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In this study, the sensitivity of the current urinary and haematological markers of the Athlete Biological Passport (ABP), as well as serum steroid biomarkers, was investigated for the monitoring of a 28\u2010day T gel treatment combined with endogenous fluctuation of the menstrual cycle in 14 healthy female subjects. Additionally, the analysis of urinary target compounds was performed on a subset of samples for endogenous\/exogenous origin via isotope ratio mass spectrometry (IRMS). In serum, concentrations of T and dihydrotestosterone (DHT) increased significantly during the treatment, whereas in urine matrix the most affected biomarkers were found to be the ratios of testosterone\/epitestosterone (T\/E) and 5\u03b1\u2010androstane\u20103\u03b1,17\u03b2\u2010diol\/epitestosterone (5\u03b1Adiol\/E). The detection capability of both urinary biomarkers was heavily influenced by [E], which fluctuated depending on the menstrual cycle, and resulted in low sensitivity of the urinary steroidal ABP module. On the contrary, an alternative approach by the longitudinal monitoring of serum T and DHT concentrations with the newly proposed T\/androstenedione ratio showed higher sensitivity. The confirmatory IRMS results demonstrated that less than one third of the tested urine samples fulfilled the criteria for positivity. Results from this study demonstrated that the \u2018blood steroid profile\u2019 represents a powerful complementary approach to the \u2018urinary module\u2019 and underlines the importance of gathering bundle of evidence to support the scenario of an endogenous prohibited substance administration.<\/jats:p>","DOI":"10.1002\/dta.3040","type":"journal-article","created":{"date-parts":[[2021,4,5]],"date-time":"2021-04-05T03:59:45Z","timestamp":1617595185000},"page":"833-850","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Longitudinal evaluation of multiple biomarkers for the detection of testosterone gel administration in women with normal menstrual cycle"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0388-1352","authenticated-orcid":false,"given":"Olivier","family":"Salamin","sequence":"first","affiliation":[{"name":"Center of Research and Expertise in Anti\u2010Doping 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