Hormones for sports performance

Have you ever wondered how your sex hormones (like testosterone) affect your athletic performance? While they aren’t going to give you superhuman powers, learning how to harness the power of your hormones (and monthly cycle) can help you optimise your sports performance, train more efficiently, and spot early signs of overtraining. 

Watch part one of Dr Dan’s video to find out how your hormones can help you optimise your sports performance and part two to find out which hormones can indicate you are overtraining.

In this blog, we look at: 

• How hormones can help optimise your sports performance  
• Testosterone and sports performance 
• Female athletes and hormones 
• Alarm bells for hormones and sports  
• The importance of monitoring your testosterone to cortisol ratio 

How hormones can help optimise your sports performance

In many ways, sports research is a frustratingly stifled discipline, and much of the top-level information is still under lock and key (partly because gold medals depend on it).  

Hormones are responsible for so many functions, from growth to metabolism. They can affect your mood, general well-being, and (you guessed it) your training. Our hormone levels change throughout various stages of our lives and can even be disrupted by our behaviour.  

Depending on your sport, athletes tend to test either pre- or post-event - or sometimes both. Why? Because monitoring certain hormone biomarkers can help to maximum preparation for (and recovery from) the competition. 

If you’re into sports (but are new to blood testing), we recommend our Ultimate Performance Blood Test. This test covers everything from the basics to a deep dive into hormones, nutrition, inflammation, and muscle health.  

Testosterone and sports performance

It’s a myth that you need higher testosterone levels for peak performance. Instead, you need the right amount for you – and that often depends on your muscle mass, genetics, and blood volume.  

So, while it is a common misconception that testosterone will give you some sort of superhuman sports power, it does have a role to play in controlling your bone mass, fat distribution, muscle mass, and strength. And although testosterone is primarily linked with men, it’s important for women too.  

Low or noticeably declining testosterone levels, along with symptoms of low testosterone, though, could be cause for further investigation. 

So how do you know if you have low testosterone? An early morning blood test can give a good idea of testosterone levels. And if your results are towards the low end of the normal range, you may benefit from boosting your testosterone levels naturally. 

Natural ways to boost your testosterone  

Testosterone replacement therapy (TRT) is needed for some people with testosterone deficiency. However, there are natural ways you can increase your testosterone levels if they are low.  

Natural ways to increase testosterone: 

• Being a healthy weight (losing weight if you need to) 
• Sleeping well 
• Reducing stress 
• Eating a healthy balanced diet 
• Stopping smoking  
• Limiting alcohol  
• Getting more regular exercise (or reduce exercise if you are going flat out every day) 

You can find more information on testosterone and natural boosters in our blog: what is testosterone and how can you boost your levels? 

Female athletes and hormones

We’re beginning to learn that women may perform differently at different points in their menstrual cycle. This probably won’t help you in a competition on a particular date but may help you keep your motivation up when it might have fallen because you know that the way you feel is normal and possibly even expected. 

However, the current advice and research that’s available are mixed (to say the least). This makes it quite difficult to give very general advice as each woman is unique (as so are her hormones). Not everyone has a regular 28-day cycle and people have different sporting goals and routines. And that’s before we get into the multiple factors that can affect performance aside from your period - training load, injuries, and nutrition.  

Having said that, there are a few general patterns that may help you explain the natural peaks and troughs in your performance every month. This (of course) is only a guide but use the below information to learn more about how hormones can affect your energy and motivation. But know that you may find this pattern doesn’t apply to you, and that’s completely normal.   

How periods affect sports performance

It goes without saying that during your period, you may have negative side effects that result in poor performance or simply not being able to train as you usually do.  

Most athletes note that cramps, headaches, and bloating can all be detrimental to competitiveness. Plus, if you have very heavy periods, you may lose blood and iron, impacting you more long-term.  

How to train with your cycle 

1. The early follicular phase (day one – five) -  At this time, oestrogen and progesterone are low. It is not uncommon for you to experience symptoms such as painful cramping and tiredness during this phase. Regular physical activity (such as stretching) can be beneficial for menstrual symptoms [2], so you don’t need to stop your routine. You could try doing more yoga or Pilates during this phase.  

