月經和避孕藥如何影響運動表現

: By 丹戈登

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月經週期和藥丸對精英運動員的影響最大。 倫納德·朱可夫斯基/ Shutterstock

The menstrual cycle, the pill and their potential impact on sporting performance have long been considered a taboo subject.月經週期，藥丸及其對運動表現的潛在影響長期以來一直被視為禁忌話題。 Yet for most females who undertake any form of exercise or high-performance sport, there are a然而，對於大多數從事任何形式的運動或高性能運動的女性來說，挑戰範圍可能會影響他們的運動表現，包括月經週期和避孕藥的使用。

But a historic lack of scientific research in these areas still means we have very limited knowledge of the specific effect that both have on athletic performance.但是，這些領域歷史上缺乏科學研究，仍然意味著我們對這兩者對運動成績的特定影響的了解非常有限。 However, what research we do have on these subjects shows both can have an impact on athletic performance – which may be especially important for elite athletes.但是，我們對這些主題所做的研究表明，兩者都可能對運動成績產生影響-這對於精英運動員而言尤其重要。

During the average menstrual cycle, levels of the sex hormones oestrogen and progesterone change throughout each phase.在平均月經週期中，每個階段的性激素雌激素和孕激素水平都會發生變化。 These hormonal fluctuations這些荷爾蒙波動引起變化在體溫，能量的存儲和利用以及肌肉產生力量的能力方面。

The cycle is divided into three phases.該循環分為三個階段。 Menses (days one to five of the cycle) is where both oestrogen and progesterone levels are low.月經（週期的第10至14天）是雌激素和孕激素水平都較低的地方。 This is followed by the follicular phase during which oestrogen concentration rises to a peak (between days 19-24).隨後是卵泡期，在此期間雌激素濃度上升至峰值（第XNUMX-XNUMX天之間）。 Immediately preceding is ovulation, where progesterone remains almost unchanged.排卵緊接在前，黃體酮幾乎保持不變。 Thereafter, during the luteal phase, the concentrations of both oestrogen and progesterone are high (days XNUMX-XNUMX).此後，在黃體期，雌激素和孕酮的濃度都很高（第XNUMX-XNUMX天）。 If no implantation of a fertilised egg occurs, both oestrogen and progesterone levels fall, and the cycle recommences.如果沒有植入受精卵，雌激素和孕激素水平都會下降，週期重新開始。

是因為波動雌激素和孕激素 which are thought to have an impact on sporting performance.被認為會對運動表現產生影響。 Research shows both oestrogen and progesterone promote the uptake and storage of研究表明，雌激素和孕激素均可促進攝取和儲存肌糖原。 Both hormones also兩種激素也改變能力在運動和休息時都使用這種儲存的碳水化合物形式的能量。

糖原是肌肉中碳水化合物的儲存形式，在供應能源 to the body during exercise.在運動中Use of muscle glycogen appears to be使用肌肉糖原似乎是更熟練 during the luteal phase, when oestrogen and progesterone are high.在黃體期，雌激素和孕激素較高。 This suggests that during menses and the folicular phases exercise requires us to use more of our stored glycogen, so may cause more fatigue.這表明在月經期和卵泡期運動需要我們使用更多的儲存糖原，因此可能導致更多的疲勞。

Another common aspect of the menstrual cycle is the fluctuation in body temperature, largely because progesterone induces heat production.月經週期的另一個常見方面是體溫的波動，這在很大程度上是因為黃體酮會產生熱量。 Increased progesterone concentrations is associated with an孕激素濃度升高與核心體溫升高。 When core temperature is raised, blood is directed to the skin in order to remove heat and lower internal temperature.當核心溫度升高時，血液被引導至皮膚，以消除熱量並降低內部溫度。 However, this can compromise oxygen delivery to the muscles, resulting in greater perceived effort and potentially earlier onset of fatigue.但是，這可能會損害氧氣向肌肉的輸送，從而導致更大的感知努力並可能導致疲勞的更早發作。 The luteal phase in particular is characterised by higher core temperature and increased heart rate.黃體期尤其以較高的核心溫度和增加的心律為特徵。

一些研究還發現肌肉力量較低 during menses compared to the other phases.在月經期間與其他階段相比。 This time it's oestrogen causing this effect.這次是雌激素引起的。 Indeed, a number of the key cellular structures involved in generating muscular force are sensitive to fluctuations in oestrogen.確實，參與產生肌肉力量的許多關鍵細胞結構對雌激素的波動敏感。 Low concentrations of oestrogen circulating during menses may make strength training feel harder, and fatigue likely to occur earlier.在月經期間循環的低濃度雌激素可能會使力量訓練更難，並且疲勞可能更早發生。 Some evidence also suggests that there's both increased sensations of一些證據還表明，兩者的感覺都有所增加。痛苦和勞累在卵泡期也是如此，使運動感覺更具挑戰性。

