Summer Olympic sports and female athletes: comparison of anti-doping collections and prohibited substances detected in Australia and New Zealand vs. France.

Like any athlete, female athletes may be tempted to use prohibited substances during competition or training to enhance their performance. Anti-doping tests performed on female athletes in summer Olympic sports from two geographical areas: Australia/ New Zealand, and France were compared. First, the distribution of sample collections across different sports disciplines, as well as the distribution of substances was investigated. Then the distribution of collections and substances detected in the five sports categories (Strength/Speed, Endurance, Mixed, Motor Skills with High Energy Expenditure, and Motor Skills with Low Energy Expenditure) were studied with consideration of therapeutic use exemptions obtained by the athlete. Australia/New Zealand and France were similar in their overall number of anti-doping collections performed. Likewise, both regions had the same sports disciplines (athletics, aquatics, cycling) and sport categories (Mixed and Endurance) as having the highest number of sample collections. The Motor Skills with High Energy Expenditure, and Motor Skills with Low Energy Expenditure categories had the lowest number of sample collections. However, the number of substances detected was significantly different (p < 0.05) with a greater number of substances found in the French data. There were a few substances in common between the two geographical areas, namely prednisone/prednisolone, carboxy-THC, terbutaline, vilanterol and methylphenidate, but most were different. In-competition tests were the category where most of the AAFs were found.

Physical activity and combined hormonal contraception: association with female students' perception of menstrual symptoms.

Aim: The aim of this study was to examine the association between physical activity (PA) and combined hormonal contraceptive (CHC) on female students' self perceptio of their menstrual cycle symptoms. Methods: Healthy French female students (n = 834) completed an online questionnaire to assess their PA level (Group 1: non-active; Group 2: moderate physical activity; Group 3: high physical activity; Group 4: very high physical activity), menstrual status or contraception use, self-reported diet and medication, impact on engagement in some social activities, and self-assessment of perceived mental and physical symptoms during the week prior to menses (PM) for students with a normal menstrual cycle (NMC), and the week of menses (ME) for normal menstrual cycle students and those using combined hormonal contraception. Results: Whatever the conditions (PM and ME, NMC and CHC), fewer self-perceived symptoms and self-reported alteration in fat intake were reported by the students in Group 4, and more analgesic and anti-inflammatory medication use was reported by Group 1. Fewer self-perceived symptoms were also found in CHC vs NMC female students for all physical activity levels, but in a more marked way when associated with very high physical activity. In addition, less university and sports practice absenteeism was observed with high and very high physical activity. Conclusion: In conclusion, the perception of menstrual cycle symptoms was lower with very high physical activity, as with combined hormonal contraception. Moreover, female students training more than 5 h/week also reported less university absenteeism and impairment in physical activities. Further studies are necessary to establish the causal link of physical activity and combined hormonal contraception on menstrual symptoms.

Short-Term Effect of Bariatric Surgery on Cardiorespiratory Response at Submaximal, Ventilatory Threshold, and Maximal Exercise in Women with Severe Obesity.

PURPOSE: People with obesity have varying degrees of cardiovascular, pulmonary, and musculoskeletal dysfunction that affect aerobic exercise testing variables. Short time after bariatric surgery, these dysfunctions could affect both peak oxygen consumption ([Formula: see text] O2 peak), the gold standard for assessing cardiorespiratory fitness (CRF) and aerobic capacity evaluated with ventilatory threshold (VT1). The purpose of this study was to evaluate the short-term effect of bariatric surgery, i.e. before the resumption of physical activity, on submaximal, at VT1 and maximal cardiorespiratory responses in middle-aged women with severe obesity. MATERIALS AND METHODS: Thirteen middle-aged women with severe obesity (age: 36.7 ± 2.3 years; weight: 110.5 ± 3.6 kg, BMI: 41.8 ± 1.1 kg/m2) awaiting bariatric surgery participated in the study. Four weeks before and 6 to 8 weeks after surgery, body composition was determined by bioelectrical impedance. The participants performed an incremental cycling test to [Formula: see text] O2 peak. RESULTS: After bariatric surgery, all body composition parameters were reduced, absolute [Formula: see text] O2 peak and peak workload decline with a lower VT1. Relative [Formula: see text] O2 at peak and at VT1 (ml/min/kg or ml/min/kg of FFM) remained unchanged. Ventilation was lower after bariatric surgery during exercise with no change in cardiac response. CONCLUSION: Our results showed that weight loss alone at short-term after bariatric surgery decreased CRF as seen by a decrease in absolute [Formula: see text] O2 peak, and peak workload with lower VT1, whereas relative [Formula: see text] O2 (ml/min/kg or ml/min/kg of FFM) during exercise remained unchanged in women with obesity. Rapid FFM loss affects cardiorespiratory responses at submaximal and maximal.

