Hyperandrogenism is the presence of excess androgen in the body. It can also be termed as a medical condition whereby high levels of androgens are found in the body of an athlete. In international sports like Olympic Games, females who have high levels of androgenic hormones are barred from participating in the sports due to the fact that they can possess an unfair advantage that is not present in the bodies of their fellow competitors. The levels of the hormones must be at a permissible level for an athlete to participate in international competitions like Olympics (Pal, 2013). Extremely high levels of androgen have been found to confer a high unfair advantage to various athletes.
In the year 2014, September, an athlete from India by the name Dutee Chand was barred from participating in international competitions due high levels of androgens in her body. She was prohibited from competing with her fellow female runners citing high level of the hormone in her system. The Association of Athletics Federations is the one that placed the ban. Female athletes are on a higher risk of having failed reproductive systems and dysfunction or osteopenia due to energy deficiency. Endocrine balance in the body is critical and it helps in essential body composition and performance. Some of these parameters are yet to be explained fully in regard to Olympic sportswomen. The aim of this proposal is therefore the exploration of hyperandrogenism in athletes and how it impacts the body composition, endocrine balance in the bodies of female Olympic athletes who participate in various disciplines.
Issues regarding hyperandrogenism in Olympic competitions arose in 1949 when a Dutch athlete named Foekje Dillema had her career cut short by the Association of Athletics Federation in 1950 following claims of hyperandrogenism. She was then expelled for life although no records were revealed pertaining to the situation.
Proposed research focus
Excellence in athletics primarily depends on the general combination of genetic makeup. It also relies on the genetic endowment, appropriate equipment, training, and proper nutrition. In addition, intrinsic hormonal makeup plays a critical role in determination of the athlete’s performance in competitions in the international arena. The concept in not well understood by many. In this proposal, I will delve into this issue particularly exploring how hyperandrogenism impacts a female’s performance in international competitions like Olympics and how the condition has changed these type of competitions globally.
Androgens, such as testosterones are believed to play a key role in the regulation of the general physiological processes of the particular target tissues as a response to exercise. In mature athletes, use of exogenous steroids that are antibiotic was proved to improve an athletes’ performance, change body composition, reduce instances of fatigue, and ultimately increase aggressiveness of the athlete (Wenn & Schaus, 2007). The impact of such substances in adolescents who are in the process of rapid growth remains a controversial issue. Explorations the relationship between performance and substance consumption particularly androgens is less studied.
The level of androgens in a female athlete’s body is studied mainly when trying to discover the relationship between the competitiveness of the person with the menstrual irregularities experienced. It has been proved that the major cause of menstrual dysfunction in most female athletes is hypothalamic inhibition of the gonadotropin excreting hormone. It can also be due to pulsatile release caused by the negative energy balance. In the past years, basic hyperandrogneism such as polycystic ovary syndrome has been said to be additional causes of menstrual disorders in female athletes. This is unrelated to energy availability.
During international athletic competitions like Olympics, hormonal screening has become an integral part of the basic medical follow up of the participants. This is as an effort to regulate training intensity. Through revision of the policies and regulations that govern inclusion of athletes in women’s sports competitions, the issue of hyperandrogenism has been substantively dealt with. In the past years, the vetting process entailed the verification of a person’s gender or femininity. In 2012, Caster Semenya was disqualified from participating in international female competitions on the basis of her sexuality. This brought uproar in the public debates. This has pushed the sport’s governing body all over the world to revise their policies to ensure that inclusion in females’ sports events rest hugely on the serum testosterone levels. This mandates that it should be less than the normal lower limit of regular men as the defining criteria.
Many forms of menstrual irregularities and sexual dysfunction have been reported in past regarding female athletes. Instances of menstrual irregularities are higher in activities where a thin body is preferred for better performance. The gonadotrophin releasing hormone pulses from the athlete’s hypothalamus; it then decreases pulsatile release of luteinizing hormone as well as follicle-stimulating hormone. This blocks the stimulation of ovary. Infertility may also develop as a result of hyperandrogenism. The condition is in most cases irreversible when it occurs. In this research, data has been analyzed with the aim of establishing the prevalence of hyperandrogenism among elite, asymptomatic, adolescent athletes. The report explains the impacts of hyperandrogenism in the international arena and with regard to Olympic competitions. It also describes the reproductive system dysfunctions and the policies that govern the regulation of this issue in international competitions.
