Andrological aspects of physical exercise and sport medicine

Endocrine

Volumn 42, Issue 2, 2012, Pages 278-284

  Di Luigi, Luigi ^a   Romanelli, Francesco ^b   Sgrò, Paolo ^a   Lenzi, Andrea ^b  

^a UNIVERSITY OF ROME FORO ITALICO   (Italy)

^b SAPIENZA UNIVERSITY OF ROME   (Italy)

Author keywords

Andrology; Exercise; Fertility; Reproduction; Sport; Testosterone

Indexed keywords

ANABOLIC AGENT; CLOMIFENE; GONADOTROPIN DERIVATIVE; LUTEINIZING HORMONE; PHOSPHODIESTERASE V INHIBITOR; PLACEBO; SILDENAFIL; TADALAFIL; TESTOSTERONE;

ANDROLOGY; ATHLETE; AZOOSPERMIA; CRYPTORCHISM; DOPING; ENDURANCE TRAINING; ENERGY METABOLISM; EXERCISE; EXERCISE INTENSITY; HUMAN; HYPOGONADISM; HYPOTHALAMUS HYPOPHYSIS GONAD SYSTEM; MALE GENITAL SYSTEM DISEASE; MALE INFERTILITY; MUSCLE STRENGTH; PHYSICAL ACTIVITY; PHYSICAL EXAMINATION; PRIORITY JOURNAL; REVIEW; SPORT; SPORTS MEDICINE; TESTIS TUMOR; TESTOSTERONE RELEASE; VARICOCELE;

EID: 84867405486     PISSN: 1355008X     EISSN: 15590100     Source Type: Journal    
DOI: 10.1007/s12020-012-9655-6     Document Type: Review

References (100)