Effects of a 3-Month Physical Training on Cortisol and Testosterone Responses in Women After Bariatric Surgery.

PURPOSE: Although it is well established that physical activity (PA) may partially correct the metabolic and hormonal alterations observed in patients with obesity, knowledge of its impact after bariatric surgery (BS) remains poor. The purpose of this study was to assess the repercussions of physical training on cortisol and testosterone responses in post-BS women. MATERIALS AND METHODS: According to a randomized clinical trial, a PA group (11 women) started a 3-month physical training 6 weeks after BS, whereas no specific activity was proposed to a control group (9 women). Submaximal exercise (i.e., 30 min at 60% VO2peak) was performed by all subjects just before and after the 3-month period. Blood samples were taken at rest, after 10, 20, and 30 min of exercise and 10 min of passive recovery for cortisol and testosterone analyses. Blood glucose, blood lactate, and heart rate were assessed at the same time. RESULTS: Before the program, a significant increase in cortisol, blood lactate, and heart rate was observed in all subjects during the submaximal exercise vs. rest, with no change in blood glucose and testosterone. After vs. before the 3-month period, no modification in any parameter was noted at rest in either group. However, during exercise, lack of cortisol increase and lower heart rate were found in the PA group only, with disappearance of the increase in blood lactate in both groups. CONCLUSION: Our results show some beneficial effects of physical training on hormonal and physical parameters. Further studies are needed to determine the biological and clinical significance of these adaptations induced by physical training in women after BS.

Prevalence of Prohibited Substance Use and Methods by Female Athletes: Evidence of Gender-Related Differences.

To achieve optimal sports performances, women and men may show specific doping practices because of the physiological and psychological gender differences, but there are few data on this topic. Here, we report the apparent use of prohibited substances and methods by female athletes based on analyses of the doping tests collected by the French Anti-Doping Agency from 2013 to 2019. We compared the frequency of use and the ergogenic and side effects to those of their male counterparts. The results revealed lower use of prohibited substances in female vs. male athletes, with significantly fewer anabolic agents, hormone and metabolic modulators, and cannabinoids. Gender specificity in utilization of substance classes was also shown. Relatively lower use of hormone modulators and cannabinoids and higher use of beta-2 agonists, diuretics and glucocorticoids were found in the woman cohort compared with men cohort, combined with the different choice of substances, possibly because of the altered ergogenic and/or side effects. However, no impact due to gender regarding the sports disciplines was observed, with both women and men showing similar use of anabolic agents, mainly in the anaerobic sports, and EPO and corticoids, mainly in endurance or mixed sports. Further studies are needed to put these French data into a global perspective, comparing uses across countries and exploring possible new developments in the fight against doping in women.

The Specificities of Elite Female Athletes: A Multidisciplinary Approach.

Female athletes have garnered considerable attention in the last few years as more and more women participate in sports events. However, despite the well-known repercussions of female sex hormones, few studies have investigated the specificities of elite female athletes. In this review, we present the current but still limited data on how normal menstrual phases, altered menstrual phases, and hormonal contraception affect both physical and cognitive performances in these elite athletes. To examine the implicated mechanisms, as well as the potential performances and health risks in this population, we then take a broader multidisciplinary approach and report on the causal/reciprocal relationships between hormonal status and mental and physical health in young (18-40 years) healthy females, both trained and untrained. We thus cover the research on both physiological and psychological variables, as well as on the Athlete Biological Passport used for anti-doping purposes. We consider the fairly frequent discrepancies and summarize the current knowledge in this new field of interest. Last, we conclude with some practical guidelines for eliciting improvements in physical and cognitive performance while minimizing the health risks for female athletes.

