| 1. |
- Ekenros, Linda, et al.
(författare)
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Changes in premenstrual symptoms in women starting or discontinuing use of oral contraceptives
- 2019
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Ingår i: Gynecological Endocrinology. - : Taylor & Francis Group. - 0951-3590 .- 1473-0766. ; 35:5, s. 422-426
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Tidskriftsartikel (refereegranskat)abstract
- It is not clear whether oral contraceptive (OC) treatment affects premenstrual symptoms in women. The aim of the present study was to evaluate changes in premenstrual symptoms (PMS) in women starting to use or discontinuing the use of OCs. Twenty-four healthy women with no previous diagnosis of premenstrual dysphoric disorder were included in this study with a prospective crossover design. Nineteen women completed daily ratings of somatic and mood symptoms during two hormonally different cycles, during a normal menstrual cycle and while using OCs. The menstrual cycle phases were hormonally verified and the low-dose, monophasic OCs were used in a 21/7 regimen. The onset of OC use significantly decreased premenstrual somatic symptoms, but it did not affect mood symptoms. In the women who discontinued OC use, no significant changes in neither somatic nor mood symptoms appeared in the premenstrual phase.
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| 2. |
- Ekenros, Linda, et al.
(författare)
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Impact of Menstrual cycle-based Periodized training on Aerobic performance, a Clinical Trial study protocol—the IMPACT study
- 2024
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Ingår i: Trials. - : BioMed Central (BMC). - 1745-6215. ; 25:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The menstrual cycle and its impact on training and performance are of growing interest. However, evidence is lacking whether periodized exercise based on the menstrual cycle is beneficial. The primary purpose of this proposed randomized, controlled trial, the IMPACT study, is to evaluate the effect of exercise periodization during different phases of the menstrual cycle, i.e., comparing follicular phase-based and luteal phase-based training with regular training during the menstrual cycle on physical performance in well-trained women.Methods: Healthy, well-trained, eumenorrheic women between 18 and 35 years (n = 120) will be recruited and first assessed for physical performance during a run-in menstrual cycle at different cycle phases and then randomized to three different interventions: follicular phase-based training, luteal phase-based training, or regular training during three menstrual cycles. The training intervention will consist of high-intensity spinning classes followed by strength training. The menstrual cycle phases will be determined by serum hormone analysis throughout the intervention period. Assessment of aerobic performance (primary outcome) and muscle strength, body composition, and blood markers will be performed at baseline and at the end of the intervention.Discussion: With a robust methodology, this study has the potential to provide evidence of the differential effects of exercise periodization during different phases of the menstrual cycle in female athletes.Trial registration: ClinicalTrials.gov NCT05697263 . Registered on 25 January 2023
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| 3. |
- Ekenros, Linda, et al.
(författare)
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Perceived impact of the menstrual cycle and hormonal contraceptives on physical exercise and performance in 1,086 athletes from 57 sports
- 2022
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Ingår i: Frontiers in Physiology. - : Frontiers Media S.A.. - 1664-042X. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Female athletes train and compete under the potential influence of hormonal fluctuations during the menstrual cycle or during use of various hormonal contraceptives. Dysmenorrhea and premenstrual symptoms are common in the general population, as well as side effects of hormonal contraceptives. More detailed knowledge concerning prevalence and perceived impact of these symptoms on training and performance in different sports is required. The aim of the study was to 1) characterize perceptions of training and performance during the menstrual cycle phases and by hormonal contraceptive use in a large population of female athletes; 2) explore whether symptoms experienced are related to perceived performance; and 3) examine potential differences in these factors between athletes at different levels of performance. The study was based on self-reported data from 1,086 athletes from 57 sports at different performance levels via a web-based questionnaire. Thirty-seven percent (n = 407) of the athletes did not use hormonal contraceptives. In this group, menstrual cycle related symptoms were common across all athlete levels, particularly dysmenorrhea (74%, n = 300) and premenstrual symptoms (78%, n = 318), which also influenced perceived performance of aerobic fitness, muscle strength, mental sharpness, balance, and sleep quality. Sixty-three percent (n = 679) of the athletes used various hormonal contraceptives and 40% (n = 272) perceived a variety of side-effects. Physical performance was experienced equally independent of time-point of the pill-chart except for the period of inactive pills, which was associated with more negative impact. Nonetheless, only 18% (n = 191) of the athletes considered menstrual cycle or hormonal contraceptive issues when planning their training or competitions. These results indicate that greater focus is needed to identify and effectively treat different menstrual cycle and hormonal contraceptive related symptoms on an individual level.