This section entails other relevant areas and materials that have been covered in the past by other researchers and investigators this field. This section discusses the information that has already been published regarding this particular subject are. The information presented in this area has been discussed and developed in a specific time span (McCook, 2002). The section also summarizes the sources. It presents an organization pattern of the information for both synthesis and analysis. The information provides summaries used as recap to the important information sources. The synthesis is the reorganization of the information presented about hyperandrogenism. It entails interpretation of old materials that has been given new interpretations. It is also in this section that a progression is built regarding this area by delving into the major debates that have been portrayed about the issue in international sports such Olympics. In this section, I have also evaluated the sources to include only the relevant materials that describe the most pertinent concepts.
Sources and methodology
In this section, I will explain the process used to collect relevant information and data. This information is used for the purpose of creation of cohesion in this research proposal. The methodology mainly entails surveys and researching techniques that are well recognized. The sources and methodology section present historical information related to hyperandrogenism with Olympic athletes.
After Caster Semeny won the women’s 800 meters at the Berlin world competitions, there were speculations all over about her sexuality. There were debates all over the world about whether she was really a woman. The controversy was triggered by a group of people raising complaints from the competition’s fairness. The complaints were also triggered by the huge margin that Semenya had at the time of winning compared to the other participants in the race. According to Adams and Levy, Caster is not a woman but a man. It is these comments that sparked the investigations by the organizers of the Olympics competitions. The governing Olympics athletics bodies have in past reevaluated and reviewed laws and policies that govern the competitions and the rules that deal with hyperandrogenism cases. Although females and males produce testosterone, women only produce a tenth of the amount produced by men. According the Olympics policies, the androgen levels should be less than a tenth in serum. Female athletes who have testosterone levels far below the normal range or who have androgen resistance conditions are also permitted to participate in Olympic competitions.
Under the IAAF policies, women athletes who are willing to participate in international competitions must be tested by the IAAF. If the female athlete has been found or diagnosed with hyperandrogenism, she is then required to notify the IAAF so as to undergo farther evaluation as outlined in the policies (Giudice, Legro & Azziz, 2006). According to the same policies, and IAAF medical team may start confidential evaluation of the said female for any evidence regarding hyperandrogenism. According to past researches, when a female is identified for evaluation, she must then be subjected to a combination of three tests. The first test is the clinical exam; the second is the endocrine exam which entails the testing of blood and urine for hormone levels. The last is the full exam text. The full exam test includes genetic testing, psychological evaluation, and imaging. After the tests, the female can then compete if she meets the requirements and criteria as stipulated in the policies set by IAAF. The testosterone level medical examiners must also review the results so that the competitor can be deemed acceptable for Olympic competitions.
IAAF and IOC have in the past outlined the principles that are used as a basis of giving judgments on who should and who should not be allowed to participate in international competitions like Olympics. They have outlined a rubric that is used to determine who is tested, the reason behind the testing, and how the test is carried out. These policies are made to ensure fairness in female athletic competitions, health of athletes, protection of confidentiality and privacy, and definition of normal standards required for one to participate in the competitions. Fairness is encompassed in the policies and is based on the respect for the essential understanding of fairness in competitions for female athletics. The attainment of this fairness is achieved through division of athletes into female and male categories. The controversy arises in the division criteria to be used.
If a female is recognized in law, then she can participate in female competitions if the androgen levels are below the male range as shown in the serum concentration of testosterone. Females with hyperandrogenism can also participate in Olympics competitions if she has androgen levels similar to men but has an androgen resistance which means that she has no competitive advantage from the levels. If for any reason, a competitor fails to comply with the laid down rules and regulations, she is not eligible for competitions at the Olympics level. To avoid complications caused by hyperandrogenism like menstrual cycle irregularities and dynsfunction, the Olympics governing body recommends appropriate protective and curative medical attention to be given to the affected athletes to make sure that females with hyperandrogenism receives sufficient medical follow up thought.
