigata, Japan
| | - Naoto Fujii
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Takeshi Nishiyasu
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Narihiko Kondo
- Laboratory for Applied Human Physiology, Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| | - Toby Mündel
- School of Sport Exercise and Nutrition, Massey University, Palmerston North, New Zealand
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32
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Thompson BM, Drover KB, Stellmaker RJ, Sculley DV, Janse de Jonge XAK. The Effect of the Menstrual Cycle and Oral Contraceptive Cycle on Muscle Performance and Perceptual Measures. Int J Environ Res Public Health 2021; 18:ijerph182010565. [PMID: 34682310 PMCID: PMC8536049 DOI: 10.3390/ijerph182010565] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 12/23/2022]
Abstract
Most reproductive-aged women are exposed to fluctuating female steroid hormones due to the menstrual cycle or oral contraceptive use. This study investigated the potential effect of the menstrual cycle and combined monophasic oral contraceptive cycle on various aspects of muscle performance. Thirty active females (12 with a natural menstrual cycle, 10 taking a high-androgenicity oral contraceptive and 8 taking a low-androgenicity oral contraceptive), aged 18 to 30 years, were tested three times throughout one menstrual or oral contraceptive cycle. Counter-movement jumps, bilateral hop jumps, handgrip strength, isometric knee extensor strength and isokinetic knee flexion and extension were assessed. Perceptual ratings of fatigue, muscle soreness, pain and mood were recorded. Most variables showed no significant changes over the menstrual or oral contraceptive cycle. However, for the menstrual cycle group, isokinetic knee flexion at 240° s−1, and time of flight in bilateral hopping and counter movement jumps showed better results during the mid-luteal phase compared with the late follicular phase. For the high-androgenicity oral contraceptive group, isokinetic knee flexion at 240° s−1 was significantly higher in the late hormone phase compared with the early hormone phase. For the low-androgenicity oral contraceptive group, time of flight for the counter-movement jumps was lower in the late hormone phase compared with the early hormone phase. The findings indicate that faster and explosive aspects of muscle performance may be influenced by endogenous and exogenous female hormones.
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Affiliation(s)
- Belinda M. Thompson
- Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, NSW 2109, Australia
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, NSW 2258, Australia; (K.B.D.); (R.J.S.); (X.A.K.J.d.J.)
- Correspondence:
| | - Kaitlyn B. Drover
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, NSW 2258, Australia; (K.B.D.); (R.J.S.); (X.A.K.J.d.J.)
| | - Rhiannon J. Stellmaker
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, NSW 2258, Australia; (K.B.D.); (R.J.S.); (X.A.K.J.d.J.)
| | - Dean V. Sculley
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Ourimbah, NSW 2258, Australia;
| | - Xanne A. K. Janse de Jonge
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, NSW 2258, Australia; (K.B.D.); (R.J.S.); (X.A.K.J.d.J.)
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Collado-Boira E, Baliño P, Boldo-Roda A, Martínez-Navarro I, Hernando B, Recacha-Ponce P, Hernando C, Muriach M. Influence of Female Sex Hormones on Ultra-Running Performance and Post-Race Recovery: Role of Testosterone. Int J Environ Res Public Health 2021; 18:10403. [PMID: 34639701 DOI: 10.3390/ijerph181910403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/21/2021] [Accepted: 09/28/2021] [Indexed: 11/17/2022]
Abstract
In recent years, increasing numbers of women have participated in extremely long races. In adult males, there is a clear association between physiological levels of endogenous sex hormones and physical performance. However, the influence of plasmatic sex hormones and the effects of different types of hormonal contraception (HC) on the modulation of physical performance in adult females remain to be fully clarified. Eighteen female ultra-endurance athletes were recruited to participate in the study. Different variables were studied, including hematological parameters, body mass index, and body composition. Strength measurements were obtained using the squat-jump and hand-grip test. A repeated-measures analysis demonstrated significant differences in hematological values of CK and LDH pre-race as compared to immediately post-race and after 24/48 h. Furthermore, statistical differences were found in squat-jump and hand-grip test results after the ultramarathon. Testosterone, estradiol, and the testosterone/estrogen ratio were significantly correlated with muscle fatigue and were found to be indirect markers of muscle damage. A multivariate analysis demonstrated the protective role of testosterone against muscle damage and severe fatigue. Fluctuations in endogenous testosterone levels were correlated with greater fatigability and muscle damage after the competition. Adjusting the menstrual cycle with HC would not provide any further benefit to the athlete's competitive capacity.
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Benham JL, Booth JE, Corenblum B, Doucette S, Friedenreich CM, Rabi DM, Sigal RJ. Exercise training and reproductive outcomes in women with polycystic ovary syndrome: A pilot randomized controlled trial. Clin Endocrinol (Oxf) 2021; 95:332-343. [PMID: 33638879 PMCID: PMC8360032 DOI: 10.1111/cen.14452] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/15/2021] [Accepted: 02/11/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Exercise is recommended for polycystic ovary syndrome (PCOS), but the most effective exercise prescription is unclear. This trial compared effects of high-intensity interval training (HIIT), continuous aerobic exercise training (CAET) and no-exercise control on reproductive, anthropometric and cardiometabolic outcomes in PCOS. DESIGN Pilot randomized controlled trial. PARTICIPANTS Previously inactive women aged 18-40 years with PCOS. MEASUREMENTS Feasibility outcomes included recruitment, retention, adherence to exercise and daily ovulation prediction kit (OPK) testing. Preliminary efficacy outcomes included reproductive, anthropometric and cardiometabolic health markers. RESULTS Forty-seven women were randomized to no-exercise control (n = 17), HIIT (n = 16), or CAET (n = 14). Forty (85%) participants completed the trial. Median exercise adherence was 68% (IQR 53%, 86%). Median daily OPK-testing adherence in the first half of the intervention was 87% (IQR 61%, 97%) compared with 65% (IQR 0%, 96%) in the second half. Body mass index decreased significantly in CAET compared with control (-1.0 kg/m2 , p = .01) and HIIT (-0.9 kg/m2 , p = .04). Mean waist circumference decreased in all groups (-7.3 cm, -6.9 cm, -4.5 cm in HIIT, CAET and control) with no significant between-group differences. Mean LDL-C was significantly reduced for HIIT compared to CAET (-0.33 mmol/L, p = .03). HDL-C increased in HIIT compared with control (0.18 mmol/L, p = .04). CONCLUSIONS There were feasibility challenges with adherence to daily ovulation assessment limiting the ability to analyse the effect of the exercise interventions on ovulation. CAET and HIIT were both effective at improving anthropometrics and some cardiometabolic health markers. Further studies need to determine optimal and acceptable exercise prescriptions for this population.