1. A.C. Hackney, Stress and the neuroendocrine system: the role of exercise as a stressor and modifier of stress. Expert Rev. Endocrinol. Metab. 1, 783-792 (2006)
2. S. Hasani-Ranjbar, E. Soleymani Far, R. Heshmat, H. Rajabi, H. Kosari, Time course responses of serum GH, insulin, IGF-1, IGFBP1, and IGFBP3 concentrations after heavy resistance exercise in trained and untrained men. Endocrine 41, 144-151 (2012)
3. M. Zitzmann, Effects of testosterone replacement and its pharmacogenetics on physical performance and metabolism. Asian J. Androl. 10, 364-372 (2008)
4. S. Bhasin, L. Woodhouse, R. Casaburi, A.B. Singh, D. Bhasin, N. Berman, X. Chen, K.E. Yarasheski, L. Magliano, C. Dzekov, J. Dzekov, R. Bross, J. Phillips, I. Sinha-Hikim, R. Shen, T.W. Storer, Testosterone dose-response relationships in healthy young men. Am. J. Physiol. Endocrinol. Metab. 281, E1172-E1181 (2001)
5. B.T. Crewther, C. Cook, M. Cardinale, R.P. Weatherby, T. Lowe, Two emerging concepts for elite athletes: the shortterm effects of testosterone and cortisol on the neuromuscular system and the dose-response training role of these endogenous hormones. Sports Med. 41, 103-123 (2011)
6. L. Di Luigi, C. Baldari, M. Gallotta, F. Perroni, F. Romanelli, A. Lenzi, L. Guidetti, Salivary steroids at rest and after a training load in young male athletes: relationship with chronological age and pubertal development. Int. J. Sports Med. 27, 709-717 (2006)
7. G.F. Gonzales, V. Tapia, M. Gasco, J. Rubio, C. Gonzales- Castañeda, High serum zinc and serum testosterone levels were associated with excessive erythrocytosis in men at high altitudes. Endocrine 40, 472-480 (2011)
8. A.M. Isidori, E. Giannetta, E.A. Greco, D. Gianfrilli, V. Bonifacio, A. Isidori, A. Lenzi, A. Fabbri, Effects of testosterone on body composition, bone metabolism and serum lipid profile in middle-aged men: a meta-analysis. Clin. Endocrinol. 63, 280-293 (2005)
9. E. Nieschlag, H.M. Behre, P. Bouchard, J.J. Corrales, T.H. Jones, G.K. Stalla, S.M. Webb, F.C. Wu, Testosterone replacement therapy: current trend and future directions. Hum. Reprod. Update 10, 409-419 (2004)
10. R. Timon, G. Olcina, P. Tomas-Carus, A. Raimundo, J.I. Maynar, M. Maynar, Urinary endogenous steroids and their relationships with BMD and body composition in healthy young males. Endocrine. (2012). doi:10.1007/s12020-012- 9604-4
11. M. Zitzmann, E. Nieschlag, Effects of androgen replacement on metabolism and physical performances in male hypogonadism. J. Endocrinol. Invest. 26, 886-892 (2003)
12. B. Crewther, J. Keogh, J. Cronin, C. Cook, Possible stimuli for strength and power adaptation: acute hormonal responses. Sports Med. 36, 215-238 (2006)
13. F. Derbré, S. Vincent, B. Maitel, C. Jacob, P. Delamarche, A. Delamarche, H. Zouhal, Androgen responses to sprint exercise in young men. Int. J. Sports Med. 31, 291-297 (2010)
14. M.S. Tremblay, J.L. Copeland, W. Van Helder, Influence of exercise duration on post-exercise steroid hormone responses in trained males. Eur. J. Appl. Physiol. 94, 505-513 (2005)
15. W.J. Kraemer, N.A. Ratamess, Hormonal responses and adaptations to resistance exercise and training. Sports Med. 35, 339-361 (2005)
16. J.L. Vingren, W.J. Kraemer, N.A. Ratamess, J.M. Anderson, J.S. Volek, C.M. Maresh, Testosterone physiology in resistance exercise and training: the up-stream regulatory elements. Sports Med. 40, 1037-1053 (2010)
