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Abstract
Women’s participation in sports has greatly expanded over the past 25 years. With this has come an increased awareness of new conditions and pathologies unique to this population.
Men and women are different from the physiological point of view, studies done so far have focused on the cerebral cortex differences, which is responsible for the higher intellectual and cognitive functions of the brain, other researchers, have shown that there are gender differences in more primitive parts of the brain, such as the hypothalamus, where most of the basic functions of life are controlled, including hormonal control via the pituitary gland. It is discovered that the volume of a specific nucleus in the hypothalamus (third cell group of the interstitial nuclei of the anterior hypothalamus) is twice large in men as in women.
There are differences too in the psychological aspect. But it is unclear how many of these differences hold true across different cultures. Nevertheless, certain trends tend to be found, as in personality tests, as women score higher in agreeableness, tendency to be compassionate and cooperative and neuroticism, tendency to feel anxiety, anger, and depression.
Researches claims that, in general, men are better at systematizing (the desire to analyze and explore systems and rules) and that women are better at empathizing (the ability to identify with other people’s feelings). Also, males are found better in performance in spatial abilities visual-spatial tasks and in Digit Span Backwards and in reaction time, while females were better on short-term memory recall and Symbol-Digit Modalities Test.
Even the motives in sport participation differ from woman to man, women rated tension release and social factors as top reasons for participation in sport, whereas men rated health and fitness most highly as motives for participation. Authors have suggested that it is possible that the relation between gender and stress may be resulting from women appraise threatening events as more stressful than men. Furthermore, women have been found to have more chronic stress than men and are exposed to more daily stress associated with their routine role functioning.
There is evidence that males are quicker to aggression and more likely than females to express their aggression physically and females are less likely to initiate physical violence, but they can express aggression by using a variety of non-physical means to inflict harm on others.
Moreover, women are more emotionally expressive and responsive, as well as giving more attention to body language and nonverbal communication than men. While men are overwhelmed by women’s expressions of emotion, also they express more anger and can control their feelings.
For most of female athletes, sports participation is a positive experience, providing improved physical fitness and better health and well being. Yet for some, the desire for athletic success combined with the pressure to achieve a prescribed body weight can lead to the development of disorders.
Eating disorders in athletes have become an area of concern in recent years. While more prevalent in female athletes and female sports, at some point in their career, almost all female athletes are concerned about their body weight. However, weight loss and weight gain can be a very crucial and beneficial part of an athletic training program. Losing weight rapidly or maintaining very low body weight may affect both weight regulation and athletic performance.
In addition of the classical types of eating disorders, the concept of Anorexia Athletica (AA) was introduced in the early 1990s because athletes constitute a unique population, and, according to the many factors associated with training, eating pattern, and psychological profile, the symptoms of ED in athletes should be interpreted somewhat differently from that of non-athletes ,
The difference in the symptoms of anorexia athletic is that the loss in body fat mass is based on performance and not on appearance or excessive concern about body shape, also, the degree of body mass loss depends not only on low energy intake but also on the volume and intensity of the training cycle and finally, AA should no longer be detectable after the cessation of an athlete’s career.
Since the participation of women in sports is being widely encouraged, there have been concerns that women involved in a wide range of physical activities may be at risk to develop: a)eating disorders, b)menstrual irregularities and c)osteoporosis what’s termed as ‘the female athlete triad’, each of these conditions alone can result in serious health consequences. However, there are also closely interrelated to each others, which lead to low energy availability which is the key contributing factor to the triad.
In fact, participation in a sport in which aesthetic appearance matters (e.g., gymnastics, ballet, etc.) or a sport in which there is pressure to “make weight” (e.g., wrestling, etc.) is associated with higher rates of disordered eating.
Because of the complexity of issues involved in working with athletes who present with ED, optimal management requires an organized, systematic approach to the development and implementation of interventions specific 1) Nutrition 2) Supplements and medicinal intervention 3)Mental health 4)Psychological 5)Exercise interventions.
Performance-enhancer abuse is growing rapidly among young women , the explosion of professional female sports is giving young women of all ages more opportunity to compete at higher levels, this increased opportunity is leading to greater pressure to win, which may be contributing to performance-enhancer usage among female athletes as young as 12 years of age.
Because of the growing number of young women using performance-enhancers, it is important for health educators to understand what these substances are, how they work, the potential side effects, and the factors contributing to usage among this population. The most common substances seen in professional, Olympic, and collegiate athletes are alcohol, tobacco, stimulants, and steroids.
Alcohol adversely impacts athletic performance in a number of different ways. Researchers have shown that alcohol consumption in the 24 hours before athletic activity significantly reduces aerobic performance, by about 11.4%
Moreover, the adverse effects of regular amphetamine and other sympathomimetic stimulant use are quite relevant to athletic performance. The most common are insomnia, irritability, weight loss, substance-induced panic attacks or generalized anxiety.