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Affiliation(s)
- Jamie L. Benham
- Department of MedicineCumming School of MedicineUniversity of CalgaryCalgaryABCanada
- Department of Community Health SciencesCumming School of MedicineUniversity of CalgaryCalgaryABCanada
| | - Jane E. Booth
- Department of Community Health SciencesCumming School of MedicineUniversity of CalgaryCalgaryABCanada
| | - Bernard Corenblum
- Department of MedicineCumming School of MedicineUniversity of CalgaryCalgaryABCanada
| | - Steve Doucette
- Department of Community Health & EpidemiologyDalhousie UniversityHalifaxNSCanada
| | - Christine M. Friedenreich
- Department of Community Health SciencesCumming School of MedicineUniversity of CalgaryCalgaryABCanada
- Department of Cancer Epidemiology and Prevention Research, Cancer Care AlbertaAlberta Health ServicesHoly Cross CentreCalgaryABCanada
- Faculty of KinesiologyUniversity of CalgaryCalgaryABCanada
- Department of OncologyCumming School of MedicineUniversity of CalgaryCalgaryABCanada
- O’Brien Institute of Public HealthUniversity of CalgaryCalgaryABCanada
| | - Doreen M. Rabi
- Department of MedicineCumming School of MedicineUniversity of CalgaryCalgaryABCanada
- Department of Community Health SciencesCumming School of MedicineUniversity of CalgaryCalgaryABCanada
- O’Brien Institute of Public HealthUniversity of CalgaryCalgaryABCanada
- Department of Cardiac SciencesCumming School of MedicineUniversity of CalgaryCalgaryABCanada
- Libin Cardiovascular InstituteUniversity of CalgaryCalgaryABCanada
| | - Ronald J. Sigal
- Department of MedicineCumming School of MedicineUniversity of CalgaryCalgaryABCanada
- Department of Community Health SciencesCumming School of MedicineUniversity of CalgaryCalgaryABCanada
- Faculty of KinesiologyUniversity of CalgaryCalgaryABCanada
- O’Brien Institute of Public HealthUniversity of CalgaryCalgaryABCanada
- Department of Cardiac SciencesCumming School of MedicineUniversity of CalgaryCalgaryABCanada
- Libin Cardiovascular InstituteUniversity of CalgaryCalgaryABCanada
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35
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Thompson BM, Hillebrandt HL, Sculley DV, Barba-Moreno L, Janse de Jonge XAK. The acute effect of the menstrual cycle and oral contraceptive cycle on measures of body composition. Eur J Appl Physiol 2021; 121:3051-3059. [PMID: 34296342 DOI: 10.1007/s00421-021-04771-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 07/14/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to investigate the effect of fluctuating female hormones during the menstrual cycle (MC) and oral contraceptive (OC) cycle on different measures of body composition. METHODS Twenty-two women with a natural MC and thirty women currently taking combined monophasic OC were assessed over three phases of the menstrual or oral contraceptive cycle. Body weight, skinfolds, bioelectric impedance analysis (BIA), ultrasound, dual-energy X-ray absorptiometry (DXA), and peripheral quantitative computed tomography (pQCT) measurements were performed to assess body composition. Urine specific gravity (USG) was measured as an indication of hydration, and serum oestradiol and progesterone were measured to confirm cycle phases. RESULTS Five participants with a natural MC were excluded based on the hormone analysis. For the remaining participants, no significant changes over the MC and OC cycle were found for body weight, USG, skinfolds, BIA, ultrasound and pQCT measures. However, DXA body fat percentage and fat mass were lower in the late follicular phase compared to the mid-luteal phase of the MC, while for the OC cycle, DXA body fat percentage was higher and lean mass lower in the early hormone phase compared with the late hormone phase. CONCLUSION Our findings suggest that assessment of body fat percentage through BIA and skinfolds may be performed without considering the MC or OC cycle. Body adiposity assessment via DXA, however, may be affected by female hormone fluctuations and therefore, it may be advisable to perform repeat testing using DXA during the same phase of the MC or OC cycle.
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Affiliation(s)
- Belinda M Thompson
- Exercise and Sport Science, The University of Newcastle, Ourimbah, Australia. .,Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, 1/75 Talavera Road, Sydney, NSW, 2109, Australia.
| | - Heidi L Hillebrandt
- Exercise and Sport Science, The University of Newcastle, Ourimbah, Australia.,Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Dean V Sculley
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Ourimbah, Australia
| | - Laura Barba-Moreno
- Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
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McGarity-Shipley EC, Schmitter SM, Williams JS, King TJ, McPhee IAC, Pyke KE. The impact of repeated, local heating-induced increases in blood flow on lower limb endothelial function in young, healthy females. Eur J Appl Physiol 2021. [PMID: 34251539 DOI: 10.1007/s00421-021-04749-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 06/15/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of the present study was to examine the effect of repeated, single leg heating on lower limb endothelial function. METHODS Macrovascular function was assessed with superficial femoral artery (SFA) reactive hyperemia flow-mediated dilation (RH-FMD) and sustained stimulus FMD (SS-FMD). Calf microvascular function was assessed as the peak and area under the curve of SFA reactive hyperemia (RH). Participants (n = 13 females, 23 ± 2 yrs) had one leg randomized to the single leg heating intervention (EXP; other leg: control (CON)). The EXP leg underwent 8 weeks of single leg heating via immersion in 42.5 ℃ water for five 35-min sessions/week. At weeks 0, 2, 4, 6, and 8, SFA RH-FMD, SS-FMD (shear stress increased via plantar flexion exercise), and SFA RH flow were measured. RESULTS None of the variables changed with repeated, single leg heating (interaction week*limb RH-FMD: p = 0.076; SS-FMD: p = 0.958; RH flow p = 0.955). Covariation for the shear stress stimulus did not alter the FMD results. CONCLUSION Eight weeks of single leg heating did not change SFA endothelial or calf microvascular function. These results are in contrast with previous findings that limb heating improves upper limb endothelial function.
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Hutchins KP, Borg DN, Bach AJE, Bon JJ, Minett GM, Stewart IB. Female (Under) Representation in Exercise Thermoregulation Research. Sports Med Open 2021; 7:43. [PMID: 34156570 PMCID: PMC8219822 DOI: 10.1186/s40798-021-00334-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 06/06/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Despite an increasing rate of women participating in professional sports, emergency services, and military settings where they are exposed to exertional heat stress, our understanding of female thermoregulation and the detrimental effects of heat on women's performance, especially regarding the menstrual cycle, is limited. This review aimed to quantify the representation of women in exercise thermoregulation research between 2010 and 2019 and the frequency that these articles reported details pertaining to female participants' menstrual cycle to determine the volume of novel research that is directly relevant to this growing population. METHODS Original exercise thermoregulatory studies published in three major sports medicine databases (PubMed, MEDLINE, and SPORTDiscus) between 2010 and 2019 were surveyed. Articles were screened to determine the number of female and male participants in the study and whether studies involving women reported menstrual orientation or phase. Research involving healthy adult participants and an exercise protocol with a thermoregulatory outcome measure were included in the review. RESULTS A total of 1407 articles were included in the review, involving 28,030 participants. The annual representation of women ranged from a mean of 11.6% [95% credible interval (CI); 9.2, 14.3] to 17.8% [95% CI; 15.2, 20.6] across the 10 years, indicating studies predominantly included men. Nonetheless, there was a small statistical increase in the overall proportion of women, with a mean overall proportion change of 0.7% [95% CI; 0.2, 1.2] per year. The increase appeared to be driven by a reduction in the number of studies including only men, rather than studies including more women alongside men, or increased women-only studies. Less than one third of articles involving women reported the menstrual orientation of participants and less than one quarter reported both menstrual orientation and phase. This study shows that women were proportionally underrepresented in exercise thermoregulation research during the past decade and the majority of studies did not report menstrual cycle details of female participants. Researchers should consider including women in future work where their inclusion could contribute meaningful data that enhance the evidence-based and ultimately improves our comprehension of women's thermal physiology.
