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dc.contributor.advisorWelde, Boye
dc.contributor.authorEngseth, Tina Pettersen
dc.date.accessioned2024-06-12T10:04:37Z
dc.date.available2024-06-12T10:04:37Z
dc.date.embargoEndDate2025-06-18
dc.date.issued2024-06-18
dc.description.abstract<p><i>Background:</i> The current understanding of the menstrual cycle (MC) and hormonal contraceptive (HC) use in female athletes is scarce and the impact on training, performance, and recovery is inconclusive. Still, many athletes perceive MC/HC use and related symptoms to interfere with training, performance, and recovery. However, as most previous studies often include athletes from multiple different sports, or focus on team sports, there is a clear need for endurance-athlete specific research. <p><i>Objective:</i> The overall objective of this PhD thesis was to explore the prevalence of HC use and the self-perceived influence of both the MC and HC use, including cycle-related symptoms, on training, performance, and recovery of female endurance athletes. <p><i>Methods:</i> This project included a large cohort of competitive female endurance athletes. In Paper I, a cross-sectional design was applied using a retrospective questionnaire. Paper II and III were prospective cohort studies using self-reported measures. Paper III employed urinary ovulation tests each cycle to verify MC phases. <p><i>Results:</i> Of all athletes, 68% used HC, of which 64% employed progestin-only HC. Sixty percent of the HC users reported non-contraceptive reasons for HC use, with cycle-related symptoms being the primary stated reason. The majority perceived a neutral or solely positive influence (81%) of HC usage on training and/or performance (Paper I). Self-reported recovery measures appeared to be negatively influenced by mid-luteal phase (Paper III) and pre-bleeding days (Paper II). Furthermore, cycle-related symptom severity was negatively associated with both self-reported sleep quality and physical readiness to train (Paper II). <p><i>Conclusion:</i> We found a higher prevalence of total HC use and an increased proportion in usage of progestin-only HC compared to previous studies. The most common reason for HC use was to attenuate negative cycle-related symptoms, with the majority of HC users perceiving a neutral or solely positive influence of HC use on training and performance. Furthermore, mid-luteal phase, prebleeding days, and cycle-related symptoms severity appear to negatively influence self-reported measures of recovery in HC and non-HC users. However, it is important to consider the presence of other possible stressors, as the MC/HC cycle and related symptoms are just one of many factors that can potentially influence recovery.en_US
dc.description.abstract<p><i>Bakgrunn:</i> Den eksisterende forståelsen av menstruasjonssyklusen (MC) og bruk av hormonelle prevensjonsmidler (HC) blant kvinnelige idrettsutøvere er mangelfull, og påvirkningen på trening, prestasjon og restitusjon er utilstrekkelig kjent. Likevel opplever mange utøvere at MC/HC-bruk og relaterte symptomer påvirker trening, prestasjon og restitusjon. Ettersom de fleste tidligere studier inkluderer utøvere fra forskjellige idretter eller fokuserer på lagidretter, er det et klart behov for forskning spesifikt rettet mot utholdenhetsutøvere. <p><i>Problemstilling:</i> Det overordnede målet for denne PhD-avhandlingen var å utforske utbredelsen av HC-bruk og selvopplevd påvirkning av MC og HC-bruk, inkludert syklus-relaterte symptomer, på trening, prestasjon og restitusjon hos kvinnelige utholdenhetsutøvere. <p><i>Metode:</i> Dette prosjektet inkluderte en stor gruppe kvinnelige utholdenhetsutøvere. I Paper I ble det brukt et tverrsnittsdesign og et retrospektivt spørreskjema, mens i Paper II og III ble prospektive kohortstudier med selvrapporterte målinger benyttet. I tillegg ble eggløsningstester benyttet for å verifisere MC faser i Paper III. <p><i>Resultat:</i> Blant alle utøvere brukte 68 % HC, hvorav 64 % benyttet et kun-gestagenpreparat. Av alle HC-brukere rapporterte 60 % ikke-prevensjonsrelaterte grunner til HC-bruk, hvor syklusrelaterte symptomer var den mest vanlige årsaken. Flertallet opplevde at HC-bruk hadde en nøytral eller utelukkende positiv påvirkning (81 %) på trening og/eller prestasjon (Paper I). Selvrapporterte restitusjonsparametere så ut til å være negativt påvirket i midtre lutealfase (Paper III), samt i dager før blødning (Paper II). Videre var alvorlighetsgraden av syklusrelaterte symptomer