The Effect of Sex Hormones on Athletic Performance in Female Athletes: Scoping Review

Abstract

ABSTRACT
Female sex hormones influence both reproductive function and physical performance, making recognition of sex‑specific hormonal responses and the potential impact of strenuous exercise on hormonal balance critical for inclusive research and athlete management. The objective of this scoping review was to systematically map and synthesize evidence on the effects of sex hormones on athletic performance in female athletes. Primary research articles in English from 2014 to 2025 were identified from major databases, and then screened for eligibility after duplicate removal. Fifteen studies involving 2,184 participants from various countries were included based on predefined criteria and hand-searching of references. The study found that hormonal contraceptive use consistently reduced epitestosterone levels and affected bone mass, with salivary hormone assessment serving as a practical, non-invasive monitoring method. Additionally, higher endogenous testosterone correlated with improved body composition and performance benefits, though it was not a sole determinant of success in all sports.. In conclusion, these findings underscore the need for individualized hormonal monitoring to optimize performance and manage health risks in female athletes, as contraceptive use modifies hormone levels without necessarily altering the functional role of testosterone. Future research should employ diverse, longitudinal, and regionally inclusive designs to refine understanding of hormone–performance relationships in different athletic and cultural contexts and to further validate salivary hormone monitoring in applied sport settings.