Longitudinal monitoring in elite female athletes: Impact of female sex hormones and confounding factors on blood steroid profile

Code: 22D05KC

With the increasing participation of female athletes in international competitions, there is growing interest in the specificities of the elite female athlete. Indeed, the elite female athlete is subject to a menstrual cycle, with huge variations in estrogen and progesterone concentrations during the cycle. A relatively large number of elite female athletes suffers from menstrual disorders, often due to intensive training and eating disorders, with inhibition of their hypothalamic-pituitary-gonadal axis, resulting in very low estradiol and progesterone levels. Finally, approximately 1 in 2 high-level female athletes uses hormonal contraception, the estrogen-progestin pill (OOP) being the most frequently used. Female sex hormone levels therefore fluctuate greatly in elite female athletes, with likely a significant impact on blood and urine steroid profiles.

However, most of the time, there is only an approximate estimation of the cycle phase, without direct blood female sex hormones and precursors analysis and if any, on a punctual way. We therefore propose to dose these hormones on a longitudinal way in elite non-hyperandrogenic female athletes, taking into account the duration of the MC, menstrual disorders or the use of OOP, in order to assess their direct impact on the blood steroid profile, in particular on testosterone (TES) and androstenedione (4-AEN), the target compounds selected by WADA for the blood steroid profile. As the environment of the athlete directly modulates the secretion of these female sex hormones, and consequently the steroid profiles, we will in parallel quantify the training load and food intake thanks to questionnaires and investigate the blood level of TSH, T3, prolactin, leptin, DHEA and cortisol, as well as the body composition during the different hormonal status.