A novel approach to improve detection of glucocorticoid doping in sport with new guidance for physicians prescribing for athletes.

The systemic effect of glucocorticoids (GCs) following injectable routes of administration presents a potential risk to both improving performance and causing harm to health in athletes. This review evaluates the current GC antidoping regulations defined by the World Anti-Doping Agency and presents a novel approach for defining permitted and prohibited use of glucocorticoids in sport based on the pharmacological potential for performance enhancement (PE) and risk of adverse effects on health. Known performance-enhancing doses of glucocorticoids are expressed in terms of cortisol-equivalent doses and thereby the dose associated with a high potential for PE for any GC and route of administration can be derived. Consequently, revised and substance-specific laboratory reporting values are presented to better distinguish between prohibited and permitted use in sport. In addition, washout periods are presented to enable clinicians to prescribe glucocorticoids safely and to avoid the risk of athletes testing positive for a doping test.

Impact of short-term hydrocortisone intake on pituitary and adrenal function in healthy young male subjects.

PURPOSE: The aim of this study was to evaluate the impact of short-term therapeutic hydrocortisone intake on pituitary and adrenal function in healthy young male subjects. METHODS: Ten physically active men received 50 mg/per day of hydrocortisone at 8:00 a.m. for 5 days. Cortisol, DHEA, and ACTH concentrations in plasma, and cortisol and DHEA concentrations in saliva were determined the week before, just before (8:00 a.m.) and 2 h after (10:00 a.m.) drug ingestion on days 1, 3, and 5 of treatment and day 1 post treatment. RESULTS: Hydrocortisone intake induced a significant increase in both plasma cortisol (×3) and saliva cortisol (×10) concentrations 2 h after administration. Plasma and saliva DHEA concentrations were significantly decreased, as were plasma ACTH concentrations, 2 h after administration, with an increase in the cortisol/DHEA and cortisol/ACTH ratios. However, no change in cortisol, DHEA, ACTH, cortisol/DHEA, or cortisol/ACTH was observed 24 h after the last intake during treatment or post treatment, except for a downward trend in saliva DHEA at days 3 and 5. The correlations between plasma and saliva cortisol, DHEA, and cortisol/DHEA were significant: respectively, r = 0.80, r = 0.80, and r = 0.88. CONCLUSIONS: Once-daily oral therapeutic administration of hydrocortisone for 5 days altered adrenal DHEA secretion by inhibiting pituitary ACTH, but this effect seemed transient without significant impairment of basal adrenal or pituitary function 24 h after administration. Given the high correlations between plasma and saliva, saliva samples may be offered as a sensitive surrogate for blood sampling to estimate adrenal and pituitary function.

Short-term DHEA administration in recreational athletes: impact on food intake, segmental body composition and adipokines.

BACKGROUND: Dehydroepiandrosterone (DHEA) administration is potentially therapeutic because it has been shown to decrease fat mass and adipokines and improve eating and mood disturbances. However, its impact on these parameters has never been investigated in a young healthy population. This study therefore sought to determine whether short-term DHEA administration would alter food intake, segmental body composition, adipokine secretion and mood in young healthy male and female volunteers with regular sport practice. METHODS: Following a double-blind and randomized protocol, 20 young healthy recreational athletes (10 men and 10 women) received treatment with either oral placebo or DHEA (100 mg/day for 4 weeks). Body weight, segmental body composition and adipokines (i.e., leptin, adiponectin and resistin) were determined before and at the end of each treatment. In parallel, spontaneous food intake was assessed at the end of each treatment, and mood was assessed before and at the end of treatment with the positive and negative affect schedule (PANAS). RESULTS: Body weight and segmental body composition showed no significant change in the men or women. Similarly, no change in adipokine secretion was found after DHEA administration. Total food intake was not affected by DHEA in any subject, despite an increase in fat intake by male subjects under DHEA (P<0.05). Positive and negative affect were not altered. CONCLUSIONS: In conclusion, in contrast to pathological populations, a young healthy population of men and women was not significantly affected by short-term DHEA administration with regard to total food intake, segmental body composition, adipokines or mood.

