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Serum androgen profile and physical performance in women Olympic athletes
  1. Emma Eklund1,
  2. Bo Berglund2,
  3. Fernand Labrie3,
  4. Kjell Carlström1,
  5. Lena Ekström4,
  6. Angelica Lindén Hirschberg1,5
  1. 1 Department of Women’s and Children’s Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden
  2. 2 Department of Internal Medicine, Karolinska Institutet, Karolinska University Hospital Solna, Stockholm, Sweden
  3. 3 CHUL Research Center, Laval University, Québec, Canada
  4. 4 Department of Laboratory Medicine and Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
  5. 5 Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
  1. Correspondence to Dr Angelica Lindén Hirschberg, Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm SE-17176, Sweden; angelica.linden-hirschberg{at}


Background The role of endogenous androgens for body composition and physical performance in women athletes is still not elucidated.

Aim To examine the serum androgen profile in relation to body composition and physical performance in women Olympic athletes and to compare endocrine variables and body composition to controls.

Study design Cross-sectional study, conducted between 2011 and 2015 at the Women’s Health Research Unit, Karolinska University Hospital, Stockholm.

Methods Swedish women Olympic athletes (n=106) and age-matched and body mass index-matched sedentary controls (n=117) were included in the study. Blood sampling was performed in a rested, fasting state for the measurement of serum androgens and their metabolites by liquid chromatography–tandem mass spectrometry. Body composition was determined by dual-energy X-ray absorptiometry (controls n=100, athletes n=65). The athletes performed standardised performance tests (n=59) (squat jump (SJ) and countermovement jump (CMJ).

Results The athletes demonstrated significantly higher levels of the precursor androgens dehydroepiandrosterone (DHEA) and 5-androstene-3β, 17β-diol (5-DIOL) and the metabolite etiocholanolone glucuronide (Etio-G), significantly lower levels of estrone (p<0.05, respectively), higher bone mineral density (p<0.001) and more lean mass (p<0.001) compared with controls. Serum levels of DHEA, 5-DIOL and Etio-G correlated positively to lean mass variables and physical performance in the athletes. DHEA and lean mass legs explained 66% of the variance in SJ, whereas lean mass explained 52% of the variance in CMJ.

Conclusions The present data suggest that endogenous androgens are associated with a more anabolic body composition and enhanced performance in women athletes. These results are of importance for the current discussion regarding hyperandrogenism in women athletes.

  • androgens
  • dehydroepiandrosterone
  • steroids
  • body composition
  • elite performance
  • female
  • athlete

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  • Contributors All authors listed met the conditions required for full authorship. EE, BB and ALH were involved in concept/design of the study, acquisition of data and data analysis. FL performed the quantification of serum androgens. EE, BB, FL, KC, LE and ALH were involved in the manuscript preparation, critical revision of the article and approval of the article.

  • Competing interests EE, LE and KC have nothing to declare. FLis the president of EndoCeutics, BB is the current medical director for SOC and ALH is a medical advisor to SOC, IAAF and IOC.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Ethics approval Regional Ethics Committee, Stockholm (EPN 2011/1426-32).

  • Provenance and peer review Not commissioned; externally peer reviewed.