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New regulations regulating the level of testosterone in the blood of female players have just entered into force. Female athletes with gender disorders will be classified separately if drugs do not lower testosterone levels. Is this the third gender in sports? What is the phenomenon of women such as the titled runner Caster Semenya?

On November 1, new regulations of the International Association of Athletics Federations (IAAF) entered into force, introducing strict criteria for competing competitors with gender development disorders (DSD - Differences of Sexual Development) at distances from 400 m to 1 mile, in including hurdles.

The new regulations include a provision about the permissible level of testosterone in the blood of competitors - below 5 nmol / l at least 6 months before the start and the maintenance of this level throughout the competition. If it is too high, it will have to be lowered through the use of appropriate medications. At the same time, a new female classification was introduced for female players with gender development disorders (DSD) who will not start treatment.

It turns out that among the best athletes out of every 1000 in a given discipline, 7.1 has an elevated testosterone level, which is 140 times more than in the entire population! Most of these women run the distances of 400, 800 and 1500 m. Is this a testorene specialization of middle distances?

What does high testosterone level mean in women?

Are the players whose level is exceeded according to the new criteria sick? Most women have blood testosterone levels between 0.7 and 2.8 nmol / l, depending on the method. For comparison, in mature men these values ​​oscillate between 7.7 - 29.4 nmol / l.

If a woman's blood testosterone concentration exceeds 5 nmol / l, it means hyperandrogenemia (increased level of androgens in the blood). Testosterone levels that are so high are common in women with androgen-producing tumors or, in rare cases, in people with gender differentiation disorders, and can reach blood levels similar to those in men.

Excessive secretion of androgens in women causes symptoms of masculinization and virilization, i.e. a change in body shape, increase in muscle mass, hirsutism (male type hair), acne, androgenic alopecia, hyperplasiaclitoris, lowering the tone of the voice and defeminization (including menstrual disorders, reduction of the breast and uterus and the loss of fat distribution typical for women).

It leads to menstrual disorders and infertility, metabolic disorders - hyperinsulinism, insulin resistance, lipid disorders and, as a result, cardiovascular diseases, and even cancer. It always requires a diagnosis and determination of the cause in order to implement appropriate treatment.

Benefits in sports competition

Testosterone and its 2.5 times stronger metabolite, 5α-dihydrotestosterone (DHT), which is formed in the target tissues, have an anabolic effect, expressed by a positive nitrogen balance and an increase in protein production. This contributes to the increase in muscle mass as a result of the overgrowth of muscle cells, increasing their volume without increasing their number, which translates into the strength and endurance of muscles and the skeletal system. Testosterone facilitates the adaptation of muscles to exercise and improves their ability to regenerate. It also inhibits the expression of the natural inhibitor of muscle hypertrophy - myostatin, thus allowing for their greater hypertrophy.

Androgens also stimulate the production of erythropoietin, which increases aerobic power and endurance. As a result, the number of erythrocytes and the concentration of hemoglobin in the blood increases, and thus the oxygen use in tissues is improved, exercise tolerance is better, and the ability to achieve above-average sports results is increased. Significant improvements in maximum exercise capacity were also observed.

Erythropoietin also has a direct effect on the brain and increases motivation to act - increasing exercise and physical performance.

Testosterone and DHT synergistic with growth hormone increase the pool of insulin-like growth factor (IGF-1) circulating in the blood, which increases protein synthesis, regulates energy processes in muscles and inhibits apoptosis (cell death and removal of used cells from the body). Currently, IGF-1, along with the derivatives of testosterone and erythropoietin, is one of the most commonly used doping agents in sports.

Testosterone is a competition hormone, so it affects the mental sphere and ensures an appropriate level of motivation of the player.

Testosterone in women's track and field athletics is primarily medium distances, where the vast majority of cases of runners with hyperandrogenemia have been recorded. Much more than long jump, high jump or sprint or long distance running.

For athletes, the anabolic effects of androgen-anabolic steroids (AAS), i.e. increasingsynthesis of proteins that build skeletal muscles, stimulation of androgen receptors in tissues and inhibition of catabolism.

Do you know that…

Skeletal muscles in humans consist mainly of three types of fibers: I, IIA and IIB, depending on the type of myosin heavy chain - the protein responsible for muscle contraction. They differ in size and metabolic capacity. For example: fibers I, the so-called The "slow" ones are smaller, they shrink slowly and use oxygen to generate energy, which means they tire more slowly - which is why they are more common in marathon runners. On the other hand, IIB fibers, the so-called "Fast", they are larger, shrink quickly and tire quickly because they use anaerobic processes as energy sources. These dominate sprinters. Research shows that in the muscles of men, type IIA prevails over IIB and over I, while in women I over IIA and over IIB. This distribution results in a difference between the sexes - men's muscles have a better ability to contract but are less durable than women's muscles.