Metabolic and isotopic signature of short-term DHEA administration in women: Comparison with findings in men.

The impact of dehydroepiandrosterone (DHEA) administration has been widely studied for anti-doping purposes in men, whereas only a few studies have been performed in women. In the present study, the impact of DHEA on the steroid profile parameters and their carbon isotopic ratios was explored. Eleven healthy young women and 10 healthy young men received two treatments: One with 100 mg/day of DHEA for 28 days and one with a placebo according to a double-blind crossover protocol. Urine and saliva (only in females) samples were collected before and for 72 hours after each short-term treatment. In all female subjects, concentrations of the urinary parameters of the steroid profile were highly impacted by short-term DHEA administration including epitestosterone (E). Gas chromatography-combustion-isotope ratio mass spectrometry (GC-C-IRMS) analysis was performed and positive results were observed for E in the four female subjects where E concentration was adequate for such analysis, whereas men results remained negative for E. Last, the ability of the Anti-Doping Administration and Management System (ADAMS) software used for the athlete biological passport to identify such doping was assessed. Of the 11 passports generated for female subjects, 10 were automatically classified as an atypical passport finding (ATPF). For the remaining passport with normal status in one woman, the variability of the concentrations prevented the ADAMS software from adjusting individual limits. The most impacted markers in women were T/E and 5αAdiol/E, with a detection window of 36 hours for 5αAdiol/E. In addition, good correlations were observed for DHEA and T concentrations in urine and saliva in females.

Short-term Dehydroepiandrosterone Intake and Supramaximal Exercise in Young Recreationally-trained Women.

WADA has banned dehydroepiandrosterone (DHEA) but its ergogenic effect in female athletes has never been investigated. The aim of this study was to determine whether short-term DHEA intake would improve performance during a supramaximal field exercise in healthy young recreationally trained women. Its impact on body composition, metabolic responses was also measured. Eleven young female volunteers completed four running-based anaerobic sprint tests: just before and after treatment with either oral placebo or DHEA (100 mg/day/28days), following a double-blind and randomized protocol. Bioelectrical impedance assessed body composition. At rest and after passive recovery, blood samples were collected for lactate measurement and saliva samples for DHEA, testosterone and cortisol analysis. There was no significant difference in body composition or performance parameters after DHEA administration, despite a tendency toward increased peak power and decreased fat mass. However, DHEA treatment induced a very marked increase in saliva DHEA and testosterone concentrations (p<0.001), with no change in cortisol or lactate levels. In conclusion, short-term DHEA administration did not improve performance or have an anabolic effect in young female recreationally trained athletes, despite the increase in androgenic hormones. Further studies are needed to determine whether a higher daily dose would generate an ergogenic effect during anaerobic exercise.

Effects of short-term DHEA intake on hormonal responses in young recreationally trained athletes: modulation by gender.

BACKGROUND: Dehydroepiandrosterone (DHEA) figures on the World Anti-Doping Agency list of prohibited substances in sport because it is assumed that athletes expect a significant increase in testosterone through DHEA administration. The literature on the hormonal effects of DHEA intake nevertheless appears to be very scant in healthy young subjects, especially women. PURPOSE: We examined the effects of DHEA on adrenal and gonadal hormones, IGF1 and free T3 in healthy young male and female recreationally trained volunteers. METHODS: The study followed a double-blind, randomized-order crossover design. Lean healthy young men (n = 10) and women (n = 11), with all women using oral contraceptives, were treated daily with 100 mg of DHEA and placebo for 4 weeks. DHEA, DHEA-sulfate (DHEA-S), androstenedione, total testosterone (Tes), dihydrotestosterone (DHT), SHBG, estrone, cortisol, IGF1, and free T3 were measured before, in the middle and at the end of each treatment, as were blood glucose, liver transaminases and lipid status. RESULTS: We observed a significant increase in DHEA, DHEA-S, androstenedione, Tes, DHT, and estrone in both men and women in the middle and at the end of DHEA treatment, but the increase in Tes was more marked in women (p < 0.001) than men (p < 0.05). No changes were found in the other parameters, irrespective of gender. CONCLUSION: In young athletes, DHEA administration induces significant blood hormonal changes, some modulated by gender, which can be used as biomarkers of doping.

