The Role of Androgens for Body Composition and Physical Performance in Women

Abstract

Androgens are considered beneficial for athletic performance by potent anabolic effects on muscle mass and bone tissue. Testosterone also increases the formation of new blood cells and circulating hemoglobin, which will enhance oxygen uptake. Furthermore, androgens may exert behavioral and psychological effects of importance for athletic performance including increased mental drive and competitiveness. Studies in men have shown dose–dependent relationship between circulating testosterone with muscle mass and strength, as well as circulating hemoglobin. Experimental evidence in women is much more limited. However, recent studies in nonathletic and athletic women have demonstrated associations between endogenous testosterone levels, muscle mass, and muscle strength. Furthermore, it has been demonstrated that women with mild hyperandrogenism like polycystic ovary syndrome (PCOS) are overrepresented in elite athletes. PCOS, which has a genetic component, is associated with an anabolic body composition, and this syndrome may therefore confer an advantage for physical performance and could play a role in the recruitment of women to competitive sport activities. The prevalence of severe hyperandrogenism, such as disorders of sex development (DSD), is also increased among female athletes. DSD may cause a greatly increased production of testosterone in the male range. These results support a significant role of endogenous androgens for athletic performance in women.