It seems that it is the increase in the volume and efficiency of "fast" fibers with a constant amount of "slow" fibers in women with hyperandrogenism that makes them the most successful medium-distance races. Additionally, some studies show that testosterone in women can increase fatty acid oxidation, which is the main source of energy in 15-60 minute workouts.

Interestingly, the hormone that promotes the conversion of slow to fast fibers is one of the thyroid hormones - triiodothyronine (T3). In addition, T3 improves the muscle's ability to contract - an effect that testosterone does not.

Swimmers from East Germany

Notorious are the stories of female swimmers from the former East Germany who were stuffed with hormones and turned into men. At the East German "star factory", thousands of athletes were fed a blue pill containing a derivative of methyltestosterone every day.

Female swimmers were given this preparation from the age of 11, which had a significant impact on the developing organism and the endocrine system. It was given to swimmers, but also to rowers and weightlifters. We know the story of Heidi Krieger, a champion in shot put, who decided to change her gender after her sports career and now works as Andreas actively against doping in sports together with his wife, former swimmer Ute Krauser.

One of the first female athletes to have male and female reproductive organs was the German representative in the high jump, Dora aka Hermann Ratjen. She competed in the women's category at the Olympic Games in Berlin in 1936, and in 1938 at the European Championships inIn Vienna, she broke the world record with the result of 170 cm. However, it was canceled after Dora accidentally discovered male genitals.

Testosterone was used as early as in the 1950s by Soviet sportswomen, Maria Itkina, and sisters Irina and Tamara Press, called the "flower of Leningrad". They mysteriously ended their sports careers after mandatory gender testing was introduced, so this has never been proven.

In sport, for the first time, compulsory gender testing commissioned by the International Association of Athletics Federations (IAAF) was carried out in 1950. At the Olympics, it was performed for the first time in 1968. The so-called "Gender passports".

As a result of such research, the career of Ewa Kłobukowska - a Polish athlete and sprinter, Olympic gold medalist from Tokyo in 1964, ended in 1967. On the basis of sex chromatin studies, chromosome mosaic was found. According to modern genetics, in women up to 20% of cells may contain sex chromatin.

Hyperandrogenism - causes

The most commonly used form of pharmacological doping in the world are AAS (anabolic androgenic steroids), i.e. androgenic-anabolic steroids that can be of both endogenous and exogenous origin. Modern analytical methods allow for effective detection of AAS doping, including the support of the so-called undetectable AAS.

If the cause of removable hyperandrogenism is identified (e.g. tumors that produce androgens, medications with androgenic activity are used), we can effectively remove it through surgery or discontinuation of AAS. Most often, however, we are dealing with ovarian or adrenal androgenization caused by chronic endocrinopathy, with causes that cannot be removed (e.g. congenital adrenal hyperplasia, Cushing's syndrome, polycystic ovary syndrome - PCOS). In the treatment of hyperandrogenism, among others, substances aimed at reducing the production and secretion of androgens. The he alth consequences are restoring the normal rhythm of menstruation, reducing hirsutism, acne, and baldness. It is also an improvement in the metabolic parameters of carbohydrate and lipid metabolism.

Third gender

The third gender, according to the new regulations, concerns people with impaired testosterone levels. The problem concerns people with disorders of sex development (DSD), in whom, as a result of mutations of sex genes or hormonal disorders in the fetal life, there is no match between the genetic, gonadal, genital, somatic and mental sexand there are abnormalities in the structure of the internal or external genital organs. Until 2005, pejorative and controversial terms were used for this type of disorder, such as hermaphroditism, hermaphroditism, gender inversion and intersexuality.

In people suffering from gender development disorders, the concentration of testosterone in the blood exceeds the upper limit of the female norm many times over. The problem of high testosterone levels in women concerns not only the world of sports. Testosterone is only one of the androgens produced in women by the ovaries (25%) and the adrenal glands (25%). The main testosterone pool - 50% - comes from the transformation of androstenedione in peripheral tissues.

Worth knowing

In women the symptoms of excess testosterone are visible to the naked eye:

  • hirsutism or excessive, stiff and hard hair in places typical for men (mustache, beard and sideburns, neck, chest, abdomen, back and buttocks)
  • acne - especially on the jaw line
  • temporal alopecia and on top of the head
  • male proportions and strong muscles
  • low timbre.

In the diagnosis of excess of this hormone, mainly the determination of the level of hormones and other parameters in the blood serum, and additionally imaging tests: ultrasound and computed tomography.

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