Physiological Dynamic Apnea Responses in Relation to Apnea Capacity in Triathletes.

The aim was to assess the cardiac, arterial oxygen saturation, lactate, hormonal and Borg rating of perceived exertion (RPE) responses to acute apnea in relation to apnea capacity in 18 middle-aged triathletes. Subjects were monitored while swimming two 50-m freestyle exercise trials with fins at maximal speed: with normal frequency breathing (NB) and with complete apnea (Ap); the latter was used to assess apnea capacity. The subjects with significant alteration in swimming performance inducing a time increase greater than 2.5% during Ap vs. NB were put in the group: bad apnea capacity (Bad Ap); the others, who showed no significant alteration in performance, were put in the group: Good Ap. Under apnea, both groups showed a decrease in arterial oxygen saturation (p<0.05). In Ap conditions, only Bad Ap had a significant lower maximal heart rate vs. NB (p<0.05), with lower blood lactate (p<0.05) and arm stroke frequency (p<0.01). No change in saliva hormonal concentrations was found during the experiment for both groups, whereas RPE responses were increased in the Good Ap group under Ap vs. NB conditions. In conclusion, a good apnea capacity seems to be associated with lower cardiovascular and metabolic apnea alterations in middle-aged recreationally-trained triathletes.

Glucocorticoid administration in athletes: Performance, metabolism and detection.

It is generally acknowledged in the sporting world that glucocorticoid (GC) use enhances physical performance. This pharmacological class is therefore banned by the World Anti-Doping Agency (WADA) in in-competition samples after systemic but not local (defined as any route other than oral, intravenous, intramuscular or rectal) administration, which thus allows athletes to use GCs for therapeutic purposes. According to the 2016 WADA list, the urine reporting level for all GCs is set at 30ng/ml to distinguish between the authorized and banned routes of administration. The actual data on the ergogenic effects of GC intake are nevertheless fairly recent, with the first study showing improved physical performance with systemic GC administration dating back only to 2007. Moreover, the studies over the last decade coupling ergogenic and metabolic investigations in humans during and after GC intake have shown discrepant results. Similarly, urine discrimination between banned and authorized GC use remains complex, but it seems likely to be improved thanks to new analytical studies and the inclusion of the authorized GC uses (local routes of administration and out-of-competition samples) in the WADA monitoring program. In this review, we first summarize the current knowledge on the ergogenic and metabolic GC effects in humans during various types of exercise. We then present the antidoping legislation and methods of analysis currently used to detect GC abuse and conclude with some practical considerations and perspectives.

Effect of pedaling cadence on muscle oxygenation during high-intensity cycling until exhaustion: a comparison between untrained subjects and triathletes.

PURPOSE: The aim of this study was to compare the muscle oxygenation between trained and untrained subjects during heavy exercise until exhaustion at two extreme pedaling cadences using a NIRS system. METHODS: Nine untrained male subjects and nine male competitive triathletes cycled until exhaustion at an intensity corresponding to 90 % of the power output achieved at peak oxygen uptake at 40 and 100 rpm. Gas exchanges were measured breath-by-breath during each exercise. Muscle (de)oxygenation was monitored continuously by near-infrared spectroscopy on the Vastus Lateralis. RESULTS: Muscle deoxygenation (∆deoxy[Hb + Mb], i.e., O2 extraction) and ∆total[Hb + Mb] were significantly higher at 40 rpm compared to 100 rpm during the exercise in untrained subjects but not in triathletes (p < 0.05). The time performed until exhaustion was significantly higher at 40 than at 100 rpm in untrained subjects (373 ± 55 vs. 234 ± 37 s, respectively) but not in triathletes (339 ± 69 vs. 325 ± 66 s). CONCLUSIONS: These results indicate that high aerobic fitness (1) allows for better regulation between [Formula: see text]O2M and VO2M following the change in pedaling cadence, and (2) is the most important factor in the relationship between pedaling cadence and performance.

Ergogenic and metabolic effects of oral glucocorticoid intake during repeated bouts of high-intensity exercise.