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| 4. |
- Ekenros, Linda, et al.
(författare)
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Postural control in women with premenstrual symptoms during oral contraceptive treatment
- 2011
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 90:1, s. 97-102
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Tidskriftsartikel (refereegranskat)abstract
- Objective. This study investigates postural control among women with and without premenstrual symptoms (PMS) on oral contraceptive (OC) treatment. Design. Prospective repeated measures design. Setting. Women's health clinical research unit at a university hospital. Population. Fifteen women using low-dose monophasic oral contraceptives participated in the study. Depending on premenstrual symptoms, the women were divided into one PMS group and one non-PMS group. Methods. Postural control (displacement area) was measured using an AMTI® force platform during the active hormone phase (OC phase) and the hormone-free phase (non-OC phase) of the pill chart. Premenstrual symptoms were evaluated prospectively using the Cyclicity Diagnoser. Main Outcome Measures. Displacement area as a measure of postural control. Results. Six of 15 women showed premenstrual symptoms (primarily negative mood symptoms) between the phases and were considered having premenstrual symptoms. When analyzing postural control, the PMS group displayed a significantly greater displacement area in the OC-phase compared to the non-OC phase. In contrast, the non-PMS group did not show any significant difference between the phases. Furthermore, the PMS group had significantly greater displacement area during the OC phase compared to the non-PMS group. Conclusions. The present study shows that women with premenstrual symptoms have greater displacement area than those without premenstrual symptoms during the active phase of oral contraceptive treatment. Negative mood symptoms may affect the maintenance of postural control by central interactions. Further studies are needed to clarify the precise mechanism for altered postural control in women with premenstrual symptoms.
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| 5. |
- Ekenros, Linda
(författare)
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The influence of sex hormones on neuromuscular function and premenstrual symptoms
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The menstrual cycle with fluctuation in female sex hormones has been suggested to influence neuromuscular function. However, variation in ligament laxity, soft tissue stiffness, and skeletal muscle strength across the menstrual cycle has led to conflicting results. Furthermore, premenstrual symptoms (PMS) have been suggested to have a negative impact on neuromuscular performance and contribute to the risk of musculoskeletal injury in physically active women. On the other hand, the use of oral contraceptives (OCs) might protect from injury. The mechanisms of the influence of sex hormones on neuromuscular function and PMS are not fully understood. The overall aim of this thesis was to explore the effect of endogenous sex hormones and OCs on muscle strength, postural control, and PMS in healthy women with moderate physical activity. A further aim was to explore the expression of sex hormone receptors in skeletal muscle during three well-defined phases of the menstrual cycle. Postural control was measured during the active and hormone-free phase of OC treatment in physically active women with or without PMS as evaluated by prospective symptom rating. In the same cohort of women, muscle strength and hop performance were measured during one OC cycle and one normal menstrual cycle at three specific phases, using a cross-over design. Furthermore, changes in PMS in the same women starting to use or discontinuing the use of OCs were evaluated. In another cohort of healthy women, muscle biopsies were collected from the musculus vastus lateralis in the follicular phase, the ovulatory phase, and the luteal phase of the menstrual cycle for determination of mRNA and protein levels of sex steroid hormone receptors. Women with PMS displayed a significant change in postural control (greater displacement area) during the active OC phase compared to the withdrawal phase of OC treatment, whereas women without such symptoms showed no variation in postural control during OC treatment. Muscle strength and hop performance did not vary during the different phases of the normal menstrual cycle, or during OC treatment. In women with PMS, OC treatment decreased ratings of premenstrual somatic symptoms, but not of negative mood symptoms. Gene and protein levels of estrogen receptor alpha and the progesterone receptor varied significantly during the three hormonally confirmed phases of the normal menstrual cycle. The results of this thesis indicate that PMS influences postural control and OC treatment decreases PMS of somatic type. Furthermore, muscle strength and hop performance are not influenced by endogenous and exogenous sex hormones. The variation in expression of sex hormone receptors in skeletal muscle may have an impact on the effects of muscular training and sports injuries in women.