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Affiliation(s)
- Kate P Hutchins
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia.
| | - David N Borg
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Aaron J E Bach
- The National Climate Change Adaption Research Facility, Griffith University, Gold Coast, Australia
| | - Joshua J Bon
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, Australia
- Australian Centre of Excellence for Mathematical and Statistical Frontiers, Brisbane, Australia
| | - Geoffrey M Minett
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Ian B Stewart
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
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Hrozanova M, Klöckner CA, Sandbakk Ø, Pallesen S, Moen F. Sex differences in sleep and influence of the menstrual cycle on women's sleep in junior endurance athletes. PLoS One 2021; 16:e0253376. [PMID: 34138961 PMCID: PMC8211225 DOI: 10.1371/journal.pone.0253376] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 06/03/2021] [Indexed: 01/12/2023] Open
Abstract
Previous research shows that female athletes sleep better according to objective parameters but report worse subjective sleep quality than male athletes. However, existing sleep studies did not investigate variations in sleep and sleep stages over longer periods and have, so far, not elucidated the role of the menstrual cycle in female athletes' sleep. To address these methodological shortcomings, we investigated sex differences in sleep and sleep stages over 61 continuous days in 37 men and 19 women and examined the role of the menstrual cycle and its phases in 15 women. Sleep was measured by a non-contact radar, and menstrual bleeding was self-reported. Associations were investigated with multilevel modeling. Overall, women tended to report poorer subjective sleep quality (p = .057), but objective measurements showed that women obtained longer sleep duration (p < .001), more light (p = .013) and rapid eye movement sleep (REM; hours (h): p < .001, %: p = .007), shorter REM latency (p < .001), and higher sleep efficiency (p = .003) than men. R2 values showed that sleep duration, REM and REM latency were especially affected by sex. Among women, we found longer time in bed (p = .027) and deep sleep (h: p = .036), and shorter light sleep (%: p = .021) during menstrual bleeding vs. non-bleeding days; less light sleep (h: p = .040), deep sleep (%: p = .013) and shorter REM latency (p = .011) during the menstrual than pre-menstrual phase; and lower sleep efficiency (p = .042) and more deep sleep (%: p = .026) during the follicular than luteal phase. These findings indicate that the menstrual cycle may impact the need for physiological recovery, as evidenced by the sleep stage variations. Altogether, the observed sex differences in subjective and objective sleep parameters may be related to the female athletes' menstrual cycle. The paper provides unique data of sex differences in sleep stages and novel insights into the role of the menstrual cycle in sleep among female athletes.
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Affiliation(s)
- Maria Hrozanova
- Center for Elite Sports Research, Faculty of Medicine and Health Sciences, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- * E-mail:
| | - Christian A. Klöckner
- Faculty of Social and Educational Sciences, Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Øyvind Sandbakk
- Center for Elite Sports Research, Faculty of Medicine and Health Sciences, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ståle Pallesen
- Faculty of Psychology, Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
- Optentia, the Vaal Triangle Campus of the North-West University, Vanderbijlpark, South-Africa
| | - Frode Moen
- Faculty of Social and Educational Sciences, Department of Education and Lifelong Learning, Norwegian University of Science and Technology, Trondheim, Norway
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Quinn KM, Cox AJ, Roberts L, Pennell EN, McKeating DR, Fisher JJ, Perkins AV, Minahan C. Temporal changes in blood oxidative stress biomarkers across the menstrual cycle and with oral contraceptive use in active women. Eur J Appl Physiol 2021; 121:2607-2620. [PMID: 34106325 DOI: 10.1007/s00421-021-04734-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/03/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To examine the temporal changes in blood oxidative stress biomarkers in recreationally-trained women that were naturally-cycling (WomenNC) or using oral contraceptives (WomenOC) across one month. METHODS Blood samples were acquired at three timepoints of the menstrual cycle (1: early-follicular, 2: late-follicular and 3: mid-luteal) and oral contraceptive packet (1: InactiveOC, 2: Mid-activeOC and 3: Late-activeOC) for determination of estradiol, progesterone, oxidative stress, C-reactive protein (CRP) and other cardiometabolic biomarkers in plasma and serum. RESULTS There was a Group by Time effect on estradiol (p < 0.001, partial η2 = 0.64) and progesterone (p < 0.001, partial η2 = 0.77). Malondialdehyde, lipid hydroperoxides and CRP concentrations were higher in WomenOC during Late-activeOC compared to InactiveOC (+ 96%, + 23% and + 104%, respectively, p < 0.05). However, there were no changes in these biomarkers across the menstrual cycle in WomenNC (p > 0.05). At all timepoints (i.e., 1, 2 and 3), WomenOC had elevated lipid hydroperoxides (+ 28, + 48% and + 50%) and CRP (+ 71%, + 117% and + 130%) compared to WomenNC (p < 0.05, partial η2 > 0.25). There was no Group by Time effect on non-enzymatic antioxidants or glutathione peroxidase; however, glutathione peroxidase was lower in WomenOC, i.e., main effect of group (p < 0.05, partial η2 > 0.20). CONCLUSION These findings demonstrate that WomenOC not only have higher oxidative stress and CRP than WomenNC, but also a transient increase across one month of habitual oral contraceptive use. Since changes in oxidative stress and CRP often relate to training stress and recovery, these outcomes may have implications to workload monitoring practices in female athletes.
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Affiliation(s)
- Karlee M Quinn
- Griffith Sports Science, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia.