在月經期間肌肉力量可能會降低。 里卡多/ Shutterstock

然而，最近的評論 have concluded that despite these biological responses, the impact on sporting performance seems to be minimal.他們得出結論，儘管有這些生物學反應，但對運動成績的影響似乎很小。 But given that at the elite level differences between winning and losing are themselves minimal, this should potentially be taken into consideration.但是，鑑於在精英級別上，輸贏之間的差異本身很小，因此應潛在地考慮這一點。

藥丸

Not only is the pill a common contraceptive method it's also used by many women to alleviate symptoms of dysmenorrhoea (painful cramps) and menorrhagia (abnormal, heavy, or prolonged bleeding).避孕藥不僅是一種常見的避孕方法，許多女性還使用它來減輕痛經（痛性痙攣）和月經過多（異常，大量或長期流血）的症狀。 Many athletes also use the pill to regulate and manipulate their cycles to許多運動員還使用藥丸來調節和控制自己的周期與訓練和比賽時間表一致。

In general, pills work by downregulating the production of sex hormones through a constant release of low doses of synthetic oestrogen and progesterone.通常，藥丸通過不斷釋放低劑量的合成雌激素和孕激素來下調性激素的產生。 Throughout the so-called pseudo-cycle, the hormone concentrations for both oestrogen and progesterone stay at levels comparable to the menstruation phase of women who do not take the pill.在整個所謂的偽週期中，雌激素和孕激素的激素濃度保持在與不服用避孕藥的女性月經期相當的水平。

最近的研究 suggests that performance levels while taking the pill remain the same.這表明服用避孕藥時的性能水平保持不變。 However, thhere's potentially a slightly negative impact of suppressing the ovarian hormones while taking the pill on但是，在服用避孕藥的同時抑制卵巢激素可能會產生輕微的負面影響運動表現 compared with non-pill users.與非藥丸使用者相比。 This suggests that the consistently elevated concentrations of progesterone and oestrogen, as seen with a mono-phasic pill may impact on energy availability and use.這表明，如單相藥丸所見，孕酮和雌激素的濃度持續升高可能會影響能量的利用和使用。

This could potentially impair both strength and endurance exercise performance.這可能會削弱力量和耐力運動表現。 However, pill use (or non-use) should be judged on an individual basis, especially given that the benefits of taking the pill can outweigh possible performance detriments from taking it.但是，應根據個人情況來判斷藥丸的使用（或不使用），尤其是考慮到服用藥丸的好處可能大於服用藥丸可能對性能造成的損害。 But in general, the pill may have less overall impact on athletic performance.但一般來說，藥丸對運動成績的總體影響可能較小。

However, researchers still know very little about the impact of the pill on athletic performance, including downsides, because the area is vastly under-researched.但是，研究人員對該藥對運動表現的影響（包括不利方面）的影響仍然知之甚少，因為該領域的研究還很不足。 Currently, there's also no research into the impact that other forms of contraception – such as injections, the coil and implants – have on athletic performance.當前，還沒有研究其他形式的避孕措施，例如注射劑，線圈和植入物，對運動成績的影響。

In the end, the impact a woman's period or contraceptive use has on her performance is highly subjective.最後，婦女的經期或避孕方法對其行為的影響是高度主觀的。 For example, former British tennis player Heather Watson exited the first round of the Australian Open in 2015 due to what she called “girl things” (“dizziness, nausea, low energy levels and spells of feeling light-headed”) – highlighting how the menstrual cycle is still a例如，前英國網球選手希瑟·沃森（Heather Watson）稱她為“女孩的事物”（“頭暈，噁心，低能量和頭暈目眩的感覺”），於XNUMX年退出了澳網的第一輪比賽。月經週期仍然是禁忌話題。 By contrast, when Paula Radcliffe first broke the marathon world record in Chicago in 2002, she was actually suffering period cramps in the相比之下，當Paula Radcliffe於XNUMX年在芝加哥首次打破馬拉松世界紀錄時，她實際上在比賽的最後部分。

但是，即使在當今時代，數量和質量方面都缺乏關於月經和藥丸如何影響運動表現的科學研究，這意味著尚未真正找到針對受影響人群的明確解決方案和實用建議。