{"title":"Hormonal and metabolic responses across phases of combined oral contraceptive use and menstrual cycle in young elite female athletes.","authors":"Katia Collomp, Agnès Olivier, Caroline Teulier, Juliette Bonnigal, Nathalie Crépin, Corinne Buisson, Magnus Ericsson, Emmanuelle Duron, Eric Favory, Mathieu Zimmermann, Virgile Amiot, Carole Castanier","doi":"10.1007/s00421-025-05745-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Despite the significant number of female athletes using combined oral contraceptives (COCs), there is scant literature on their hormonal and metabolic effects across different phases.</p><p><strong>Methods: </strong>In order to contribute to a wider knowledge of COC-action mechanisms involved in athletes' performance and health, we therefore examined the effects of low-dose monophasic COC (ethinylestradiol/levonorgestrel) intake on sex hormones (estradiol, progesterone, sex hormone binding protein (SHBG)) as well as on a large number of pituitary (LH, TSH, prolactin) and peripheral (triiodothyronine, cortisol, DHEA, DHEA-S, aldosterone, osteocalcin, 25(OH)D) basal hormone levels in nine young elite female athletes, across COC administration (first and second half of active hormone intake, washout phases), compared to eleven female athletes without hormonal contraception across their normal menstrual cycle (NMC, i.e., early follicular, end follicular/peri-ovulatory, mid-luteal phases).</p><p><strong>Results: </strong>COC vs. NMC increased SHBG (p < 0.01), TSH, cortisol and 25(OH)D (p < 0.05), and decreased DHEA and DHEA-S (p < 0.05) concentrations. Across COC and NMC phases, higher estradiol and aldosterone concentrations (p < 0.05) were observed during the washout and mid-luteal phases, respectively.</p><p><strong>Conclusion: </strong>In highly trained female athletes, COC vs. NMC induced several hormonal alterations, irrespective of the phases, leading to potential ergogenic and clinical repercussions that merit clarification. In NMC athletes, the impact of endogenous sex hormone fluctuations on the parameters studied appeared limited, perhaps mitigated by intense physical training, with only aldosterone change. Given the high prevalence of vitamin D insufficiency, it seems warranted to monitor this parameter, not yet routinely considered in female athletes, taking into account COC intake.</p><p><strong>Trial registration: </strong>ID-RCB:2020-A02965-34, France.</p>","PeriodicalId":12005,"journal":{"name":"European Journal of Applied Physiology","volume":" ","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Applied Physiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00421-025-05745-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PHYSIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Despite the significant number of female athletes using combined oral contraceptives (COCs), there is scant literature on their hormonal and metabolic effects across different phases.
Methods: In order to contribute to a wider knowledge of COC-action mechanisms involved in athletes' performance and health, we therefore examined the effects of low-dose monophasic COC (ethinylestradiol/levonorgestrel) intake on sex hormones (estradiol, progesterone, sex hormone binding protein (SHBG)) as well as on a large number of pituitary (LH, TSH, prolactin) and peripheral (triiodothyronine, cortisol, DHEA, DHEA-S, aldosterone, osteocalcin, 25(OH)D) basal hormone levels in nine young elite female athletes, across COC administration (first and second half of active hormone intake, washout phases), compared to eleven female athletes without hormonal contraception across their normal menstrual cycle (NMC, i.e., early follicular, end follicular/peri-ovulatory, mid-luteal phases).
Results: COC vs. NMC increased SHBG (p < 0.01), TSH, cortisol and 25(OH)D (p < 0.05), and decreased DHEA and DHEA-S (p < 0.05) concentrations. Across COC and NMC phases, higher estradiol and aldosterone concentrations (p < 0.05) were observed during the washout and mid-luteal phases, respectively.
Conclusion: In highly trained female athletes, COC vs. NMC induced several hormonal alterations, irrespective of the phases, leading to potential ergogenic and clinical repercussions that merit clarification. In NMC athletes, the impact of endogenous sex hormone fluctuations on the parameters studied appeared limited, perhaps mitigated by intense physical training, with only aldosterone change. Given the high prevalence of vitamin D insufficiency, it seems warranted to monitor this parameter, not yet routinely considered in female athletes, taking into account COC intake.
Trial registration: ID-RCB:2020-A02965-34, France.
期刊介绍:
The European Journal of Applied Physiology (EJAP) aims to promote mechanistic advances in human integrative and translational physiology. Physiology is viewed broadly, having overlapping context with related disciplines such as biomechanics, biochemistry, endocrinology, ergonomics, immunology, motor control, and nutrition. EJAP welcomes studies dealing with physical exercise, training and performance. Studies addressing physiological mechanisms are preferred over descriptive studies. Papers dealing with animal models or pathophysiological conditions are not excluded from consideration, but must be clearly relevant to human physiology.