{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T15:18:06Z","timestamp":1780327086965,"version":"3.54.1"},"reference-count":71,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European Journal of Sport Science"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      This observational study investigated the potential influence of hormonal contraceptive (HC) use on selected hormonal biomarkers (estradiol, total testosterone, IGF\u20101, cortisol, triiodothyronine, and leptin) that respond to diet and physical training\u2013induced low energy availability (LEA). Thirty\u2010six female physique athletes\u2014combined HC users (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a011), low\u2010dose progestin\u2010only HC users (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a011), and naturally menstruating females (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a014)\u2014prepared for a physique competition. All participants voluntarily restricted energy intake while simultaneously participating in resistance training to maintain lean mass and aerobic training to increase energy expenditure. Measurements were completed over approximately 46\u00a0weeks as follows: before commencing the pre\u2010competition period, including dietary restriction and physical training (pre); after \u223c23\u00a0weeks of dietary restriction and physical training (post); and after \u223c23\u00a0weeks of recovery (recovery). Hormones were analyzed from fasting blood samples, whereas body mass, fat mass, fat\u2010free mass, and body fat percentage were measured using bioimpedance. Our main findings established that after \u223c23\u00a0weeks of LEA, concentrations of estradiol and total testosterone remained stable in the combined HC users but decreased significantly in progestin\u2010only HC users and naturally menstruating females. Serum IGF\u20101, triiodothyronine, and leptin decreased comparably from pre to post in all groups, whereas serum cortisol concentrations remained statistically unchanged throughout the investigation. These results indicate that the exogenous hormones in combined HCs users may maintain already suppressed hypothalamic\u2013pituitary\u2013ovarian axis function in the presence of LEA, whereas LEA\u2010induced changes in IGF\u20101, triiodothyronine, and leptin may be comparable in combined and progestin\u2010only HC users and naturally menstruating females.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      The second study was registered at\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      ID: NCT04392752\n                    <\/jats:p>\n                  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