17. V.D. Sherk, K.A. Sherk, S. Kim, K.C. Young, D.A. Bemben, Hormone responses to a continuous bout of rock climbing in men. Eur. J. Appl. Physiol. 111, 687-693 (2011)
18. K. Kuoppasalmi, Plasma testosterone and sex-hormone-binding globulin capacity in physical exercise. Scand. J. Clin. Lab. Invest. 40, 411-418 (1980)
19. J.E. Wilkerson, S.M. Horvath, B. Gutin, Plasma testosterone during treadmill exercise. J. Appl. Physiol. 49, 249-253 (1980)
20. D.C. Cumming, L.A. Brunsting, G. Strich, A.L. Ries, R.W. Rebar, Reproductive hormone increases in response to acute exercise in men. Med. Sci. Sports Exerc. 18, 369-373 (1986)
21. A. Dessypris, K. Kuoppasalmi, H. Adlercreutz, Plasma cortisol, testosterone, androstenedione and luteinizing hormone (LH) in a non-competitive marathon run. J. Steroid Biochem. 7, 33-37 (1976)
22. A.N. Elias, A.F. Wilson, Exercise and gonadal function. Hum. Reprod. 8, 1747-1761 (1993)
23. K. Kuoppasalmi, H. Naveri, S. Rehunen, M. Harkonen, H. Adlercreutz, Effect of strenuous anaerobic running exercise on plasma growth hormone, cortisol, luteinizing hormone, testosterone, androstenedione, estrone and estradiol. J. Steroid Biochem. 7, 823-829 (1976)
24. L. Di Luigi, L. Guidetti, C. Baldari, A. Fabbri, C. Moretti, F. Romanelli, Physical stress and qualitative gonadotropin secretion: LH biological activity at rest and after exercise in trained and untrained men. Int. J. Sports Med. 23, 307-312 (2002)
25. M. Grandys, J. Majerczak, K. Duda, J. Zapart-Bukowska, J. Kulpa, J.A. Zoladz, Endurance training of moderate intensity increases testosterone concentration in young, healthy men. Int. J. Sports Med. 30, 489-495 (2009)
26. J.P. Ahtiainen, J.J. Hulmi, W.J. Kraemer, M. Lehti, K. Nyman, H. Selänne, M. Alen, A. Pakarinen, J. Komulainen, V. Kovanen, A.A. Mero, K. Häkkinen, Heavy resistance exercise training and skeletal muscle androgen receptor expression in younger and older men. Steroids 76, 183-192 (2011)
27. A.C. Hackney, Effects of endurance exercise on the reproductive system of men: the "exercise-hypogonadal male condition". J. Endocrinol. Invest. 31, 932-938 (2008)
28. M.R. Safarinejad, K. Azma, A.A. Kolahi, The effects of intensive, long-term treadmill running on reproductive hormones, hypothalamus-pituitary- testis axis, and semen quality: a randomized controlled study. J. Endocrinol. 200, 259-271 (2009)
29. M. Duclos, Effects of physical training on endocrine functions. Ann. Endocrinol. 62, 19-32 (2001)
30. M. Maynar, R. Timon, A. González, G. Olcina, F. Toribio, J.I. Maynar, M.J. Caballero, SHBG, plasma, and urinary androgens in weight lifters after a strength training. J. Physiol. Biochem. 66, 137-142 (2010)
31. B.C. Nindl, W.J. Kraemer, D.R. Deaver, J.L. Peters, J.O. Marx, J.T. Heckman, J.A. Lumis, LH secretion and testosterone concentrations are blunted after resistance exercise in men. J. Appl. Physiol. 91, 1251-1258 (2001)
32. G.D. Wheeler, S.R. Wall, A.N. Belcastro, D.C. Cumming, Reduced serum testosterone and prolactin levels in male distance runners. JAMA 252, 514-516 (1982)
33. J.C. Arce, M.J. De Souza, L.S. Pescatelo, A.A. Luciano, Subclinical alterations in hormone and semen profile in athletes. Fertil. Steril. 59, 398-404 (1993)
34. M.J. De Souza, J.C. Arce, L.S. Pescatello, H.S. Scherzer, A.A. Luciano, Gonadal hormones and semen quality in male runners. A volume threshold effect of endurance training. Int. J. Sports Med. 15, 383-391 (1994)
