Oosthuyse, T, Strauss, JA and Hackney, AC (2022) Understanding the female athlete: molecular mechanisms underpinning menstrual phase differences in exercise metabolism. European Journal of Applied Physiology. ISSN 1439-6319

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Abstract

Research should equitably reflect responses in men and women. Including women in research, however, necessitates an understanding of the ovarian hormones and menstrual phase variations in both cellular and systems physiology. This review outlines recent advances in the multiplicity of ovarian hormone molecular signaling that elucidates the mechanisms for menstrual phase variability in exercise metabolism. The prominent endogenous estrogen, 17-β-estradiol (E2), molecular structure is bioactive in stabilizing plasma membranes and quenching free radicals and both E2 and progesterone (P4) promote the expression of antioxidant enzymes attenuating exercise-induced muscle damage in the late follicular (LF) and mid-luteal (ML) phases. E2 and P4 bind nuclear hormone receptors and membrane-bound receptors to regulate gene expression directly or indirectly, which importantly includes cross-regulated expression of their own receptors. Activation of membrane-bound receptors also regulates kinases causing rapid cellular responses. Careful analysis of these signaling pathways explains menstrual phase-specific differences. Namely, E2-promoted plasma glucose uptake during exercise, via GLUT4 expression and kinases, is nullified by E2-dominant suppression of gluconeogenic gene expression in LF and ML phases, ameliorated by carbohydrate ingestion. E2 signaling maximizes fat oxidation capacity in LF and ML phases, pending low-moderate exercise intensities, restricted nutrient availability, and high E2:P4 ratios. P4 increases protein catabolism during the luteal phase by indeterminate mechanisms. Satellite cell function supported by E2-targeted gene expression is countered by P4, explaining greater muscle strengthening from follicular phase-based training. In totality, this integrative review provides causative effects, supported by meta-analyses for quantitative actuality, highlighting research opportunities and evidence-based relevance for female athletes.

Item Type:	Article
Additional Information:	This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: http://doi.org/10.1007/s00421-022-05090-3
Uncontrolled Keywords:	Estrogen and progesterone signaling; Eumenorrhea; Exercise metabolism; Exercise-induced muscle damage; Premenopausal women; 1106 Human Movement and Sports Sciences; Sport Sciences
Subjects:	R Medicine > RC Internal medicine > RC1200 Sports Medicine G Geography. Anthropology. Recreation > GV Recreation Leisure > GV561 Sports
Divisions:	Sport & Exercise Sciences
Publisher:	Springer
SWORD Depositor:	A Symplectic
Date Deposited:	18 Jan 2023 12:47
Last Modified:	19 Nov 2023 00:50
DOI or ID number:	10.1007/s00421-022-05090-3
URI:	https://researchonline.ljmu.ac.uk/id/eprint/18669

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