女性训练、荷尔蒙与营养：事实与虚构 | 劳伦·科伦索-森普尔博士

因为摘除了卵巢，大鼠维持肌肉质量的能力受到了影响。

Because you remove the ovaries and the rodent's ability to maintain muscle mass seems impaired.

是的。

Yeah.

就像我们之前说的，激素缺失会导致卫星细胞池减少，现在我们又说激素缺失会导致肌肉流失。

So just like we said, okay, absence of hormone means downregulation of satellite cell pool, now we're saying absence of hormone means loss of muscle.

那是不是意味着补充激素就能促进肌肉增长？

Does that mean presence of hormone means muscle growth?

当然不是。

Of course not.

不是。

No.

所以我们这里又做了个很大的推论。

So again, we're taking a big leap here.

但我觉得理解这个推论的来源很重要，因为它引出一个有趣的问题，尤其是在肌肉流失和激素治疗的背景下，这比周期性波动或急性变化更值得关注。

But I think it's important to understand sort of where it comes from because it does generate an interesting question, especially in the context of muscle loss and hormone therapy, I think more so than cycle sinking or acute fluctuations.

但这个情况更接近更年期和激素替代疗法的模型，而不是单纯的雌激素存在或性别差异这类广义概念。

But I think it's closer to the model of menopause and hormone therapy than it is to just presence of estrogen or sex differences more broadly.

但我们用的是一个非常简单的模型——啮齿动物，而啮齿动物根本就没有月经周期。

But we're taking a very simple model that is a a rodent, and rodents don't even have a a menstrual cycle.

不过

But

那也不是发情周期。

That's not estrous.

而我们却把它简化成了雌激素。

And we're we're making it estrogen.

对。

Yeah.

但当你切除卵巢时，实际上是在关闭所有激素的分泌。

But when you remove the ovaries, you're shutting down all hormone production.

你不能把问题单纯归结为雌激素本身，因为这些激素在生理上是协同作用的。

You can't pinpoint to estrogen in and of itself because these hormones work together in concert physiologically.

但问题的根源就在这儿。

But that's where it comes from.

现在我们有了数据，对比了男性和女性在蛋白质合成上的差异，因为之前确实有这种说法。

And now we have data looking at protein synthesis differences in men and women because that was another theory that was out there.

有人猜测，雌激素可能会影响蛋白质合成，可能会影响肌球蛋白的功能，也可能会影响卫星细胞的数量。

Maybe there are that estrogen would affect protein synthesis somehow, that estrogen would affect myosin function somehow, that estrogen would affect the satellite cell pool.

但别忘了，我们原本想研究的是那些特定的通路或机制，虽然有意思，但现在得把这些发现推广到更复杂、更动态的人体生理系统中。

But remember, we're trying to look at these really targeted pathways or mechanisms that are interesting, but now we have to extrapolate that to a human model, much more complex model, much more dynamic physiology.

通常当我们改变某一个因素时，其他很多方面也会随之发生变化。

And often when we look at changing one thing, then there's a downstream change of many other things.

所以，很少会出现我们调整了A，就直接导致B发生，中间没有任何中间环节的情况。

And so it's so rare that this we adjust this and therefore that happens and there's no intermediary.

我知道这对很多人来说特别让人沮丧，因为我们总希望有个简单的因果关系：如果这样，那就那样，然后我就能这么解决。

And I know it's really frustrating for people because we want that simple if this, then that, and therefore I can address it this way.

但现实往往没那么简单。

And, you know, it often doesn't pan out that way.

这种情况我们一再看到，尤其是在研究机制问题和大鼠实验时，我们总想深入某一条通路或某个触发因素，看它如何产生影响或阻断作用。

And we've seen this time and time again, especially when we look at mechanistic stuff and rodent stuff, and we really try to drill down into one pathway or one trigger that is going to interfere or block or extrapolate from there.

这种结果在人体中没重现，并不是什么坏事，关键是我们得坦诚说明数据的来源。

So it's not a bad thing that this doesn't necessarily pan out in humans, but we just need to be honest about where we're getting our data.

我们有没有在合适的模型中重复实验，或者至少适当地探讨了这个问题？

And did we replicate it or at least explore the question appropriately in an appropriate model.

这不仅适用于从大鼠到人类的转化过程。

And that's true not only when we go from rodent to human.

从短期反应到长期适应的变化也是如此。

It's also true when we go from acute to long term adaptation.

我就想到一些例子，比如运动时急性脂肪氧化的研究。

I can think of examples of looking at acute fat oxidation during exercise.

空腹有氧就是一个很好的例子。

Fasted cardio is a great example of that.

