探討女性籃球運動員賽季前及賽季中的能量可用率與訓練負荷對月經週期與睡眠的影響

Abstract

隨著女性參與競技運動日益增加，由低能量可用率與高訓練負荷所引發的內分泌失調、月經異常與睡眠障礙，已成為重要的運動健康議題。然而，相關研究多以短期橫斷設計為主，缺乏對女性運動員在實際賽季中長期追蹤的健康變化進行探討。本研究針對大專女子籃球選手進行為期七個月的連續監測，蒐集能量可用率、訓練負荷與血液生化指標，並透過多元逐步回歸與邏輯回歸分析，探討能量可用率與訓練負荷及其交互作用對內分泌賀爾蒙、月經與睡眠狀況的影響。多元迴歸研究結果顯示，賽季前一週訓練負荷總和可解釋 32.4% 的四碘甲狀腺素濃度變異性 (p = .01); 一週平均能量可用率與一週訓練負荷總和交互作用可解釋 29% 的睪固酮濃度變異性 (p = .02)。賽季中一週平均能量可用率與一週訓練負荷總和的交互作用可預測 25.1%的四碘甲狀腺素濃度變異性 (p = .04)、25.3%的睪固酮濃度變異 (p = .04) 及38.7% 的黃體素濃度變異 (p = .01); 四週訓練負荷總和可預測 47.2% 的四碘甲狀腺素濃度變異性 (p = .003);四週平均能量可用率與四週訓練負荷總和的交互作用可預測34％ 的睪固酮濃度變異性 (p = .02) 及34% 的睪固酮與皮質醇比值變異 (p< .001)。邏輯回歸雖未建立顯著模型，但個案分析發現能量可用率改善與月經週期恢復具有時序對應關係，且有六成選手出現睡眠障礙，顯示需納入更多心理與生活變項以釐清其影響機制。本研究進一步發現，訓練負荷對賀爾蒙的影響並非單一線性關係，而是取決於能量可用率的狀態。在能量可用率高於 30 kcal/kg FFM/day 時，訓練負荷與睪固酮、黃體素等指標呈現穩定且正向的濃度反應。此結果說明能量與訓練負荷間的交互作用，對女性運動員內分泌穩定性與健康風險有關鍵影響，強調整合性監控對女性運動員健康的重要性。As female participation in competitive sports continues to grow, health issues such as endocrine disruption, menstrual irregularities, and sleep disturbances often resulting from low energy availability and high training loads. However, most existing research is limited to short-term cross-sectional designs, lacking longitudinal data during actual competitive seasons. This study conducted seven months of continuous monitoring on collegiate female basketball players, collecting data on energy availability, training load, and blood biochemical markers. Regression results revealed that preseason training load explained 32.4% of the variance in thyroxine (p = .01), and one-week interaction explained 29% of testosterone variance (p = .02). In-season, one-week interactions significantly predicted thyroxine (25.1%, p = .04), testosterone (25.3%, p = .04), and progesterone (38.7%, p = .01). Four-week training load predicted 47.2% of thyroxine variance (p = .003), while four-week interactions explained 34% of the variance in testosterone (p = .02) and testosterone-to-cortisol ratio (p<.001). No significant models emerged from logistic regression, but case analyses suggested that improvements in energy availability were temporally associated with menstrual recovery. Over 60% of athletes experienced sleep disturbances, indicating the need to consider psychosocial factors in future studies. Furthermore, this study found that the effect of training load on hormone levels was not a simple linear relationship but rather depended on the status of energy availability. When energy availability exceeded 30 kcal/kg FFM/day, training load was associated with stable and positive hormonal responses in indicators such as testosterone and progesterone. These findings suggest that the interaction between energy availability and training load plays a key role in hormonal stability and health risks among female athletes, underscoring the importance of integrated monitoring for female athlete health.