negativt assosiert med både selvrapportert søvnkvalitet og «readiness to train» (Paper II). <p><i>Konklusjon:</i> Sammenlignet med tidligere studier fant vi en høyere utbredelse av HC-bruk og en økning i bruk av kun-gestagenpreparater. Den vanligste grunnen til HC-bruk var relatert til å dempe negative syklusrelaterte symptomer. I tillegg opplevde flertallet en nøytral eller positiv påvirkning av HC-bruk på trening og prestasjon. Videre kan det virke som midtre lutealfase, dagene før blødning og alvorlighetsgraden av syklusrelaterte symptomer har en negativ innvirkning på selvrapporterte restitusjonsparametere. Likevel er det viktig å ta hensyn til andre mulige stressfaktorer, da MC/HCsyklus og relaterte symptomer, bare er en av mange faktorer som potensielt kan påvirke restitusjon.en_US
dc.description.doctoraltypeph.d.en_US
dc.description.popularabstractMany athletes perceive the menstrual cycle (MC) and hormonal contraceptive (HC) use to influence their training, performance, and recovery. However, the current understanding is scarce and inconclusive. The main aim of this thesis was to explore HC use prevalence and the perceived influence of MC, HC use, and cycle-related symptoms on training, performance, and recovery in female endurance athletes. With cross-sectional and longitudinal study designs, we found a high prevalence of HC use, with negative MC symptoms being the most common reason for usage. The majority perceived a neutral or solely positive influence of HC usage on training and performance. Mid-luteal phase, pre-bleeding days, and cycle-related symptoms severity appear to negatively influence self-reported measures of recovery in HC and non-HC users. However, it is important to consider other possible stressors, as the MC/HC cycle and related symptoms are just one of many factors that can potentially influence recovery.en_US
dc.description.sponsorshipUiT The Arctic University of Norway and Tromsø Research Foundation (Tromsø Forskningsstiftelse)en_US
dc.identifier.urihttps://hdl.handle.net/10037/33779
dc.language.isoengen_US
dc.publisherUiT The Arctic University of Norwayen_US
dc.publisherUiT Norges arktiske universiteten_US
dc.relation.haspart<p>Paper I: Engseth, T.P., Andersson, E.P., Solli, G.S., Morseth, B., Thomassen, T.O., Noordhof, D.A., Sandbakk, Ø. & Welde, B. (2022). Prevalence and self-perceived experience with the use of hormonal contraceptives among competitive female cross-country skiers and biathletes in Norway: The FENDURA project. <i>Frontiers in Sports and Active Living, 4</i>, 873222. Also available in Munin at <a href=https://hdl.handle.net/10037/26238>https://hdl.handle.net/10037/26238</a>. <p>Paper II: Engseth, T.P., Osborne, J., Solli, G.S., Morseth, B., Andersson, E.P., Topranin, V.D.M., … Welde, B. Influence of menstrual/withdrawal bleeding on self-reported symptoms and recovery during an annual cycle in endurance athletes: The FENDURA project. (Submitted manuscript). <p>Paper III: Topranin, V.D.M., Engseth, T.P., Hrozanova, M., Taylor, M., Sandbakk, Ø. & Noordhof, D.A. (2023). The influence of menstrual cycle phase on measures of recovery status in endurance athletes: The FENDURA project. <i>International Journal of Sports Physiology and Performance (IJSPP), 18</i>(11), 1296-1303. Published version not available in Munin due to publisher’s restrictions. Published version available at <a href=https://doi.org/10.1123/ijspp.2022-0325>https://doi.org/10.1123/ijspp.2022-0325</a>. Accepted manuscript available in Munin at <a href=https://hdl.handle.net/10037/32174>https://hdl.handle.net/10037/32174</a>.en_US
dc.rights.accessRightsembargoedAccessen_US
dc.rights.holderCopyright 2024 The Author(s)
dc.subject.courseIDDOKTOR-003
dc.subjectfemale athletesen_US
dc.subjectenduranceen_US
dc.subjecthormonal contraceptiveen_US
dc.subjectprogestin-only hormonal contraceptiveen_US
dc.subjectcombined hormonal contraceptiveen_US
dc.subjectrecoveryen_US
dc.subjecttrainingen_US
dc.subjectperformanceen_US
dc.subjectmenstrual cycleen_US
dc.subjectpremenstrualen_US
dc.subjectsleep qualityen_US
dc.subjectreadiness to trainen_US
dc.subjectresting heart rateen_US
dc.subjectfollicular phaseen_US
dc.subjectovulatory phaseen_US
dc.subjectluteal phaseen_US
dc.subjecthormonal fluctationsen_US
dc.titleThe perception of the menstrual cycle, cycle-related symptoms, and hormonal contraception in female endurance athletes: The FENDURA projecten_US
dc.typeDoctoral thesisen_US
dc.typeDoktorgradsavhandlingen_US


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