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Urinary Steroid Profile in Elite Female Athletes in Relation to Serum Androgens and in Comparison With Untrained Controls
Abstract
Introduction: In female athletes, the interpretation of doping tests is complex due to hormonal variations during the menstrual cycle and hormonal contraceptive use, both influencing the urinary steroid profile. Exercise is suggested to affect circulating steroid hormone levels, and in women, the urinary steroid profile differs between in competition testing and out of competition testing. No previous study has investigated the relationship between amount of exercise and the urinary steroid profile in female elite athletes. Purpose: To compare the urinary steroid profile between female Olympic athletes and age- and BMI-matched untrained controls, and to study the urinary steroid profile in relation to serum hormones and amount of exercise. Methods: In this cross-sectional study conducted at the Women’s Health Research Unit, Karolinska University Hospital, Stockholm, 94 female elite athletes and 86 untrained controls were included. Serum estrogens and testosterone and the urinary steroid profile were analyzed by liquid chromatography–tandem mass spectrometry and gas chromatography-tandem mass spectrometry, respectively. Exercise hours/week were evaluated by questionnaire. Results: Although serum steroid hormones were comparable between groups, the athletes demonstrated approximately 30% lower urinary steroid metabolites of testosterone, epitestosterone, androsterone, etiocholanolone, 5α-androstan-3α, 17β-diol, and 5β-androstan-3α, 17β-diol compared to the controls. The urinary steroid metabolites correlated positively with serum steroid hormones. In the athletes, urinary steroid metabolites: androsterone (rs = −0.28, p = 0.007), epitestosterone (rs = −0.22, p = 0.034), 5αAdiol (rs = −0.31, p = 0.002) and testosterone (rs = −0.24, p = 0.026), were negatively correlated with amount of training (hours per week). Conclusion: The urinary concentrations of steroid metabolites were lower in elite athletes than in sedentary controls, although serum steroids were comparable between groups. Moreover, exercise time was negatively associated with the urinary concentrations. Our findings suggest alternative excretion routes of androgens in the athletes related to training.
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“An increased training load has been associated with lower urinary androgen levels (Eklund et al., 2021).”
From Effect of live‐high, train‐low strategy induced by chronic low‐dose carbon monoxide exposure on haematological parameters and performance in trained individuals (2026) · cites this paper as Eklund et al., 2021
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Burger, H. G. (2002) · Fertility and Sterility · doi:10.1016/s0015-0282(02)02985-0 · Cited by 771 · cited 1×
“In women, a great part of the androgen production occurs in the adrenal gland stimulated by adrenocorticotropic hormone (ACTH) from the pituitary gland (Burger, 2002; Schiffer et al., 2019).”
BackgroundSchiffer, L., Barnard, L., Baranowski, E. S., Gilligan, L. C., Taylor, A. E., Arlt, W., Shackleton, C. H. L., & Storbeck, K.-H. (2019) · The Journal of Steroid Biochemistry and Molecular Biology · doi:10.1016/j.jsbmb.2019.105439 · Cited by 450 · cited 3×
“Even though glucuronidation is the main excretion route of androgens, the ABP metabolites are also to a lesser extent excreted as sulfate-conjugates (Rane and Ekstrom, 2012; Schiffer et al., 2019).”
BackgroundHirschberg, A. L., Elings Knutsson, J., Helge, T., Godhe, M., Ekblom, M., Bermon, S., & Ekblom, B. (2020) · British Journal of Sports Medicine · doi:10.1136/bjsports-2018-100525 · Cited by 106
Self-citationCirculating Androgens in Women: Exercise-Induced Changes
Enea, C., Boisseau, N., Fargeas-Gluck, M. A., Diaz, V., & Dugué, B. (2011) · Sports Medicine · doi:10.2165/11536920-000000000-00000 · Cited by 103
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Cited by
Villanova, S., Porcelli, S., Ekström, L., & Cardinale, D. A. (2026) · Experimental Physiology · doi:10.1113/ep093005 · Cited by 5
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Metadata
- Authors
- Eklund, E., Andersson, A., Ekström, L., & Hirschberg, A. L.
- Venue
- Frontiers in Physiology
- Publisher
- Frontiers Media SA
- Published
- 2021-08-30
- Volume
- 12
- ISSN
- 1664-042X
- Cited by
- 17
- References
- 4
- Funders
- Vetenskapsrådet
- Centrum för idrottsforskning
- Karolinska Institutet
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