All systemically administered glucocorticoids (GC) are prohibited in-competition, because of the potential ergogenic effects. Although short-term GC intake has been shown to improve performance during submaximal exercise, literature on its impact during brief intense exercise appears to be very scant. The purpose of this study was to examine the ergogenic and metabolic effects of prednisone during repeated bouts of high-intensity exercise. In a double-blind randomized protocol, ten recreational male athletes followed two 1-week treatments (Cor: prednisone, 60mg/day or Pla: placebo). At the end of each treatment, they hopped on their dominant leg for 30s three times consecutively and then hopped until exhaustion, with intervals of 5min of passive recovery. Blood and saliva samples were collected at rest and 3min after each exercise bout to determine the lactate, interleukin-6, interleukin-10, TNF-alpha, DHEA and testosterone values. The absolute peak force of the dominant leg was significantly increased by Cor but only during the first 30-s hopping bout (p<0.05), whereas time to exhaustion was not significantly changed after Cor treatment vs Pla (Pla: 119.9±24.7; Cor: 123.1±29.5s). Cor intake lowered basal and end-exercise plasma interleukin-6 and saliva DHEA (p<0.01) and increased interleukin-10 (p<0.01), whereas no significant change was found in blood lactate and TNF-alpha or saliva testosterone between Pla and Cor. According to these data, short-term glucocorticoid intake did not improve endurance performance during repeated bouts of high-intensity exercise, despite the significant initial increase in absolute peak force and anti-inflammatory effect.

Acute apnea swimming: metabolic responses and performance.

Competitive swimmers regularly perform apnea series with or without fins as part of their training, but the ergogenic and metabolic repercussions of acute and chronic apnea have not been examined. Therefore, we aimed to investigate the cardiovascular, lactate, arterial oxygen saturation and hormonal responses to acute apnea in relation to performance in male swimmers. According to a randomized protocol, 15 national or regional competitive swimmers were monitored while performing four 100-m freestyle trials, each consisting of four 25-m segments with departure every 30 seconds at maximal speed in the following conditions: with normal frequency breathing with fins (F) and without fins (S) and with complete apnea for the four 25-m segments with (FAp) and without fins (SAp). Heart rate (HR) was measured continuously and arterial oxygen saturation, blood, and saliva samples were assessed after 30 seconds, 3 minutes, and 10 minutes of recovery, respectively. Swimming performance was better with fins than without both with normal frequency breathing and apnea (p < 0.001). Apnea induced no change in lactatemia, but a decrease in arterial oxygen saturation in both SAp and FAp (p < 0.001) was noted and a decrease in HR and swimming performance in SAp (p < 0.01). During apnea without fins, performance alteration was correlated with bradycardia (r = 0.63) and arterial oxygen desaturation (r = -0.57). Saliva dehydroepiandrosterone was increased compared with basal values whatever the trial (p ≤ 0.05), whereas no change was found in saliva cortisol or testosterone. Further studies are necessary to clarify the fin effect on HR and performance during apnea swimming.

Effect of pedal cadence on the heterogeneity of muscle deoxygenation during moderate exercise.

This study examined the effect of pedal cadence on the heterogeneity of muscle deoxygenation during exercise of moderate intensity. Twelve healthy subjects performed 6 min of cycling at 40 and 100 r · min(-1) at 80% of the workload corresponding to the gas exchange threshold. Gas exchanges were measured breath by breath during each exercise. Muscle deoxygenation (HHb, i.e., O2 extraction) was monitored continuously by near-infrared spectroscopy at eight sites on the vastus lateralis. The heterogeneity of HHb was assessed using the relative dispersion of the signal measured at the eight sites (i.e., 100 × standard deviation/mean). HHb was not altered by the pedal cadence, whereas pulmonary V̇O2 was higher at 100 r · min(-1) than at 40 r · min(-1) (p < 0.001). The relative dispersion of HHb was significantly higher at 100 r · min(-1) than at 40 r · min(-1) (p < 0.001). These results indicate that pedal cadence has no effect on O2 extraction but that an elevated cadence would increase muscle V̇O2, suggesting an increase in muscle blood flow. Elevated cadence also induced greater heterogeneity of the muscle's V̇O2/Q̇O2 delivery ratio, suggesting a change in the adequacy between O2 demand and O2 delivery in some regions of active muscle.