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| 6. |
- Ekenros, Linda, et al.
(författare)
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The perceived influence of menstrual cycle and hormonal contraceptives on training and performance: Comparison between football, handball, and orienteering
- 2023
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Ingår i: International journal of sports science & coaching. - : Sage Publications. - 1747-9541 .- 2048-397X.
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Tidskriftsartikel (refereegranskat)abstract
- Recently, we published self-reported data concerning the perceived effects of the menstrual cycle and hormonal contraceptives on the training and performance of 1086 female athletes participating in 57 sports. However, studies comparing differences between sports with large sample sizes are lacking. The aim of this ancillary study was to compare the impact of the menstrual cycle and hormonal contraceptives on training and performance between the three largest sports in the cohort, that is, football, handball, and orienteering, as well as the knowledge and support provided to the female athletes engaged in these sports. The results are from a web-based questionnaire completed by 312 football players, 243 handball players, and 93 orienteers. A total of 54% of the orienteers planned their training based on the menstrual cycle, which was a higher proportion compared to football (45%) and handball (29%) players (p < 0.05). Fewer football players believed that the menstrual cycle had an impact on their performance during training and competition compared to the two other sports. A high proportion of the athletes used hormonal contraceptives in all three sports, but a lower proportion of the orienteers (40%) used hormonal contraceptives compared to football (76%) and handball players (66%) (p < 0.05). Football and handball players received overall more support than orienteers, and the support was mostly provided by a physiotherapist and/or a strength and conditioner coach besides the main coach. These findings demonstrate that the perceived influence of the menstrual cycle and hormonal contraceptives on training and performance differs between endurance athletes in orienteering compared to team-sport athletes in football and handball.
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| 7. |
- von Rosen, Philip, et al.
(författare)
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Offered Support and Knowledge about the Menstrual Cycle in the Athletic Community: A Cross-Sectional Study of 1086 Female Athletes
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:19
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Tidskriftsartikel (refereegranskat)abstract
- Many female athletes perceive that symptoms related to the menstrual cycle such as dysmenorrhea, premenstrual symptoms, amenorrhea or side-effects of hormonal contraceptives negatively impact their training, performance, and general well-being. Knowledge and communication about female athletes’ health is therefore important in the sport community. The aims of this study were to explore the level of knowledge and communication about menstrual cycle issues and use of hormonal contraceptives in the athletic community and to describe the kinds of medical support offered to female athletes. A total of 1086 Swedish and Norwegian athletes from 57 different sports responded to a web-based questionnaire. Of these, 58% (n = 627) practiced team sports and 42% (n = 459) individual sports. Twenty-six percent (n = 278) of the athletes perceived their knowledge about female athlete health to be poor/very poor and the knowledge was most often acquired from medical staff. Fifty-three percent (n = 572) of the athletes perceived the knowledge acquired of their coaches as poor/very poor, even though a significantly (p < 0.001) higher proportion of athletes with a female coach (30%, n = 31) rated their coach’s knowledge as very good/good, compared to athletes with a male coach (5%, n = 31). Only 11% (n = 116) of the athletes discussed female health issues with their coach. The majority (81%, n = 842) of the athletes partly to strongly agreed that female athlete health is considered a taboo topic in the athletic community. Forty-seven percent (n = 510) of the athletes had access to a physiotherapist, while only three percent (n = 29) had access to a gynecologist. Low perceived knowledge, lack of communication and support demonstrate the need for a multi-professional medical team and enhanced educational efforts focused on female athlete health in the athletic community.
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