MENSTRUAL CYCLE, CONTRACEPTION, AND PERFORMANCE
Section snippets
Review of Normal Menstrual Physiology
There is a well-defined, predictable pattern of hormonal changes that occur throughout the menstrual cycle. An average menstrual cycle lasts 28 days but may range from 20 to 45 days. The changes in the female sex steroids that modulate the endocrine events during the menstrual cycle can be divided into two phases. The follicular phase starts with menses and ends with ovulation. During the early follicular phase, both estrogen and progesterone levels are low. Prior to ovulation, there is a
MENSTRUAL CYCLE AND ATHLETIC PERFORMANCE
The cyclical endogenous hormonal variations throughout the menstrual cycle affect numerous metabolic, thermoregulatory, cardiovascular, and respiratory parameters that can alter athletic performance. Although physical fitness often is measured in terms of aerobic fitness, anaerobic fitness, muscle strength, flexibility, and body fat percentage, athletic performance itself is more complex. Neuromuscular, sensorimotor, psychomotor, and cognitive functions also are believed to influence
ORAL CONTRACEPTIVES
Women often require contraception during the reproductive years; however, there is no recent prevalence data on OC use in female athletes. OCs can now be administered safely to women from the age of 16 or 3 years past menarche21 up until the perimenopausal years in nonsmoking women. Evidence-based guidelines suggest that there are only two prerequisites for safe screening for potential OC users: a careful personal and family medical history with particular attention to cardiovascular risk
SUMMARY
Although understanding of the unique physiology of the female athlete has increased, there are still many questions to be answered. Endogenous and exogenous female sex steroids have been shown to influence various cardiovascular, respiratory, and metabolic parameters, but these changes probably have minimal impact on the ability of most recreational athletes to participate in and enjoy their sport. Statistically significant data may or may not have clinical or performance relevance. By the same
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Addres reprint requests to: Constance M. Lebrun, MD, FACSM, Fowler Kennedy Sport Medicine Clinic, 3M Centre, University of Western Ontario, London, Ontario N6A 3K7, Canada