- Sport Performance Innovation and Knowledge Excellence Unit, Queensland Academy of Sport, Brisbane, 4111, Australia.
| | - Amanda J Cox
- School of Medical Science, Griffith University, Gold Coast, 4222, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, 4222, Australia
| | - Llion Roberts
- Griffith Sports Science, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia
- Sport Performance Innovation and Knowledge Excellence Unit, Queensland Academy of Sport, Brisbane, 4111, Australia
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, 4072, Australia
| | - Evan N Pennell
- School of Medical Science, Griffith University, Gold Coast, 4222, Australia
| | - Daniel R McKeating
- School of Medical Science, Griffith University, Gold Coast, 4222, Australia
| | - Joshua J Fisher
- School of Medical Science, Griffith University, Gold Coast, 4222, Australia
| | - Anthony V Perkins
- School of Medical Science, Griffith University, Gold Coast, 4222, Australia
| | - Clare Minahan
- Griffith Sports Science, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia
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Romero-Parra N, Rael B, Alfaro-Magallanes VM, Janse de Jonge X, Cupeiro R, Peinado AB. The Effect of the Oral Contraceptive Cycle Phase on Exercise-Induced Muscle Damage After Eccentric Exercise in Resistance-Trained Women. J Strength Cond Res 2021; 35:353-359. [PMID: 33337689 DOI: 10.1519/jsc.0000000000003897] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
ABSTRACT Romero-Parra, N, Rael, B, Alfaro-Magallanes, VM, Janse de Jonge, X, Cupeiro, R, and Peinado, AB; On Behalf of the IronFEMME Study Group. The effect of the oral contraceptive cycle phase on exercise-induced muscle damage after eccentric exercise in resistance-trained women. J Strength Cond Res 35(2): 353-359, 2021-To evaluate the influence of the active pill phase versus withdrawal phase of a monophasic oral contraceptive (OC) cycle on exercise-induced muscle damage and inflammation after eccentric resistance exercise. Eighteen resistance-trained female OC users (age: 25.6 ± 4.2 years, height: 162.4 ± 5.0 cm, and body mass: 58.1 ± 5.7 kg) performed an eccentric squat-based exercise during the active pill phase and withdrawal phase of their OC cycle. Muscle soreness, counter movement jump (CMJ), and blood markers of muscle damage and inflammation were evaluated before and postexercise (0, 2, 24, and 48 hours). Creatine kinase (CK) values were higher in the withdrawal (181.8 ± 89.8 U·L-1) than in the active pill phase (144.0 ± 39.7 U·L-1) (p < 0.001). The highest CK concentrations and muscle soreness values were observed 24 hours postexercise (217.9 ± 117.5 U·L-1 and 44.7 ± 19.7, respectively) compared with baseline (115.3 ± 37.4 U·L-1 and 4.4 ± 9.2, respectively; p < 0.001). In addition, a decrease in CMJ immediately postexercise (20.23 ± 4.6 cm) was observed in comparison with baseline (24.2 ± 6.1 cm), which was not yet recovered 24 hours postexercise (21.9 ± 5.9 cm; p < 0.001). No other phase or time effects were observed. An eccentric squat-based exercise session elicits muscle damage but no inflammation response in resistance-trained women. Furthermore, the highest CK concentrations observed in the withdrawal phase suggest that this phase might be more vulnerable to muscle damage and, therefore, less adequate to administer high training loads. However, the lack of differences in other muscle damage variables between OC phases does not warrant any guidance on the active pill versus withdrawal phase.
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Affiliation(s)
- Nuria Romero-Parra
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Polytechnic University of Madrid (UPM), Madrid, Spain; and
| | - Beatriz Rael
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Polytechnic University of Madrid (UPM), Madrid, Spain; and
| | - Víctor M Alfaro-Magallanes
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Polytechnic University of Madrid (UPM), Madrid, Spain; and
| | - Xanne Janse de Jonge
- School of Environmental and Life Sciences, Faculty of Science, the University of Newcastle (UON), Ourimbah, NSW, Australia
| | - Rocío Cupeiro
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Polytechnic University of Madrid (UPM), Madrid, Spain; and
| | - Ana B Peinado
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Polytechnic University of Madrid (UPM), Madrid, Spain; and
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Zheng H, Badenhorst CE, Lei TH, Liao YH, Che Muhamed AM, Fujii N, Kondo N, Mündel T. Menstrual phase and ambient temperature do not influence iron regulation in the acute exercise period. Am J Physiol Regul Integr Comp Physiol 2021; 320:R780-R790. [PMID: 33787332 DOI: 10.1152/ajpregu.00014.2021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The current study investigated whether ambient heat augments the inflammatory and postexercise hepcidin response in women and if menstrual phase and/or self-pacing modulate these physiological effects. Eight trained females (age: 37 ± 7 yr; V̇o2max: 46 ± 7 mL·kg-1·min-1; peak power output: 4.5 ± 0.8 W·kg-1) underwent 20 min of fixed-intensity cycling (100 W and 125 W) followed by a 30-min work trial (∼75% V̇o2max) in a moderate (MOD: 20 ± 1°C, 53 ± 8% relative humidity) and warm-humid (WARM: 32 ± 0°C, 75 ± 3% relative humidity) environment in both their early follicular (days 5 ± 2) and midluteal (days 21 ± 3) phases. Mean power output was 5 ± 4 W higher in MOD than in WARM (P = 0.02) such that the difference in core temperature rise was limited between environments (-0.29 ± 0.18°C in MOD, P < 0.01). IL-6 and hepcidin both increased postexercise (198% and 38%, respectively); however, neither was affected by ambient temperature or menstrual phase (all P > 0.15). Multiple regression analysis demonstrated that the IL-6 response to exercise was explained by leukocyte and platelet count (r2 = 0.72, P < 0.01), and the hepcidin response to exercise was explained by serum iron and ferritin (r2 = 0.62, P < 0.01). During exercise, participants almost matched their fluid loss (0.48 ± 0.18 kg·h-1) with water intake (0.35 ± 0.15 L·h-1) such that changes in body mass (-0.3 ± 0.3%) and serum osmolality (0.5 ± 2.0 osmol·kgH2O-1) were minimal or negligible, indicating a behavioral fluid-regulatory response. These results indicate that trained, iron-sufficient women suffer no detriment to their iron regulation in response to exercise with acute ambient heat stress or between menstrual phases on account of a performance-physiological trade-off.
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Affiliation(s)
- Huixin Zheng
- School of Sport Exercise and Nutrition, Massey University, Palmerston North, New Zealand
| | - Claire E Badenhorst
- School of Sport Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Tze-Huan Lei
- College of Physical Education, Hubei Normal University, Huangshi, China
| | - Yi-Hung Liao
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | | | - Naoto Fujii
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Narihiko Kondo
- Laboratory for Applied Human Physiology, Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| | - Toby Mündel
- School of Sport Exercise and Nutrition, Massey University, Palmerston North, New Zealand
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Elliott-Sale KJ, Minahan CL, de Jonge XAKJ, Ackerman KE, Sipilä S, Constantini NW, Lebrun CM, Hackney AC. Methodological Considerations for Studies in Sport and Exercise Science with Women as Participants: A Working Guide for Standards of Practice for Research on Women. Sports Med 2021; 51:843-61. [PMID: 33725341 DOI: 10.1007/s40279-021-01435-8] [Citation(s) in RCA: 180] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2021] [Indexed: 12/25/2022]
Abstract
Until recently, there has been less demand for and interest in female-specific sport and exercise science data. As a result, the vast majority of high-quality sport and exercise science data have been derived from studies with men as participants, which reduces the application of these data due to the known physiological differences between the sexes, specifically with regard to reproductive endocrinology. Furthermore, a shortage of specialist knowledge on female physiology in the sport science community, coupled with a reluctance to effectively adapt experimental designs to incorporate female-specific considerations, such as the menstrual cycle, hormonal contraceptive use, pregnancy and the menopause, has slowed the pursuit of knowledge in this field of research. In addition, a lack of agreement on the terminology and methodological approaches (i.e., gold-standard techniques) used within this research area has further hindered the ability of researchers to adequately develop evidenced-based guidelines for female exercisers. The purpose of this paper was to highlight the specific considerations needed when employing women (i.e., from athletes to non-athletes) as participants in sport and exercise science-based research. These considerations relate to participant selection criteria and adaptations for experimental design and address the diversity and complexities associated with female reproductive endocrinology across the lifespan. This statement intends to promote an increase in the inclusion of women as participants in studies related to sport and exercise science and an enhanced execution of these studies resulting in more high-quality female-specific data.