35. A. Lucia, J.L. Chicharro, M. Perez, L. Serratosa, F. Bandres, J.C. Legido, Reproductive function in male endurance athletes: sperm analysis and hormonal profile. J. Appl. Physiol. 81, 2627-2636 (1996)
36. A.C. Roberts, R.D. McClure, R.I. Weiner, G.A. Brooks, Overtraining affects male reproductive status. Fertil. Steril. 60, 686-692 (1993)
37. J.W. Ayers, Y. Komesu, T. Romani, R. Ansbacher, Anthropomorphic, hormonal, and psychologic correlates of semen quality in endurance-trained male athletes. Fertil. Steril. 43, 917-921 (1985)
38. C.J. Bagatell, W.J. Bremner, Sperm counts and reproductive hormones in male marathoners and lean controls. Fertil. Steril. 53, 688-692 (1990)
39. M.J. De Souza, B.E. Miller, The effect of endurance training on reproductive function in male runners. A 'volume threshold' hypothesis. Sports Med. 23, 357-374 (1997)
40. D. Vaamonde, M.E. Da Silva-Grigoletto, J.M. García-Manso, R. Vaamonde-Lemos, R.J. Swanson, S.C. Oehninger, Response of semen parameters to three training modalities. Fertil. Steril. 92, 1941-1946 (2009)
41. L.A. Wise, D.W. Cramer, M.D. Hornstein, R.K. Ashby, S.A. Missmer, Physical activity and semen quality among men attending an infertility clinic. Fertil. Steril. 95, 1025-1030 (2011)
42. F. Pelliccione, V. Verratti, A. D'Angeli, A. Micillo, C. Doria, A. Pezzella, G. Iacutone, F. Francavilla, C. Di Giulio, S. Francavilla, Physical exercise at high altitude is associated with a testicular dysfunction leading to reduced sperm concentration but healthy sperm quality. Fertil. Steril. 96, 28-33 (2011)
43. B. Koch, S. Glaser, C. Schaper, A. Krebs, M. Nauck, M. Dorr, R. Haring, H. Volzke, S.B. Felix, R. Ewert, H. Wallaschofski, N. Friedrich, Association between serum testosterone and sex hormone-binding globulin and exercise capacity in men: results of the Study of Health in Pomerania (SHIP). J. Androl. 32, 135-143 (2011)
44. E. Darby, B.D. Anawalt, Male hypogonadism: an update on diagnosis and treatment. Treat. Endocrinol. 4, 293-309 (2005)
45. E. Orwoll, L.C. Lambert, L.M. Marshall, J. Blank, E. Barrett- Connor, J. Cauley, K. Ensrud, S.R. Cummings, Osteoporotic Fractures in Men Study Group. Endogenous testosterone levels, physical performance, and fall risk in older men. Arch. Intern. Med. 166, 2124-2131 (2006)
46. A.D. Seftel, Male hypogonadism. Part I: epidemiology of hypogonadism. Int. J. Impot. Res. 18, 115-120 (2006)
47. L. Di Luigi, P. Sgrò, V. Fierro, S. Bianchini, G. Battistini, V. Magini, E.A. Jannini, A. Lenzi, Prevalence of undiagnosed testosterone deficiency in aging athletes: does exercise training influence the symptoms of male hypogonadism? J. Sex. Med. 7, 2591-2601 (2010)
48. L. Di Luigi, P. Sgrò, F. Romanelli, M. Mazzarino, F. Donati, M.C. Braganò, S. Bianchini, V. Fierro, M. Casasco, F. Botrè, A. Lenzi, Urinary and serum hormones profiles after testosterone enanthate administration in male hypogonadism: concerns on the detection of doping with testosterone in treated hypogonadal athletes. J. Endocrinol. Invest. 32, 445-453 (2009)
49. L. Di Luigi, P. Sgrò, A. Aversa, S. Migliaccio, S. Bianchini, F. Botrè, F. Romanelli, A. Lenzi, Concerns about serum androgens monitoring during testosterone replacement treatments in hypogonadal male athletes: a pilot study. J. Sex. Med. 9, 873-886 (2012)
50. L.J. Gooren, H.M. Behre, Testosterone treatment of hypogonadal men participating in competitive sport. Andrologia 40, 195-199 (2008)
