Abstract
If is frequently assumed that female athletes are prone to hyperandrogenism. However, literature on this subject is difficult to interpret since exercise protocols and intensifies are very heterogeneous, as well as the timings of blood sampling. In women performing only recreative exercise, a 1 hour submaximal exercise increases by 40 to 50% plasma testosterone, and return to baseline is achieved within 4-6 hours after exercise has stopped. For some investigators this increase in testosterone mainly occurs when exercise is performed during the follicular phase and is lower in luteal phase, while others report that this increase can be found only in amenorrheic women. In those women, training does not seem to modify plasma testosterone. The picture is not the same for high level female athletes, in whom high intensity exercise always acutely increases testosterone by 195%, cortisol by 211% and prolactin by 327%, with no change in FSH and marginal changes in LH, which either remains unchanged or decreases by 30%. Return to baseline occurs for testosterone within 6-12 hours after stopping exercise and is further delayed for other hormones such as dehydroepiandrosterone sulfate. During repeated intensive matches, plasma testosterone gradually decreases, as well as sex-hormone binding globulin and the testosterone/cortisol ratio. Regular training is associated with moderate decreases in plasma testosterone, while cortisol increases. There is a reversal of testosterone decrease when physical activity decreases, so that the ratio-free testosterone/cortisol is proposed as a marker of exhaustion, mostly for men, with this point being less demonstrated in women. The endocrine status of female elite swimmers is different from other sports. In these cases, strenuous exercise acutely reduces plasma testosterone by 30% and low intensity prolonged exercise moderately increases testosterone. Thus, swimmers would be prone to some degree of hyperandrogenemia, which is explained in part by the fact that they are generally rather young, and therefore with a low adipose mass and a high frequency of menstrual disorders. Literature on these endocrine modifications is thus rather difficult to summarize, and it is important to avoid oversimplification in such a complex and highly interactive system.