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Giersch GEW, Charkoudian N, Pereira T, Edgell H, Freeberg KA, Craighead DH, Neill M, Allison EY, Zapcic AK, Smith KJ, Bock JM, Casey DP, Shenouda N, Ranadive SM, Tremblay JC, Williams AM, Simpson LL, Meah VL, Ruediger SL, Bailey TG, Pereira HM, Lei TH, Perry B, Mündel T, Freemas JA, Worley ML, Baranauskas MN, Carter SJ, Johnson BD, Schlader ZJ, Bates LC, Stoner L, Zieff G, Poles J, Adams N, Meyer ML, Hanson ED, Greenlund IM, Bigalke JA, Carter JR, Kerr ZY, Stanford K, Pomeroy A, Boggess K, de Souza HLR, Meireles A, Arriel RA, Leite LHR, Marocolo M, Chapman CL, Atencio JK, Kaiser BW, Comrada LN, Halliwill JR, Minson CT, Williams JS, Dunford EC, MacDonald MJ, Santisteban KJ, Larson EA, Reed E, Needham KW, Gibson BM, Gillen J, Barbosa TC, Cardoso LLY, Gliemann L, Tamariz-Ellemann A, Hellsten Y, DuBos LE, Babcock MC, Moreau KL, Wickham KA, Vagula M, Moir ME, Klassen SA, Rodrigues A. Commentaries on Point:Counterpoint: Investigators should/should not control for menstrual cycle phase when performing studies of vascular control. J Appl Physiol (1985) 2021; 129:1122-1135. [PMID: 33197376 DOI: 10.1152/japplphysiol.00809.2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Gabrielle E W Giersch
- Thermal and Mountain Medicine Division, United States Army Research Institute for Environmental Medicine, Natick, Massachusetts,Oak Ridge Institute for Science and Education, Oak Ridge, Tennnessee
| | - Nisha Charkoudian
- Thermal and Mountain Medicine Division, United States Army Research Institute for Environmental Medicine, Natick, Massachusetts
| | - T Pereira
- School of Kinesiology and Health Sciences, York University, Toronto, Ontario, Canada
| | - H Edgell
- School of Kinesiology and Health Sciences, York University, Toronto, Ontario, Canada
| | - Kaitlin A Freeberg
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
| | - Daniel H Craighead
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
| | - Matthew Neill
- Department of Kinesiology, Lakehead University, Thunder Bay, Ontario, Canada
| | - Elric Y Allison
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Andrea K Zapcic
- Department of Kinesiology, Lakehead University, Thunder Bay, Ontario, Canada
| | - Kurt J Smith
- Integrative Physiology Lab, Department of Kinesiology and Nutrition, University of Chicago, Chicago, Illinois
| | - Joshua M Bock
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Darren P Casey
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, Iowa,Abboud Cardiovascular Research Center, Carver College of Medicine, University of Iowa, Iowa City, Iowa,Fraternal Order of Eagles Diabetes Research Center, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Ninette Shenouda
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware
| | - Sushant M Ranadive
- Department of Kinesiology, University of Maryland, College Park, Maryland
| | - Joshua C Tremblay
- Centre for Heart, Lung and Vascular Health, University of British Columbia–Okanagan, Kelowna, British Columbia, Canada
| | - Alexandra M Williams
- Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada,International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, Canada
| | - Lydia L Simpson
- Extremes Research Group, School of Sport, Health and Exercise Sciences, Bangor University, Bangor, United Kingdom
| | - Victoria L Meah
- Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Stefanie L Ruediger
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre of Research on Exercise, Physical Activity and Health, The University of Queensland, Australia
| | - Tom G Bailey
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre of Research on Exercise, Physical Activity and Health, The University of Queensland, Australia,School of Nursing, Midwifery and Social Work, The University of Queensland, Australia
| | - Hugo M Pereira
- Department of Health and Exercise Science, University of Oklahoma, Norman, Oklahoma
| | - Tze-Huan Lei
- College of Physical Education, Hubei Normal University, Huangshi, China,Laboratory for Applied Human Physiology, Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| | - Blake Perry
- School of Health Sciences, Massey University, Wellington, New Zealand
| | - Toby Mündel
- School of Sport Exercise and Nutrition, Massey University, Palmerston North, New Zealand
| | - Jessica A Freemas
- H.H. Morris Human Performance Laboratories, Dept. of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - Morgan L Worley
- H.H. Morris Human Performance Laboratories, Dept. of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - Marissa N Baranauskas
- H.H. Morris Human Performance Laboratories, Dept. of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - Stephen J Carter
- H.H. Morris Human Performance Laboratories, Dept. of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - Blair D Johnson
- H.H. Morris Human Performance Laboratories, Dept. of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - Zachary J Schlader
- H.H. Morris Human Performance Laboratories, Dept. of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - Lauren C Bates
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Gabriel Zieff
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jillian Poles
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Nathan Adams
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Michelle L Meyer
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Erik D Hanson
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Ian M Greenlund
- Department of Health and Human Development, Montana State University, Bozeman, Montana,Department of Psychology, Montana State University, Bozeman, Montana
| | - Jeremy A Bigalke
- Department of Health and Human Development, Montana State University, Bozeman, Montana,Department of Psychology, Montana State University, Bozeman, Montana
| | - Jason R Carter
- Department of Health and Human Development, Montana State University, Bozeman, Montana,Department of Psychology, Montana State University, Bozeman, Montana
| | - Zachary Y Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kathleen Stanford
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Alex Pomeroy
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kim Boggess
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Hiago L R de Souza
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Anderson Meireles
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Rhai A Arriel
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Laura H R Leite
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Moacir Marocolo
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | | | - Jessica K Atencio
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Brendan W Kaiser
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Lindan N Comrada
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - John R Halliwill
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | | | - Jennifer S Williams
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Emily C Dunford
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Maureen J MacDonald
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | | | - Emily A Larson
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Emma Reed
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Karen W Needham
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Brandon M Gibson
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Jenna Gillen
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Thales C Barbosa
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi
| | - Licy L Yanes Cardoso
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Lasse Gliemann
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
| | | | - Ylva Hellsten
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
| | - Lyndsey E DuBos
- Division of Geriatric Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Matthew C Babcock
- Division of Geriatric Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Kerrie L Moreau
- Division of Geriatric Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado,Veterans Affairs Eastern Colorado Geriatric Research, Educational and Clinical Center, Denver, Colorado
| | - Kate A Wickham
- Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada
| | | | - M Erin Moir
- School of Kinesiology, University of Western Ontario, London, Ontario, Canada
| | | | - Alex Rodrigues
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
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McNulty KL, Elliott-Sale KJ, Dolan E, Swinton PA, Ansdell P, Goodall S, Thomas K, Hicks KM. The Effects of Menstrual Cycle Phase on Exercise Performance in Eumenorrheic Women: A Systematic Review and Meta-Analysis. Sports Med 2021; 50:1813-1827. [PMID: 32661839 PMCID: PMC7497427 DOI: 10.1007/s40279-020-01319-3] [Citation(s) in RCA: 215] [Impact Index Per Article: 71.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Background Concentrations of endogenous sex hormones fluctuate across the menstrual cycle (MC), which could have implications for exercise performance in women. At present, data are conflicting, with no consensus on whether exercise performance is affected by MC phase. Objective To determine the effects of the MC on exercise performance and provide evidence-based, practical, performance recommendations to eumenorrheic women. Methods This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four databases were searched for published experimental studies that investigated the effects of the MC on exercise performance, which included at least one outcome measure taken in two or more defined MC phases. All data were meta-analysed using multilevel models grounded in Bayesian principles. The initial meta-analysis pooled pairwise effect sizes comparing exercise performance during the early follicular phase with all other phases (late follicular, ovulation, early luteal, mid-luteal and late luteal) amalgamated. A more comprehensive analysis was then conducted, comparing exercise performance between all phases with direct and indirect pairwise effect sizes through a network meta-analysis. Results from the network meta-analysis were summarised by calculating the Surface Under the Cumulative Ranking curve (SUCRA). Study quality was assessed using a modified Downs and Black checklist and a strategy based on the recommendations of the Grading of Recommendations Assessment Development and Evaluation (GRADE) working group. Results Of the 78 included studies, data from 51 studies were eligible for inclusion in the initial pairwise meta-analysis. The three-level hierarchical model indicated a trivial effect for both endurance- and strength-based outcomes, with reduced exercise performance observed in the early follicular phase of the MC, based on the median pooled effect size (ES0.5 = − 0.06 [95% credible interval (CrI): − 0.16 to 0.04]). Seventy-three studies had enough data to be included in the network meta-analysis. The largest effect was identified between the early follicular and the late follicular phases of the MC (ES0.5 = − 0.14 [95% CrI: − 0.26 to − 0.03]). The lowest SUCRA value, which represents the likelihood that exercise performance is poor, or among the poorest, relative to other MC phases, was obtained for the early follicular phase (30%), with values for all other phases ranging between 53 and 55%. The quality of evidence for this review was classified as “low” (42%). Conclusion The results from this systematic review and meta-analysis indicate that exercise performance might be trivially reduced during the early follicular phase of the MC, compared to all other phases. Due to the trivial effect size, the large between-study variation and the number of poor-quality studies included in this review, general guidelines on exercise performance across the MC cannot be formed; rather, it is recommended that a personalised approach should be taken based on each individual's response to exercise performance across the MC. Electronic supplementary material The online version of this article (10.1007/s40279-020-01319-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kelly Lee McNulty
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK
| | - Kirsty Jayne Elliott-Sale
- Department of Sport Science, Sport, Health and Performance Enhancement (SHAPE) Research Centre, Nottingham Trent University, Nottingham, UK.
| | - Eimear Dolan
- Applied Physiology and Nutrition Research Group, Escola de Educação Física e Esporte, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Paul Alan Swinton
- School of Health Sciences, Robert Gordon University, Aberdeen, Scotland, UK
| | - Paul Ansdell
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK
| | - Stuart Goodall
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK
| | - Kevin Thomas
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK
| | - Kirsty Marie Hicks
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK
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Alfaro‐Magallanes VM, Barba‐Moreno L, Rael B, Romero‐Parra N, Rojo‐Tirado MA, Benito PJ, Swinkels DW, Laarakkers CM, Díaz ÁE, Peinado AB. Hepcidin response to interval running exercise is not affected by oral contraceptive phase in endurance-trained women. Scand J Med Sci Sports 2021; 31:643-652. [PMID: 33249618 PMCID: PMC7984293 DOI: 10.1111/sms.13894] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 11/21/2020] [Accepted: 11/24/2020] [Indexed: 12/15/2022]
Abstract
The use of oral contraceptives (OCs) by female athletes may lead to improved iron status, possibly through the regulation of hepcidin by sex hormones. The present work investigates the response of hepcidin and interleukin-6 (IL-6) to an interval exercise in both phases of the OC cycle. Sixteen endurance-trained OC users (age 25.3 ± 4.7 years; height 162.4 ± 5.7 cm; body mass 56.0 ± 5.7 kg; body fat percentage 24.8 ± 6.0%; peak oxygen consumption [VO2peak ]: 47.4 ± 5.5 mL min-1 kg-1 ) followed an identical interval running protocol during the withdrawal and active pill phases of the OC cycle. This protocol consisted of 8 × 3 minutes bouts at 85% VO2peak speed with 90 seconds recovery intervals. Blood samples were collected pre-exercise, and at 0 hour, 3 hours, and 24 hours post-exercise. Pre-exercise 17β-estradiol was lower (P = .001) during the active pill than the withdrawal phase (7.91 ± 1.81 vs 29.36 ± 6.45 pg/mL [mean ± SEM]). No differences were seen between the OC phases with respect to hepcidin or IL-6 concentrations, whether taking all time points together or separately. However, within the withdrawal phase, hepcidin concentrations were higher at 3 hours post-exercise (3.33 ± 0.95 nmol/L) than at pre-exercise (1.04 ± 0.20 nmol/L; P = .005) and 0 hour post-exercise (1.41 ± 0.38 nmol/L; P = .045). Within both OC phases, IL-6 was higher at 0 hour post-exercise than at any other time point (P < .05). Similar trends in hepcidin and IL-6 concentrations were seen at the different time points during both OC phases. OC use led to low 17β-estradiol concentrations during the active pill phase but did not affect hepcidin. This does not, however, rule out estradiol affecting hepcidin levels.
