The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.
Serum Androgen Levels in Elite Female Athletes
Abstract
Objective: Prior to the implementation of the blood steroidal module of the Athlete Biological Passport, we measured the serum androgen levels among a large population of high-level female athletes as well as the prevalence of biochemical hyperandrogenism and some disorders of sex development (DSD). Methods and Results: In 849 elite female athletes, serum T, dehydroepiandrosterone sulphate, androstenedione, SHBG, and gonadotrophins were measured by liquid chromatography-mass spectrometry high resolution or immunoassay. Free T was calculated. The sampling hour, age, and type of athletic event only had a small influence on T concentration, whereas ethnicity had not. Among the 85.5% that did not use oral contraceptives, 168 of 717 athletes were oligo- or amenorrhoic. The oral contraceptive users showed the lowest serum androgen and gonadotrophin and the highest SHBG concentrations. After having removed five doped athletes and five DSD women from our population, median T and free T values were close to those reported in sedentary young women. The 99th percentile for T concentration was calculated at 3.08 nmol/L, which is below the 10 nmol/L threshold used for competition eligibility of hyperandrogenic women with normal androgen sensitivity. Prevalence of hyperandrogenic 46 XY DSD in our athletic population is approximately 7 per 1000, which is 140 times higher than expected in the general population. Conclusion: This is the first study to establish normative serum androgens values in elite female athletes, while taking into account the possible influence of menstrual status, oral contraceptive use, type of athletic event, and ethnicity. These findings should help to develop the blood steroidal module of the Athlete Biological Passport and to refine more evidence-based fair policies and recommendations concerning hyperandrogenism in female athletes.
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“Hyperandrogenic 46, XY DSD female athletes in the 2011 IAAF World Championships were 140 times more prevalent (0.7% of athletes had testosterone concentrations of > 15.6 nmol/L [20]) compared to 0.005% [20, 21] reported in the general population [22, 23]”
From Integrating Transwomen and Female Athletes with Differences of Sex Development (DSD) into Elite Competition: The FIMS 2021 Consensus Statement (2021) · cites this paper as [20]
In the citing paper
“which could be an indicator of performance advantage [20].”
From Integrating Transwomen and Female Athletes with Differences of Sex Development (DSD) into Elite Competition: The FIMS 2021 Consensus Statement (2021) · cites this paper as [20]
In the citing paper
“There is evidence that the first three conditions, components of 46,XY DSDs, are 140-fold more prevalent among elite female athletes than expected in the general population (80).”
From Circulating Testosterone as the Hormonal Basis of Sex Differences in Athletic Performance (2018) · cites this paper as [80]
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“(33) estimated a 46 XY DSD occurrence rate of 1 in 20 000”
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Self-citationEffect of Exercise on Ovulation: A Systematic Review
Hakimi, O., & Cameron, L. C. (2016) · Sports Medicine · doi:10.1007/s40279-016-0669-8 · Cited by 165
“Moreover, the prevalence of biochemical hyperandrogenism has been reported as being 140 times higher in athletes than in the general population [17], and case studies in female elite athletes have shown they may suffer from anovulatory menstrual cycles, especially after exertion, despite not becoming amenorrhoeic or l…”
Background
Metadata
- Authors
- Bermon, S., Garnier, P. Y., Hirschberg, A. L., Robinson, N., Giraud, S., Nicoli, R., Baume, N., Saugy, M., Fénichel, P., Bruce, S. J., Henry, H., Dollé, G., & Ritzen, M.
- Affiliations
- Laboratoire Motricité Humaine Éducation Sport Santé (FR)
- International Association of Athletics Federations Medical and Anti-Doping Department and Commission (S.B., P.Y.G., M.S., G.D.), 98000 Monaco
- Centre Hospitalier Universitaire Vaudois (CH)
- Inserm (FR)
- Karolinska University Hospital (SE)
- Corresponding author
- Bermon, Stéphane
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2014-11-01
- Volume
- 99
- Issue
- 11
- Pages
- 4328-4335
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2113140165
- Cited by
- 125
- References
- 32
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 21 · 2023: 14 · 2022: 7 · 2021: 11 · 2020: 6 · 2019: 8 · 2018: 17 · 2017: 12 · 2016: 9 · 2015: 8 · 2014: 1
- FWCI
- 32.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- IRIS (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion)
- Funders
- World Anti-Doping Agency
- Korea Institute of Science and Technology
- Topics
- Social Sciences › Sociology and Political Science › Doping in Sports
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Sexual Differentiation and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Keywords
- serum androgens, female athletes, hyperandrogenism, 46,XX disorders of sex development, testosterone, dehydroepiandrosterone sulfate, androstenedione, sex hormone-binding globulin, gonadotropins, oral contraceptives, amenorrhea, oligomenorrhea, Athlete Biological Passport, doping detection, reference values
- MeSH terms
- Adolescent, Adult, Androstenedione, Female, Humans, Menstrual Cycle, Middle Aged, Sex Hormone-Binding Globulin, Testosterone, Prevalence, Hyperandrogenism, Dehydroepiandrosterone Sulfate, Young Adult, Athletes
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