51. J.Y.W. Cheng, E.M.L. Ng, Body mass index, physical activity and erectile dysfunction: an U-shaped relationship from population- based study. Int. J. Obesity 31, 1571-1578 (2007)
52. K. Esposito, F. Giugliano, C. Di Palo, G. Giugliano, R. Marfella, F. D'Andrea, M. D'Armiento, D. Giugliano, Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA 291, 2978-2984 (2004)
53. C. Gazzaruso, S.B. Solerte, A. Pujia, A. Coppola, M. Vezzoli, F. Salvucci, C. Valenti, A. Giustina, A. Garzaniti, Erectile dysfunction as a predictor of cardiovascular events and death in diabetic patients with angiographically proven asymptomatic coronary artery disease: a potential protective role for statins and 5-phosphodiesterase inhibitors. J. Am. Coll. Cardiol. 51, 2040-2044 (2008)
54. C. Gazzaruso, A. Coppola, T. Montalcini, C. Valenti, A. Garzaniti, G. Pelissero, F. Salvucci, P. Gallotti, A. Pujia, C. Falcone, S.B. Solerte, A. Giustina, Erectile dysfunction can improve the effectiveness of the current guidelines for the screening for asymptomatic coronary artery disease in diabetes. Endocrine 40, 273-279 (2011)
55. J.L. Hannan, M.T. Maio, M. Komolova, M.A. Adams, Beneficial impact of exercise and obesity interventions on erectile function and its risk factors. J. Sex. Med. 6(Suppl. 3), 254-261 (2009)
56. K. Horasanli, U. Boylu, M. Kendirci, C. Miroglu, Do lifestyle changes work for improving erectile dysfunction? Asian J. Androl. 10, 28-35 (2008)
57. C.W. Kratzik, J.E. Lackner, I. Märk, E. Rücklinger, J. Schmidbauer, G. Lunglmayr, G. Schatzl, How much physical activity is needed to maintain erectile function? Results of the Androx Vienna Municipality Study. Eur. Urol. 55, 509-516 (2009)
58. S. La Vignera, R. Condorelli, E. Vicari, R. D'Agata, A. Calogero, Aerobic physical activity improves endothelial function in the middle-aged patients with erectile dysfunction. Aging Male 14, 265-272 (2011)
59. D.R. Meldrum, J.C. Gambone, M.A. Morris, K. Esposito, D. Giugliano, L.J. Ignaro, Lifestyle and metabolic approaches to maximizing erectile and vascular health. Int. J. Impot. Res. 24, 61-68 (2012)
60. T.G. Travison, A.B. Araujo, V. Kupelian, A.B. O'Donnell, J.B. McKinlay, The relative contributions of aging, health, and lifestyle factors to serum testosterone decline in men. J. Clin. Endocrinol. Metab. 92, 549-555 (2007)
61. S.T. Skarda, M.R. Burge, Prospective evaluation of risk factors for exercise-induced hypogonadism in male runners. West. J. Med. 169, 9-12 (1998)
62. N.J. Dettori, D.C. Norvell, Non-traumatic bicycle injuries: a review of the literature. Sports Med. 36, 7-18 (2006)
63. I. Goldstein, A.L. Lurie, J.P. Lubisich, Bicycle riding, perineal trauma, and erectile dysfunction: data and solutions. Curr. Urol. Rep. 8, 491-497 (2007)
64. V. Huang, R. Munarriz, I. Goldstein, Bicycle riding and erectile dysfunction: an increase in interest (and concern). J. Sex. Med. 2, 596-604 (2005)
65. L. Di Luigi, A. Casini, F. Romanelli, F. Pigozzi, A. Parisi, I.G. Ricagni, F. Leonelli, G. Fortunio, A. Isidori, Role of sport medicine in andrological prevention. Med. Sport 47, 665-670 (1994)
66. E. Rigano, G. Santoro, P. Impellizzeri, P. Antonuccio, D. Fugazzotto, L. Bitto, C. Romeo, Varicocele and sport in the adolescent age. Preliminary report on the effects of physical training. J. Endocrinol. Invest. 27, 130-132 (2004)
67. A. Scaramuzza, R. Tavana, A. Marchi, Varicocele in young soccer players. Lancet 348, 1180-1181 (1996)
