{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T19:09:19Z","timestamp":1781291359332,"version":"3.54.1"},"reference-count":121,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Sports Med"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In the female athletic community, there are several endogenous and exogenous variables that influence the status of the hypothalamus-pituitary-ovarian axis and serum sex steroid hormones concentrations (e.\u2009g., 17\u03b2-estradiol, progesterone, androgens) and their effects. Moreover, female athletes with different sex chromosome abnormalities exist (e.\u2009g., 46XX, 46XY, and mosaicism). Due to the high variability of sex steroid hormones serum concentrations and responsiveness, female athletes may have different intra- and inter-individual biological and functional characteristics, health conditions, and sports-related health risks that can influence sports performance and eligibility. Consequently, biological, functional, and\/or sex steroid differences may exist in the same and in between 46XX female athletes (e.\u2009g., ovarian rhythms, treated or untreated hypogonadism and hyperandrogenism), between 46XX and 46XY female athletes (e.\u2009g., treated or untreated hyperandrogenism\/disorders of sexual differentiation), and between transgender women and eugonadal cisgender athletes. From a healthcare perspective, dedicated physicians need awareness, knowledge, and an understanding of sex steroid hormones\u2019 variability and related health concerns in female athletes to support physiologically healthy, safe, fair, and inclusive sports participation. In this narrative overview, we focus on the main clinical relationships between hypothalamus-pituitary-ovarian axis function, endogenous sex steroids and health status, health risks, and sports performance in the heterogeneous female athletic community.<\/jats:p>","DOI":"10.1055\/a-1909-1196","type":"journal-article","created":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T22:51:51Z","timestamp":1664491911000},"page":"81-94","source":"Crossref","is-referenced-by-count":6,"title":["Clinical Concerns on Sex Steroids Variability in Cisgender and Transgender Women Athletes"],"prefix":"10.1055","volume":"44","author":[{"given":"Luigi","family":"Di Luigi","sequence":"additional","affiliation":[{"name":"Department of Movement, Human and Health Sciences, Universit\u00e0 degli Studi di Roma 'Foro Italico', Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela A","family":"Greco","sequence":"additional","affiliation":[{"name":"Department of Movement, Human and Health Sciences, Universit\u00e0 degli Studi di Roma 'Foro Italico', Rome, Italy"},{"name":"Department of Science of Movement, Universit\u00e0 degli Studi Niccol\u00f2 Cusano, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Fossati","sequence":"additional","affiliation":[{"name":"Department of Movement, Human and Health Sciences, Universit\u00e0 degli Studi di Roma 'Foro Italico', Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Aversa","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Sgr\u00f2","sequence":"additional","affiliation":[{"name":"Department of Movement, Human and Health Sciences, Universit\u00e0 degli Studi di Roma 'Foro Italico', Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Antinozzi","sequence":"additional","affiliation":[{"name":"Department of Movement, Human and Health Sciences, Universit\u00e0 degli Studi di Roma 'Foro Italico', Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,9,29]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1136\/bjsports-2018-100054","article-title":"Collider bias (aka sample selection bias) in observational studies: why the effects of hyperandrogenism in elite women's sport are likely underestimated","volume":"54","author":"NT Borgen","year":"2020","journal-title":"Br J Sports Med"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1136\/bjsports-2018-099387","article-title":"A question of \u2019fairness\u2019: why ethics should factor in the court of arbitration for sport\u2019s decision on the IAAF Hyperandrogenism Regulations","volume":"53","author":"S. 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