Search Results

Purpose: To identify the period prevalence of hormonal contraceptive (HC) use and characterize the perceived side effects associated with the menstrual cycle and HC use. Methods: A total of 430 elite female athletes completed a questionnaire to assess the period prevalence of HC use, the reasons for initiation and discontinuation of HCs, and the side effects experienced by HC and non-HC users. Descriptive statistics, between-groups comparisons, and associations between categorical variables were calculated. Results : Of athletes studied, 49.5% were currently using HCs and 69.8% had used HCs at some point. Combined oral contraceptives were most commonly used (68.1%), with 30.0% using progestin-only contraceptives (implant = 13.1%, injection = 3.7%, and intrauterine system = 2.8%). Perceived negative side effects were more common with progestin-only HC use (39.1%) compared with combined-HC use (17.8%; P = .001) and were most prevalent in implant users (53.6%; P = .004). HC users reported perceived positive side effects relating to their ability to predict and/or manipulate the timing, frequency, and amount of menstrual bleeding. Non-HC users had a menstrual cycle length of 29 (5) d and 77.4% reported negative side effects during their menstrual cycle, primarily during days 1–2 of menstruation (81.6%). Conclusions: Approximately half of elite athletes used HCs, and progestin-only contraceptive users reported greater incidences of negative side effects, especially with the implant. Because of the high interindividual variability in reported side effects, athletes and practitioners should maintain an open dialogue to pursue the best interests of the athlete.

Throughout their lifespans, women undergo unique endocrinological changes relative to their reproductive hormones. The influence of how the female sex steroid hormones have nonreproductive actions is a trending topic of great interest in the exercise–sports sciences, especially among women of reproductive age. Herein, we present several key points on our perspective for moving the study of this topic forward in the future. These are (a) encouraging researchers to pursue high-quality research on female physiology–endocrinology in the exercise–sports science setting, (b) the need for exercise–sports science educational curriculums at the university level to embrace the study of female physiology–endocrinology area, and (c) the need for innovation in the study of this topic. As such, we propose using research design models involving supraphysiological hormonal states in vivo, that is, pregnancy and in vitro fertilization treatment, to gain new insights on sex steroid hormonal actions in women. Herein, we provide the rationale for our recommendations as well as a brief physiological overview of these clinical states. We acknowledge, exercise sports sciences need more studies on women! But there is a need to “think outside the box” on this topic, and we encourage researchers to be unconventional, be bold, think creatively, and contemplate whether these supraphysiological hormonal states might give them insightful information on female physiology and ovarian sex steroid hormones actions.

Physique competitions are events in which aesthetic appearance and posing ability are valued above physical performance. Female physique athletes are required to possess high lean body mass and extremely low fat mass in competition. As such, extended periods of reduced energy intake and intensive training regimens are used with acute weight loss practices at the end of the precompetition phase. This represents an increased risk for chronic low energy availability and associated symptoms of relative energy deficiency in sport, compromising both psychological and physiological health. Available literature suggests that a large proportion of female physique athletes report menstrual irregularities (e.g., amenorrhea and oligomenorrhea), which are unlikely to normalize immediately postcompetition. Furthermore, the tendency to reduce intakes of numerous essential micronutrients is prominent among those using restrictive eating patterns. Following competition, reduced resting metabolic rate, and hyperphagia, is also a concern for these female athletes, which can result in frequent weight cycling, distorted body image, and disordered eating/eating disorders. Overall, female physique athletes are an understudied population, and the need for more robust studies to detect low energy availability and associated health effects is warranted. This narrative review aims to define the natural female physique athlete, explore some of the physiological and psychological implications of weight management practices experienced by female physique athletes, and propose future research directions.

In response to the ongoing sex data gap, the present study provides a qualitative exploration of females’ nutritional experiences in elite sporting environments. Semistructured interviews were conducted with multiple participant groups (n = 18), including athletes (n = 7), practitioners (n = 6), and researchers (n = 5) across differing disciplines within professional sporting organizations and/or national governing bodies. Combined content and thematic analysis provided an insight into the specific factors influencing current sport nutrition practices. A common theme highlighted among all participant groups was the paradoxical struggle between adequate fueling for training and competition demands, and the fear this may impact body mass and body composition goals. This tension was identified as being rooted within athletes’ perceptions of body image and driven by other participant groups and wider societal ideals. Each participant group also highlighted influences on cravings and approaches to food and dietary supplementation, centered around individual perceptions and challenges driven by symptomology associated with the female menstrual cycle and contraceptive use. To address these challenges, all participant groups called for more research to inform future change and continuing education pathways. In summary, this study contributes to providing a more complete understanding of elite female athlete sport nutrition experiences than currently exists. Multiple perspectives highlight the complexity of providing sport nutrition support to elite female athlete populations and directs future research, and practice, to reconsider one-size-fits-all approaches and acknowledge unique individual contexts which may influence these areas.

This study examined the type, frequency, and severity of symptoms experienced by naturally menstruating women and combined, monophasic, oral contraceptive pill users and their perceived effects on exercise performance and recovery time posttraining. Forty-two recreationally active women; 21 naturally menstruating and 21 combined, monophasic, oral contraceptive pill users participated in the study. Data were collected using two approaches: (a) an online 54-part retrospective survey and (b) a daily questionnaire. “Total number of symptoms,” “symptom index score,” “average symptom severity,” and “symptom index × severity score” were calculated from the retrospective data set. Real-time symptom data (i.e., “symptom frequency per phase” and “phase symptom frequency × severity score”) were calculated across predefined cycle phases from the daily questionnaire. The retrospective survey showed that symptoms were commonly reported by recreationally active women, but there were no differences in symptomology between the groups (p > .113). The daily questionnaire showed both groups experienced a greater frequency and severity of symptoms while bleeding (p ≤ .001), which was associated with perceived reductions in exercise performance (odds ratio = 1.04–1.07) and a perceived longer recovery time posttraining (odds ratio = 1.03–1.04). The results from this study show that cycle-related symptoms were commonly reported by a group of recreationally active women, with no difference in symptomology between naturally menstruating women and combined, monophasic, oral contraceptive pill users. The magnitude of symptoms was greater while bleeding, which was associated with a perceived reduction in exercise performance and a longer recovery time posttraining.

The ability to buffer H⁺ could be vital to exercise performance, as high concentrations of H⁺ contribute to the development of fatigue.

The aim of this audit was to assess the representation of female athletes, dietary control methods, and gold standard female methodology that underpins the current guidelines for chronic carbohydrate (CHO) intake strategies for athlete daily training diets. Using a standardized audit, 281 studies were identified that examined high versus moderate CHO, periodized CHO availability, and/or low CHO, high fat diets. There were 3,735 total participants across these studies with only ∼16% of participants being women. Few studies utilized a design that specifically considered females, with only 16 studies (∼6%) including a female-only cohort and six studies (∼2%) with a sex-based comparison in their statistical procedure, in comparison to the 217 studies (∼77%) including a male-only cohort. Most studies (∼72%) did not provide sufficient information to define the menstrual status of participants, and of the 18 studies that did, optimal methodology for control of ovarian hormones was only noted in one study. While ∼40% of male-only studies provided all food and beverages to participants, only ∼20% of studies with a female-specific design used this approach for dietary control. Most studies did not implement strategies to ensure compliance to dietary interventions and/or control energy intake during dietary interventions. The literature that has contributed to the current guidelines for daily CHO intake is lacking in research that is specific to, or adequately addresses, the female athlete. Redressing this imbalance is of high priority to ensure that the female athlete receives evidence-based recommendations that consider her specific needs.