68. L. Di Luigi, V. Gentile, F. Pigozzi, A. Parisi, D. Giannetti, F. Romanelli, Physical activity as a possible aggravating factor for athletes with varicocele: impact on the semen profile. Hum. Reprod. 16, 1180-1184 (2001)
69. N. Zampieri, A. Dall'Agnola, Subclinical varicocele and sports: a longitudinal study. Urology 77, 1199-1202 (2011)
70. L. Di Luigi, F. Romanelli, A. Casini, V. Gentile, A. Parisi, F. Leonelli, I.G. Ricagni, F. Pigozzi, Varicocele and sport: clinical management and sport eligibility in athletes. Med. Sport 48, 313-327 (1995)
71. S. Basaria, Androgen abuse in athletes: detection and consequences. J. Clin. Endocrinol. Metab. 95, 1533-1543 (2010)
72. F. Hartgens, H. Kuipers, Effects of androgenic-anabolic steroids in athletes. Sports Med. 34, 513-554 (2004)
73. L. Di Luigi, F. Romanelli, A. Lenzi, Androgenic-anabolic steroids abuse in males. J. Endocrinol. Invest. 28(3 suppl), 81-84 (2005)
74. D.J. Handelsman, Androgen misuse and abuse. Best Pract. Res. Clin. Endocrinol. Metab. 25, 377-389 (2011)
75. I. Pirola, C. Cappelli, A. Delbarba, T. Scalvini, B. Agosti, D. Assanelli, A. Sonetti, M. Castellano, Anabolic steroids purchased on the internet as a cause of prolonged hypogonadotropic hypogonadism. Fertil. Steril. 94, 2331.e1-2331.e3 (2010)
76. P. Laure, C. Binsinger, Doping prevalence among preadolescent athletes: a 4-year follow-up. Br. J. Sports Med. 41, 660-663 (2007)
77. T.M. Smurawa, J.A. Congeni, Testosterone precursors: use and abuse in pediatric athletes. Pediatr. Clin. North Am. 54, 787-796 (2007)
78. P. Van den Berg, D. Neumark-Sztainer, G. Cafri, M. Wall, Steroid use among adolescents: longitudinal findings from Project EAT. Pediatrics 119, 476-486 (2007)
79. G.L. De Souza, J. Hallak, Anabolic steroids and male infertility: a comprehensive review. B.J.U. Int. 108, 1860-1865 (2011)
80. T. Schürmeyer, U.A. Knuth, L. Belkien, E. Nieschlag, Reversible azoospermia induced by the anabolic steroid 19-nortestosterone. Lancet 8374, 417-420 (1984)
81. J. Torres-Calleja, M. González-Unzaga, R. DeCelis-Carrillo, L. Calzada-Sánchez, N. Pedrón, Effect of androgenic anabolic steroids on sperm quality and serum hormone levels in adult male bodybuilders. Life Sci. 68, 1769-1774 (2001)
82. H. Martikainen, M. Alén, P. Rahkila, R. Vihko, Testicular responsiveness to human chorionic gonadotrophin during transient hypogonadotrophic hypogonadism induced by androgenic/ anabolic steroids in power athletes. J. Steroid Biochem. 25, 109-112 (1986)
83. A. Drakeley, R. Gazvani, I. Lewis-Jones, Duration of azoospermia following anabolic steroids. Fertil. Steril. 81, 226 (2004)
84. J.P. Jarow, L.I. Lipshultz, Anabolic steroid-induced hypogonadotropic hypogonadism. Am. J. Sports Med. 18, 429-431 (1990)
85. P.J. Turek, R.H. Williams, J.H. Gilbaugh 3rd, L.I. Lipshultz, The reversibility of anabolic steroid-induced azoospermia. J. Urol. 153, 1628-1630 (1995)
86. R. Tan, D. Vasudevan, Use of clomiphene citrate to reverse premature andropause secondary to steroid abuse. Fertil. Steril. 79, 203-205 (2003)
87. D.K. Menon, Successful treatment of anabolic steroid-induced azoospermia with human chorionic gonadotropin and human menopausal gonadotropin. Fertil. Steril. 79 (Suppl 3), 1659-1661 (2003)
88. E.A. Bocchi, G. Guimaraes, A. Mocelin, F. Bacal, G. Bellotti, J.F. Ramires, Sildenafil effects on exercise, neurohormonal activation, and erectile dysfunction in congestive heart failure: a double-blind, placebo-controlled, randomized study followed by a prospective treatment for erectile dysfunction. Circulation 106, 1097-1103 (2002)
