A perspective on current research investigating the effects of hormonal contraceptives on determinants of female athlete performance

Abstract Hormonal contraceptives are used by approximately half of female athletes and may affect athletic performance as a result of their action on the endogenous hormonal milieu. In athletes, hormonal contraceptive use appears to have little effect on body composition, however further studies are needed assessing progestin-only contraceptives as they may have a negative effect in the general population. The type of progestin contained within the contraceptive may influence the anabolic response of muscle to loading although this relationship is complex as it may be due to either direct or indirect effects of exogenous hormones on protein synthesis and satellite cell proliferation. The altered hormonal milieu in hormonal contraceptive users has predominately been shown to have no effect on muscle strength and whilst maximal oxygen uptake is sometimes reduced, this does not translate into measures of performance. The majority of previous research has used cross-sectional designs and/or grouped together different types and brands of hormonal contraceptives and little research has been conducted on progestin-only contraceptives in athletes. Future research should use prospective, randomised-controlled designs to assess the effects of all types of hormonal contraceptives on athletic performance in females.

【摘要】 约有半数女运动员会使用激素避孕药（hormonal contraceptives），这类药物通过作用于人体内源激素环境，可能会对运动表现产生影响。现有研究显示，女运动员使用激素避孕药似乎对身体成分影响甚微，但针对仅含孕激素避孕药的相关研究仍有待补充——这类药物在普通人群中可能会产生不良影响。避孕药中所含孕激素的类型，可能会影响肌肉对负荷的合成代谢反应，但二者之间的关联较为复杂：外源性激素对蛋白质合成与肌卫星细胞增殖（satellite cell proliferation）的作用可分为直接与间接两类，具体机制尚未明确。现有研究普遍表明，使用激素避孕药者的激素环境改变，并不会对肌肉力量产生影响；尽管部分使用者的最大摄氧量（maximal oxygen uptake）有时会出现下降，但这并未体现在运动表现的相关指标中。既往多数相关研究采用了横断面研究设计（cross-sectional designs），或将不同类型、不同品牌的激素避孕药进行合并分析，而针对运动员群体使用仅含孕激素避孕药的专项研究则较为匮乏。未来的研究应采用前瞻性随机对照试验设计（prospective, randomised-controlled designs），全面评估各类激素避孕药对女性运动员运动表现的影响。