2. Late follicular phase (day six – 14) - As you begin to experience a slow rise in oestrogen, you’re likely to have more energy and feel more motivated. You may feel like picking up your exercise pace or intensity (think HIIT). Around day 12 or 13, oestrogen is at its highest (during ovulation), making it the ideal time for strength and resistance exercises (like lifting weights). Make sure you always warm up (and down). Some research has found that high oestrogen levels are associated with increased injury risk (such as to ligaments). 
3. Luteal phase (day 14-28) - During this stage, your body will produce high amounts of progesterone (which can improve sleep quality – essential for repairing your body). However, you could also feel more fatigued and have a lower mood during this stage. Try to keep your routine enjoyable and use exercise to lift your mood. Finally, your energy requirements increase during this phase, so remember to fuel your body right.  

For more on this, have a look at our blog: can my menstrual cycle benefit my performance? 

If you are wondering whether your hormonal contraceptives are affecting your sports performance, then you are not alone. Research is still ongoing, but most indicate that if there is a drop, it is minimal [3]. 

Alarm bells for hormones and sports

To train at your peak, your energy intake needs to match and sustain the energy it takes for you to train and compete. If there is a mismatch between the energy going in and the energy going out, you can head into a condition known as RED-S (relative energy deficiency in sport).  

If your RED-S gap lengthens, eventually, your body cannot compensate, and performance and recovery fall away. If you realise this is happening early on, you can reduce your workload and recover. But if you do not realise this is happening (or choose to carry on regardless) it can take weeks or even months to get back to normal. 

As well as looking at your nutrient levels (including vitamins and minerals) and oxygen-carrying capacity (iron and red cells), a blood test, such as our Ultimate Performance Blood Test, can also measure relevant hormones and inflammation that could indicate RED-S. Remember, if you’ve noticed a drop-off in performance, tell our doctors so that they can look at your result with this in mind. 

Testosterone and cortisol

Cortisol is a stress hormone and is catabolic, which means it breaks things down (as opposed to testosterone, which is anabolic and builds things up). By looking at the testosterone: cortisol ratio (T: C ratio) in men, we can spot signs of overtraining (if the ratio decreases over time). 

It is harder to spot a relevant change in the T: C ratio in women because testosterone levels are lower to start with. Instead, the bigger picture becomes useful.  

You can read more about the T: C ratio in our blog.

The female athlete triad 

One part of RED-S is called the female athlete triad. This shows that low energy availability (e.g. calorie restriction), low bone mineral density, and menstrual disturbance can all contribute to poor performance individually – and even more so when combined.  

Some athletes, especially those with little body fat or those cutting down on weight (e.g. boxers, ballet dancers, rowers, gymnasts, and bodybuilders), may not take in enough calories for their exertions.  

Not taking in enough calories can cause low oestrogen levels, which can lead to: 

• Periods stopping 
• Weak bones  
• Muscle aches 
• Weakness 
• Poor recovery  
• Fractures 

Low oestrogen and nutrient levels in your blood could indicate that you are overdoing it. If our doctors suspect something like RED-S, they will advise you on how to rest, recover, and return to play. 

You can read more in our blog about sex in sport – the impact of the female body on performance.  

Can hormones affect sports performance? 

Looking at your hormones is a great way to optimise for sport and to spot potential issues early. But of course, there’s no silver bullet when it comes to peak performance. It’s a combination of training, nutrition, rest, and well-being. 

If you are interested in hormones for sports performance, a blood test can help you identify what’s normal for you and track changes over time. It can also help identify any areas you are high or low in. You'll find more about the benefits of this in our Sports Performance guide. 

Finally, you may be curious about steroids or performance-enhancing drugs. Steroids are never safe, but we recognise that many gym goers and people interested in sports may want to learn more about them. We cover how steroids work in our blog: the effect of steroids on the body.

---

References 

1. The menstrual cycle and female athletic performance. Ihalainen, J. Mid Sweden University. 2019.  https://www.miun.se/en/Research/research-centers/swsrc/news/2019-2/the-menstrual-cycle-and-female-athletic-performance/ 
2. IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update. Mountjoy, M. 2018  https://bjsm.bmj.com/content/52/11/687 
3. Elliott-Sale, K., McNulty, K., Ansdell, P., Goodall, S., Hicks, K., Thomas, K., Swinton, P. and Dolan, E., 2020. The Effects of Oral Contraceptives on Exercise Performance in Women: A Systematic Review and Meta-analysis. Sports Medicine, 50(10), pp.1785-1812.