89. H.A. Ghofrani, R. Voswinckel, F. Reichenberger, H. Olschewski, P. Haredza, B. Karadas, R.T. Schermuly, N. Weissmann, W. Seeger, F. Grimminger, Differences in hemodynamic and oxygenation responses to three different phosphodiesterase-5 inhibitors in patients with pulmonary arterial hypertension: a randomized prospective study. J. Am. Coll. Cardiol. 44, 1488-1496 (2004)
90. H.A. Ghofrani, F. Reichenberger, M.G. Kohstall, E.H. Mrosek, T. Seeger, H. Olschewski, W. Seeger, F. Grimminger, Sildenafil increased exercise capacity during hypoxia at low altitudes and at Mount Everest base camp: a randomized, double-blind, placebo- controlled crossover trial. Ann. Intern. Med. 141, 169-177 (2004)
91. A.R. Hsu, K.E. Barnholt, N.K. Grundmann, J.H. Lin, S.W. McCallum, A.L. Friedlander, Sildenafil improves cardiac output and exercise performance during acute hypoxia, but not normoxia. J. Appl. Physiol. 100, 2031-2040 (2006)
92. J.P. Richalet, P. Gratadour, P. Robach, I. Pham, M. Dechaux, A. Joncquiert-Latarjet, P. Mollard, J. Brugniaux, J. Cornolo, Sildenafil inhibits altitude-induced hypoxemia and pulmonary hypertension. Am. J. Respir. Crit. Care Med. 171, 275-281 (2005)
93. R.A. Kloner, M. Mitchell, J.T. Emmick, Cardiovascular effects of tadalafil. Am. J. Cardiol. 92, 37M-46M (2003)
94. L. Di Luigi, C. Baldari, P. Sgrò, G.P. Emerenziani, M.C. Gallotta, S. Bianchini, F. Romanelli, F. Pigozzi, A. Lenzi, L. Guidetti, The type 5 phosphodiesterase inhibitor tadalafil influences salivary cortisol, testosterone, and dehydroepiandrosterone sulphate responses to maximal exercise in healthy man. J. Clin. Endocrinol. Metab. 93, 3510-3514 (2008)
95. L. Guidetti, G.P. Emerenziani, M.C. Gallotta, F. Pigozzi, L. Di Luigi, C. Baldari, Effect of tadalafil on anaerobic performance indices in healthy athletes. Br. J. Sports Med. 42, 130-133 (2008)
96. L. Di Luigi, P. Sgrò, C. Baldari, M.C. Gallotta, G.P. Emerenziani, C. Crescioli, S. Bianchini, F. Romanelli, A. Lenzi, L. Guidetti, The phosphodiesterases type 5 inhibitor tadalafil reduces the activation of the hypothalamus-pituitary-adrenal axis in men during cycle ergometric exercise. Am. J. Physiol. Endocrinol. Metab. (2012). doi:10.1152/ajpendo.00573.2011
97. S. Sabatini, P. Sgrò, G. Duranti, R. Ceci, L. Di Luigi, Tadalafil alters energy metabolism in C2C12 skeletal muscle cells. Acta Biochim. Pol. 58, 237-241 (2011)
98. D.E. Greydanus, D.R. Patel, E.F. Luckstead, H.D. Pratt, Value of sports pre-participation examination in health care for adolescents. Med. Sci. Monit. 10, RA204-RA214 (2004)
99. L. Di Luigi, A. Pelliccia, A. Bonetti, G. Francavilla, G.P. Ganzit, A. Veicsteinas, D. Accettura, B. Bagnini, R. Cantore, W. Castagna, C. Ciacciarelli, G. Costini, B. Cuffari, E. Drago, V. Federici, C.G. Gribaudo, G. Iacovelli, L. Landolfi, G. Menichetti, U. Olla Atzeni, A. Parisi, A. Pizzi, M. Rosa, F. Santelli, F. Santilio, F. Culasso, Clinical efficacy and preventive role of the pre-partecipation physical examination in Italy: results of a national study on 32,652 athletes examined at the operative units of sports medicine associated with the Italian Federation of Sport Medicine (FMSI). Med. Sport 57, 243-270 (2004)
100. F. Minuto, A. Barreca, G. Melioli, Indirect evidences of hormone abuse. Proof of doping? J. Endocrinol. Invest. 26, 919-923 (2003)