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Affiliation(s)
- Víctor M. Alfaro‐Magallanes
- LFE Research GroupDepartment of Health and Human PerformanceFaculty of Physical Activity and Sport SciencesUniversidad Politécnica de Madrid (UPM)MadridSpain
| | - Laura Barba‐Moreno
- LFE Research GroupDepartment of Health and Human PerformanceFaculty of Physical Activity and Sport SciencesUniversidad Politécnica de Madrid (UPM)MadridSpain
| | - Beatriz Rael
- LFE Research GroupDepartment of Health and Human PerformanceFaculty of Physical Activity and Sport SciencesUniversidad Politécnica de Madrid (UPM)MadridSpain
| | - Nuria Romero‐Parra
- LFE Research GroupDepartment of Health and Human PerformanceFaculty of Physical Activity and Sport SciencesUniversidad Politécnica de Madrid (UPM)MadridSpain
| | - Miguel A. Rojo‐Tirado
- LFE Research GroupDepartment of Health and Human PerformanceFaculty of Physical Activity and Sport SciencesUniversidad Politécnica de Madrid (UPM)MadridSpain
| | - Pedro J. Benito
- LFE Research GroupDepartment of Health and Human PerformanceFaculty of Physical Activity and Sport SciencesUniversidad Politécnica de Madrid (UPM)MadridSpain
| | - Dorine W. Swinkels
- Department of Laboratory MedicineTranslational Metabolic Laboratory (TML 830)Radboud University Medical CenterNijmegenThe Netherlands
- Hepcidinanalysis.comRadboud University Medical CenterNijmegenThe Netherlands
| | - Coby M. Laarakkers
- Department of Laboratory MedicineTranslational Metabolic Laboratory (TML 830)Radboud University Medical CenterNijmegenThe Netherlands
- Hepcidinanalysis.comRadboud University Medical CenterNijmegenThe Netherlands
| | - Ángel E. Díaz
- Clinical LaboratoryDepartment of National Center of Sport Medicine, Health and SportsAEPSADMadridSpain
| | - Ana B. Peinado
- LFE Research GroupDepartment of Health and Human PerformanceFaculty of Physical Activity and Sport SciencesUniversidad Politécnica de Madrid (UPM)MadridSpain
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Martin D, Timmins K, Cowie C, Alty J, Mehta R, Tang A, Varley I. Injury Incidence Across the Menstrual Cycle in International Footballers. Front Sports Act Living 2021; 3:616999. [PMID: 33733235 PMCID: PMC7956981 DOI: 10.3389/fspor.2021.616999] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 01/20/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives: This study aimed to assess how menstrual cycle phase and extended menstrual cycle length influence the incidence of injuries in international footballers. Methods: Over a 4-year period, injuries from England international footballers at training camps or matches were recorded, alongside self-reported information on menstrual cycle characteristics at the point of injury. Injuries in eumenorrheic players were categorized into early follicular, late follicular, or luteal phase. Frequencies were also compared between injuries recorded during the typical cycle and those that occurred after the cycle would be expected to have finished. Injury incidence rates (per 1,000 person days) and injury incidence rate ratios were calculated for each phase for all injuries and injuries stratified by type. Results: One hundred fifty-six injuries from 113 players were eligible for analysis. Injury incidence rates per 1,000 person-days were 31.9 in the follicular, 46.8 in the late follicular, and 35.4 in the luteal phase, resulting in injury incidence rate ratios of 1.47 (Late follicular:Follicular), 1.11 (Luteal:Follicular), and 0.76 (Luteal:Late follicular). Injury incident rate ratios showed that muscle and tendon injury rates were 88% greater in the late follicular phase compared to the follicular phase, with muscle rupture/tear/strain/cramps and tendon injuries/ruptures occurring over twice as often during the late follicular phase compared to other phases 20% of injuries were reported as occurring when athletes were “overdue” menses. Conclusion: Muscle and tendon injuries occurred almost twice as often in the late follicular phase compared to the early follicular or luteal phase. Injury risk may be elevated in typically eumenorrheic women in the days after their next menstruation was expected to start.
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Affiliation(s)
- Dan Martin
- School of Sport and Exercise Science, University of Lincoln, Lincoln, United Kingdom
| | - Kate Timmins
- School of Sport and Exercise Science, University of Lincoln, Lincoln, United Kingdom
| | | | - Jon Alty
- The Football Association, London, United Kingdom
| | - Ritan Mehta
- The Football Association, London, United Kingdom
| | - Alicia Tang
- The Football Association, London, United Kingdom
| | - Ian Varley
- Department of Sport and Exercise Science, Nottingham Trent University, Nottingham, United Kingdom
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Romero-Parra N, Cupeiro R, Alfaro-Magallanes VM, Rael B, Rubio-Arias JÁ, Peinado AB, Benito PJ. Exercise-Induced Muscle Damage During the Menstrual Cycle: A Systematic Review and Meta-Analysis. J Strength Cond Res 2021; 35:549-561. [PMID: 33201156 DOI: 10.1519/jsc.0000000000003878] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Romero-Parra, N, Cupeiro, R, Alfaro-Magallanes, VM, Rael, B, Rubio-Arias, JA, Peinado, AB, and Benito, PJ, IronFEMME Study Group. Exercise-induced muscle damage during the menstrual cycle: A systematic review and meta-analysis. J Strength Cond Res 35(2): 549-561, 2021-A strenuous bout of exercise could trigger damage of muscle tissue, and it is not clear how sex hormone fluctuations occurring during the menstrual cycle (MC) affect this response. The aims of this study were to systematically search and assess studies that have evaluated exercise-induced muscle damage (EIMD) in eumenorrheic women over the MC and to perform a meta-analysis to quantify which MC phases display the muscle damage response. The guidelines of the Preferred Reported Items for Systematic Reviews and Meta-Analysis were followed. A total of 19 articles were analyzed in the quantitative synthesis. Included studies examined EIMD in at least one phase of the following MC phases: early follicular phase (EFP), late follicular phase (LFP), or midluteal phase (MLP). The meta-analysis demonstrated differences between MC phases for delayed onset muscle soreness (DOMS) and strength loss (p < 0.05), whereas no differences were observed between MC phases for creatine kinase. The maximum mean differences between pre-excercise and post-exercise for DOMS were EFP: 6.57 (4.42, 8.71), LFP: 5.37 (2.10, 8.63), and MLP: 3.08 (2.22, 3.95), whereas for strength loss were EFP: -3.46 (-4.95, -1.98), LFP: -1.63 (-2.36, -0.89), and MLP: -0.72 (-1.07, -0.36) (p < 0.001). In conclusion, this meta-analysis suggests that hormone fluctuations throughout the MC affect EIMD in terms of DOMS and strength loss. Lower training loads or longer recovery periods could be considered in the EFP, when sex hormone concentrations are lower and women may be more vulnerable to muscle damage, whereas strength conditioning loads could be enhanced in the MLP.