Modern techniques and science shows that any sort of advantage that can be conferred due to hyperandrogenism is really complex that testosterone levels alone cannot indicate the advantage, and are therefore the appropriate measures for eligibility (Garcia, 2012). In addition, farther medical conditions give females relatively higher levels of testosterone. Unlike doping, hyperandrogenism entails hormones that are not external to the body of the athlete and are therefore added intentionally to gain unfair advantage. Women with hyperandrogenism on the other hand did not introduce external substances into their bodies that can result into any unfair practice.
Sources and methodology
Females from the female athletes’ team in the United States and the national Olympic team were engaged in a study. The particular sports that were used in the evaluation were volleyball, swimming, ice skating, fencing, sailing, and running. The baseline blood samples were collected from the bodies of the participants at the first stage of the training session. The participants were then tested routinely for the use of substances that enhance their performance. Early morning blood samples were also taken during the early follicular phase of the athlete’s menstrual cycle. This refers to the first five days of the cycle. The blood samples were then spun at 4 degrees and 3000rpm for 25 minutes. After this, serum was then separated and stored at a room at -70 degrees. The samples were then analyzed using the same methodology by a team of experienced technicians.
Certain procedures are used in the investigation of female hyperandrogenism during Olympic competitions. The first step is the making of a formal request by the chairman and the investigation is then started. The medical team affiliated to Olympics games and the scientific director carries on with the investigation thereafter. All the relevant documents of the athletes are then investigated. These include the medical history, diagnosis, current finding, and sex hormone levels. These are availed by the investigated athlete and her team physician. If the documents are found to contain insufficient information, farther investigations are conducted with the direction of the medical team of the Olympic Games. If it is deemed necessary, a team of experts is nominated to deal with the case specifically.
The nominated team can require the physician to provide farther information regarding the athlete and all the medical records that may not have been availed during the first stage .The investigated athlete is then undertaken through a series of examinations and tests so as to determine whether female hyperandrogenim is actually present and whether she can be said to pose an unfair advantage compared to other athletes. The panel is responsible for examination of all relevant information to determine whether the investigate athlete’s androgen level is within the male range when compared to the testosterone levels in serum. If a positive answer is found, the panel goes ahead to determine if such hyperandrogenism is actually functional or not.
Both the athlete and the physician have an opportunity to be heard before the determination of female hyperandrogenism by the panel. If the athlete being investigated or the physician refuses to provide the required information, then she can be suspended in accordance to the Olympic Games policies and regulations. This also happens when the athlete intentionally refuses to undergo the tests. Further sanctions can also be imposed on the athlete for refusal to undergo the necessary tests. If according to the panel of specialist the investigated athlete does not have female hyperandrogenism, then the case is closed and the concerned athlete is eligible for competitions in the female’s category. The decision is final and is not subject to appeal. If on the other hand, the experts find out the athlete has female hyperandrogenism which does not give her an unfair advantage because it is non-functional or if the level of androgen is far below the male range, then the case is also closed and the particular athlete is pronounced eligible for participation in the competitions under the female’s category.
If the team of experts from the selected panel declares that the female has female hyperandrogenism that gives her a competitive advantage due to its functionality, or if the levels of androgen fall above the males range, the particular athlete is pronounced ineligible for the competitions under the female category. The Olympic Games board can also impose farther sanctions on the athlete and the entire team including the physician if they deem that necessary.
For the purpose of ensuring that the respect of the concerned athlete is maintained and his dignity is upheld, privacy is encouraged throughout the entire process. Information obtained from the athlete and the physician is treated with utmost care to ensure confidentiality of any data about the female hyperandrogenism. Performance between males and females at the Olympics differ due to the fact that males release more androgenic hormones than females and are therefore under a more powerful influence of such hormones.
During the methodology stage, determination of the athlete’s body composition was also done using ultrasound. There was also the examination and analysis of reproductive hormones as well as biomarkers of the energy availability. The results indicated that 47% used hormonal contraception. Menstrual dysfunction was also common at the rate of 27% in those who did not use hormonal contraception and in particular in endurance athletes. The percentage of body biomarkers of energy and fate availability were found to be within the normal ranges and no one exhibited osteopenia. The very common diagnosis established was menstrual dysfunction and the specific type found was polycystic ovary syndrome as opposed to hypothalamic inhibition due to energy deficiency. Female Olympic athletes were found to have anabolic body composition as well as biomarkers. These are the athletes who participated in various kinds of sports. The energy and biomarkers levels were within the normal ranges.