Outstanding performances during elite-standard short and middle-distance finals and the hyperandrogenism regulation—A detailed analysis of Caster Semenya’s results

ABSTRACT

Recently, there has been much controversy over the International Association of Athletics Federation (IAAF) regulations regarding eligibility to compete and natural testosterone levels in female athletes. Much interest lies in the analysis of Caster Semenya's extraordinary performance. The objective of this work were, a) Complete an analysis of Caster Semenya's results during the 800m finals and b) search for existing similar performances by other female athletes. We analysed the results of the finals of all IAAF World Championships and Olympic Games from 1984–2016, including the 800m results of the Diamond Leagues 2016–2018. Exponential curves were fit to the data to characterise and predict performance for each event. Caster Semenya's finishing times before her ineligibility to compete and after the suspension of the IAAF hyperandrogenism regulation were found to be 1.24% and 1.49%, respectively, faster than the characteristic performance of the elite-standard in the women’s 800m final. Other female athletes, with finishing times faster than the ones predicted by the characteristic curves were also discovered. The percentage difference in performance between Caster Semenya and the other participants did not reach 3% in the 800m event. No conclusions can be drawn regarding extraordinary results ever performed during the 100m, 200m or 400m finals.     

Hyperandrogenic athletes: performance differences in elite-standard 200m and 800m finals

The purpose of this study was to examine whether the difference in elite-standard track and field performance between women athletes with and without hyperandrogenism reaches the 10–12% difference in performance between men and women, using only results from elite-standard track and field final competitions. Officially available data from two hyperandrogenic women (Caster Semenya and Dutee Chand) were compared with the characteristic performance of 200m and 800m elite-standard finals. The finishing times of Caster Semenya, before her ineligibility to compete in 2009 and after the suspension of the 2011 IAAF Hyperandrogenism Regulations were found to be respectively 1.24% and 1.49% faster than the predicted performance in 800m finals. When compared with the result of the second classified, the difference was respectively 0.65% and 2.08%. The analysis of the finishing times of Dutee Chand did not lead to any conclusions due to the lack of available data. The present study indicates that the percentage difference in performance between women with and women without hyperandrogenism does not reach the 3% difference requested by the Court of Arbitration for Sport for the reinstatement of the Hyperandrogenism Regulations, neither does it reach the 10% accepted range of difference in performance between men and women.     

Reconnoitring the Status of Prostate Specific Antigen and its Role in Women

Prostate specific antigen is considered to be a tumour marker having maximum utility and specificity for prostate cancer since decades. After the discovery of methods to quantify different molecular fractions of prostate specific antigen (PSA), its usefulness in diagnosing early prostate cancer cases has increased tremendously. The “specificity” of PSA, is now challenged by many studies which proved that PSA, once believed to be secreted exclusively by prostatic epithelium, is also present in females. The exact biological role of extraprostatic PSA is still debatable though many theories substantiated by in vitro evidence has been put forward. With the advent of ultrasensitive analytical techniques, PSA is now quantifiable in female serum in its various molecular forms and this has led to many assumptions of it being useful as a marker in female breast cancers. In a similar scenario to prostate cancer, the ratio of free to total PSA is shown to be useful in detecting early breast cancer cases. It is also shown to be a good prognostic indicator and a predictor of response to therapy and recurrence. Apart from its role in breast cancer, it has been advocated to be a marker of hyper androgenic states in women like hirsutism and polycystic ovarian syndrome. Conflicting reports regarding the role of extra prostatic PSA is accumulating but it has been proven beyond doubt that PSA is no longer specific and confined to prostate gland. Various studies have registered that PSA is an ubiquitous molecule, secreted by hormone responsive organs and its synthesis is stimulated by androgens and progesterone but not oestrogens. In this article, a review of various literatures is done about the presence of extra prostatic PSA, its probable role in those sites as well as its utility as a tumour marker in breast cancer.     

Effect of Metformin on Hormonal and Biochemical Profile in PCOS Before and After Therapy

Insulin resistance and the resultant hyperinsulinemia exacerbate the reproductive abnormalities of Polycystic Ovarian Syndrome by increasing ovarian androgen productions and decreasing serum sex hormone binding globulin. The present study was conducted to estimate serum insulin and testosterone level in 44 PCOS cases and 32 control patients. Simultaneously the role of metformin (an insulin sensitizing agent) in modulating insulin resistance and serum androgen level was also analyzed. A significant rise in serum insulin and testosterone (P < 0.001) was observed in cases in comparison to control. Fasting Plasma Glucose to insulin ratio, a marker of insulin resistance revealed a significant fall in PCOS group. Follow up of cases with metformin for 3 months revealed a significant fall in serum insulin (P < 0.05) with improvement in insulin resistance along with a nonsignificant fall in testosterone level. Serum insulin registered a significant positive correlation (P < 0.05) with serum testosterone revealing its etiological association. Thus administration of drugs ameliorating insulin levels is expected to provide new therapeutic modality for PCOS.