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Affiliation(s)
- Nuria Romero-Parra
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Polytechnic University of Madrid (UPM), Madrid, Spain
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Rael B, Alfaro-Magallanes VM, Romero-Parra N, Castro EA, Cupeiro R, Janse de Jonge XAK, Wehrwein EA, Peinado AB. Menstrual Cycle Phases Influence on Cardiorespiratory Response to Exercise in Endurance-Trained Females. Int J Environ Res Public Health 2021; 18:860. [PMID: 33498274 DOI: 10.3390/ijerph18030860] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/16/2021] [Accepted: 01/18/2021] [Indexed: 01/01/2023]
Abstract
The aim of this study was to analyse the impact of sex hormone fluctuations throughout the menstrual cycle on cardiorespiratory response to high-intensity interval exercise in athletes. Twenty-one eumenorrheic endurance-trained females performed an interval running protocol in three menstrual cycle phases: early-follicular phase (EFP), late-follicular phase (LFP) and mid-luteal phase (MLP). It consisted of 8 × 3-min bouts at 85% of their maximal aerobic speed with 90-s recovery at 30% of their maximal aerobic speed. To verify menstrual cycle phase, we applied a three-step method: calendar-based counting, urinary luteinizing hormone measurement and serum hormone analysis. Mixed-linear model for repeated measures showed menstrual cycle impact on ventilatory (EFP: 78.61 ± 11.09; LFP: 76.45 ± 11.37; MLP: 78.59 ± 13.43) and heart rate (EFP: 167.29 ± 11.44; LFP: 169.89 ± 10.62; MLP: 169.89 ± 11.35) response to high-intensity interval exercise (F2.59 = 4.300; p = 0.018 and F2.61 = 4.648; p = 0.013, respectively). Oxygen consumption, carbon dioxide production, respiratory exchange ratio, breathing frequency, energy expenditure, relative perceived exertion and perceived readiness were unaltered by menstrual cycle phase. Most of the cardiorespiratory variables measured appear to be impassive by menstrual cycle phases throughout a high-intensity interval exercise in endurance-trained athletes. It seems that sex hormone fluctuations throughout the menstrual cycle are not high enough to disrupt tissues’ adjustments caused by the high-intensity exercise. Nevertheless, HR based training programs should consider menstrual cycle phase.
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Peinado AB, Alfaro-Magallanes VM, Romero-Parra N, Barba-Moreno L, Rael B, Maestre-Cascales C, Rojo-Tirado MA, Castro EA, Benito PJ, Ortega-Santos CP, Santiago E, Butragueño J, García-de-Alcaraz A, Rojo JJ, Calderón FJ, García-Bataller A, Cupeiro R. Methodological Approach of the Iron and Muscular Damage: Female Metabolism and Menstrual Cycle during Exercise Project (IronFEMME Study). Int J Environ Res Public Health 2021; 18:ijerph18020735. [PMID: 33561085 PMCID: PMC7831010 DOI: 10.3390/ijerph18020735] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 12/21/2022]
Abstract
Abstract Background: The increase in exercise levels in the last few years among professional and recreational female athletes has led to an increased scientific interest about sports health and performance in the female athlete population. The purpose of the IronFEMME Study described in this protocol article is to determine the influence of different hormonal profiles on iron metabolism in response to endurance exercise, and the main markers of muscle damage in response to resistance exercise; both in eumenorrheic, oral contraceptive (OC) users and postmenopausal well-trained women. Methods: This project is an observational controlled randomized counterbalanced study. One hundered and four (104) active and healthy women were selected to participate in the IronFEMME Study, 57 of which were eumenorrheic, 31 OC users and 16 postmenopausal. The project consisted of two sections carried out at the same time: iron metabolism (study I) and muscle damage (study II). For the study I, the exercise protocol consisted of an interval running test (eight bouts of 3 min at 85% of the maximal aerobic speed), whereas the study II protocol was an eccentric-based resistance exercise protocol (10 sets of 10 repetitions of plate-loaded barbell parallel back squats at 60% of their one repetition maximum (1RM) with 2 min of recovery between sets). In both studies, eumenorrheic participants were evaluated at three specific moments of the menstrual cycle: early-follicular phase, late-follicular phase and mid-luteal phase; OC users performed the trial at two moments: withdrawal phase and active pill phase. Lastly, postmenopausal women were only tested once, since their hormonal status does not fluctuate. The three-step method was used to verify the menstrual cycle phase: calendar counting, blood test confirmation, and urine-based ovulation kits. Blood samples were obtained to measure sex hormones, iron metabolism parameters, and muscle damage related markers. Discussion: IronFEMME Study has been designed to increase the knowledge regarding the influence of sex hormones on some aspects of the exercise-related female physiology. Iron metabolism and exercise-induced muscle damage will be studied considering the different reproductive status present throughout well-trained females’ lifespan. Trial registration The study was registered at Clinicaltrials.gov NCT04458662 on 2 July 2020.
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Affiliation(s)
- Ana B. Peinado
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Correspondence:
| | - Victor M. Alfaro-Magallanes
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Nuria Romero-Parra
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Laura Barba-Moreno
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Beatriz Rael
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Cristina Maestre-Cascales
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Miguel A. Rojo-Tirado
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Eliane A. Castro
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Sports Sciences and Physical Conditioning, Faculty of Education, Universidad Católica de la Santísima Concepción, 2850 Concepción, Chile
| | - Pedro J. Benito
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | | | | | - Javier Butragueño
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
| | - Antonio García-de-Alcaraz
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Faculty of Educational Sciences, Universidad de Almería, 04120 Almería, Spain
| | - Jesús J. Rojo
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Francisco J. Calderón
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Alberto García-Bataller
- Department of Sports, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
| | - Rocío Cupeiro
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
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Dubol M, Epperson CN, Sacher J, Pletzer B, Derntl B, Lanzenberger R, Sundström-Poromaa I, Comasco E. Neuroimaging the menstrual cycle: A multimodal systematic review. Front Neuroendocrinol 2021; 60:100878. [PMID: 33098847 DOI: 10.1016/j.yfrne.2020.100878] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 09/29/2020] [Accepted: 10/15/2020] [Indexed: 12/15/2022]
Abstract
Increasing evidence indicates that ovarian hormones affect brain structure, chemistry and function of women in their reproductive age, potentially shaping their behavior and mental health. Throughout the reproductive years, estrogens and progesterone levels fluctuate across the menstrual cycle and can modulate neural circuits involved in affective and cognitive processes. Here, we review seventy-seven neuroimaging studies and provide a comprehensive and data-driven evaluation of the accumulating evidence on brain plasticity associated with endogenous ovarian hormone fluctuations in naturally cycling women (n = 1304). The results particularly suggest modulatory effects of ovarian hormones fluctuations on the reactivity and structure of cortico-limbic brain regions. These findings highlight the importance of performing multimodal neuroimaging studies on neural correlates of systematic ovarian hormone fluctuations in naturally cycling women based on careful menstrual cycle staging.
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Affiliation(s)
- Manon Dubol
- Department of Neuroscience, Science for Life Laboratory, Uppsala University, Sweden
| | - C Neill Epperson
- Department of Psychiatry, Department of Family Medicine, University of Colorado School of Medicine-Anschutz Medical Campus, USA
| | - Julia Sacher
- Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Germany
| | - Belinda Pletzer
- Department of Psychology, Centre for Cognitive Neuroscience, University of Salzburg, Austria
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Germany
| | - Rupert Lanzenberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | | | - Erika Comasco
- Department of Neuroscience, Science for Life Laboratory, Uppsala University, Sweden; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria.
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