Researches revealed that 23% of steroids users reported major mood syndromes, 12% with psychotic symptoms and 8% with drug dependence. As regard female users there are specific adverse effects such as reduction in breast tissue sensitivity, clitoral enlargement and sensitivity, increased muscle vascularity, altered thyroid function tests, reduced inhibitions for risky behaviors, increased libido and orgasmic response. Moreover, it cause disturbance in sleep cycles, increased appetite, as well as menstrual disturbances and deepening tone of the voice.
In addition, professional athletes are using the Spit tobacco, primarily as moist snuff, with prevalence rates of 35% to 40%, the reasons of using includes pregame and postgame relaxation and improve performance. Spit tobacco users can develop many adverse health effects, including oral cancer, oral leukoplakia, caries, hypertension, cardiovascular disease, sexual impotence, gastric ulcers, anxiety, insomnia, and nicotine addiction.
Management of performance-enhancers includes early detection through physical examination, mental state examination and laboratory investigations. The goals of treatment are to alleviate distressing withdrawal symptoms and prevent complica¬tions, to facilitate and initiate abstinence, to prevent relapse to further use of these drugs and to restore the functioning of the hypothalamic-pltuitary-gonadal (HPG) axis.
These goals could be achieved through the use of pharmacotherapy, supportive psychotherapy, as well as psycho education and finally harm reduction.
Furthermore, in many sports athletes are expected to deliver perfect performance outcomes, perfectionism in athletes has been shown to be related to characteristics that may undermine performance, particularly competitive anxiety.
High stress levels and excessive anxiety are associated with many unfavorable outcomes, athletes are perhaps most concerned that anxiety results in poor performance, and this issue is strongly represented in the sport psychology literature. Researchers found that athletes frequently experiencing anxiety that interfered with sport performance.
The anxiety-performance relationship may be different for different sports, the negative impact of anxiety may be most likely seen in sports that require high levels concentration and fine motor coordination, such as gymnastics, diving, etc. A certain level of anxiety may benefit field hockey players, whereas the same degree of anxiety could be detrimental to a swimmer’s performance.
There are different psychological interventions to reduce anxiety which include Cognitive Approaches, Progressive Muscle Relaxation (PMR), Cue-Controlled Relaxation (CCR).
Other common morbidity is depression which is approximately twice more common in women than it is in men but there are high risk causes of depression in athletes, the first is Concussion, which account for as many as 90% of all cases of head injury, after a cerebral concussion, individuals often report a cluster of symptoms referred to as post concussive symptoms (PCS). The psychiatric issue is particularly relevant in sport concussion because symptoms of depression in athletes with concussion have often been attributed to the loss of position on the team, lack of teammate support, poorly defined timeline to recovery, and the fact that this injury, being “invisible,” raises issues of treatment compliance or malingering.
The second cause is linking and competition, if the athlete believes that happiness and wellbeing are conditional upon goal achievement, any thoughts of goal pursuit will be accompanied by a belief that the individual is not yet happy or content. This negative self-focus can be described as rumination, an increase in rumination is in turn likely to cause an increase in depression levels.
Finally, the retirement problems are revealed. Many athletes train for years, reach the apex of their careers and then crash, after the peak of competition is over and the highs of winning, commercial endorsements, sponsors and the excitement dies down, depression then sets in. The athlete is left with a feeling of loss, loss of purpose, asking oneself silently ”Now what do I do?”
The management of depression includes, psychotherapy, pharmacotherapy and alternative treatment may be used, it includes meditation, relaxation, herbal agents, etc.
Athletes also, experience Jet lag which is a direct result of humankind’s ability to traverse numerous time zones in a short period of time, in addition to nocturnal sleep disturbances and impaired daytime alertness.
Acute physical exercise results in a transient reduction of sleepiness that depends on the intensity and the time of day at which the exercise is performed.
Overtraining syndrome frequently occurs in athletes who are training for competition or a specific event and train beyond the body’s ability to recover. Athletes often exercise longer and harder so they can improve, but without adequate rest and recovery, these training regimens can backfire, and actually decrease performance. Nevertheless, the responses of athletes to overtraining have essentially been measured from 2 categories of symptoms: physiological as decrease immune response and cortisol level and psychological which includes negative feelings like decreased interest in training and competition and frustration.
Many athletes engage in what is called compulsive exercise, they do so to feel more in control of their lives, and the majority of them are female, they often define their self-worth through their athletic performance and try to deal with emotions like anger or depression by pushing their bodies to the limit, in sticking to a rigorous workout schedule, they seek a sense of power to help them cope with low self-esteem. Experts say that repeatedly exercising beyond the requirements for good health is an indicator of compulsive behavior.
Furthermore, it is found that narcissism develops to over as a response evaluation, a player’s ego may be boosted by the celebrity and publicity, other players show signs of borderline personality disorder with a pattern of unstable interpersonal relations, are impulsive and self-destructive, are affectively unstable.
So, we recommend further attention from psychiatrist on the female athletes to provide for them better performance and better life style