人们以为，脂肪氧化多了，效果就更好。

People thought, Oh, more fat oxidation.

如果我长期这么做，就能长期减掉更多脂肪。

If I do this long term, I will lose more fat long term.

其实并不是这样。

It isn't so.

你的研究领域，还有这几年你一直在做的工作，蛋白质合成就是个很好的例子。

I mean, is your area specifically of research and what you've been doing the last several years, protein synthesis is the best example.

就算某种干预措施能提升蛋白质合成，也不代表就能带来长期的肌肉增长。

So just because an intervention elevates protein synthesis, it doesn't necessarily promise long term muscle growth.

当然，这两者关系很密切。

Highly related, of course.

但如果你去看相关研究，比如说具体的数据。

But if you look at the research there, let's say for example, numbers.

如果你吃某种补充剂、做某种训练，或者其他方法，发现肌肉蛋白合成提高了40%，这并不意味着八周或十周后你的肌肉会大上40%。

If you were to do something, take a supplement, do a type of training or anything else, and you saw muscle protein synthesis increase by 40%, That does not mean you'll have 40% bigger muscles in eight weeks or ten weeks or anything.

实际上，能增长2%到3%就不错了，甚至可能连这点都达不到，对吧？

In fact, it probably means you'll have two or 3% growth, if any, right?

所以它们关系密切，但并不是一一对应的，对吧？

So they are highly related and connected, but they are not exact one to one exchanges, right?

回到你的雌激素模型，切除卵巢导致雌激素归零，和绝经时的情况并不一样。

So going back to your estrogen model, cutting out an ovary going to zero is not the same thing that you experience through menopause.

这和你月经周期不同阶段经历的变化也不一样，哪怕那些变化本身是正常的。

It's not the same thing you experience in different phases of your cycle, if that's even normal.

我想再回头看看我们真正清楚的那些差异，以及如何识别它们，不过我得先接一下你刚才提到的内分泌学话题。

So I wanna go back to these kind of top end what differences we actually know, how to identify these things, but I have to take the bait here a little bit for some endocrinology.

我想深入聊一聊，因为这真的特别有意思。

So I want to go deep into this because it's just really interesting.

如果你不介意的话，能不能简单给我们讲讲，正常月经周期中雌激素、孕激素和睾酮是怎么变化的？

So if you wouldn't mind, would you share with us a really quick overview of the normal estrogen, progesterone, testosterone flow throughout the menstrual cycle?

顺便也帮我理清楚，这些激素在男性和女性体内的功能有什么不同。

And then also help me understand the functional role of these things in men versus women.

你刚才提到，我们对睾酮的作用其实已经了解得很多了。

You started off earlier by saying like, we know a ton about testosterone in the role.

所以从最宏观的角度来说，你先做个概括吧。

So at kind of the highest level, I'll let you generalize.

细节和限制我来补充。

I'll do the caveats for you.

那睾酮在男性和女性体内的作用分别是什么？

But what is the role of testosterone in men versus women?

再来说说，按照教科书的说法，激素在月经周期中是怎么变化的？

And then, again, how do the hormones change throughout the cycle as a textbook?

教科书上是怎么写的？

What would the textbook say?

然后我们再来看实际情况。

And then we'll get into reality.

你先给我们讲讲，理论上应该是什么样的。

So start us off with what's generally supposed to happen.

这些都属于生殖激素。

So these are all reproductive hormones.

它们的主要功能是支持生殖系统。

So their primary role is for reproductive function.

但这些激素只要作用于有相应受体的组织，就会产生影响，而这类组织其实很多。

But these hormones can act on any tissues that have those receptors, of which there are many.

对于男性来说，睾酮影响最显著的时期是青春期。

When we look at testosterone in men, the most impactful time is puberty.

睾酮水平上升时，男性会出现第二性征，肌肉质量也会明显增加。

And the increase in testosterone, you get your secondary sex characteristics and you also have an increase in muscle mass.

如果比较一名没有训练过的成年男性和一名没有训练过的成年女性，在一次即时力量测试中，男性的肌肉量和力量平均来说都会更高。

So if we have an untrained adult man and an untrained adult woman, the man on average will have more muscle and more muscle strength if you do an acute strength test.

当我们说相对增长幅度相似时，绝对数值上依然存在差距，因为起点不同，这种差异很大程度上源于青春期睾酮带来的基础差异。

So when we talk about relative growth being similar, at the absolute level, there will still be that difference because the starting point is different and we can attribute those testosterone effects from puberty to that baseline difference.

女性体内的睾酮也会有昼夜波动，但总体水平始终非常低。

Testosterone in women, there are some diurnal fluctuations, but we're talking about levels that are extremely low always.

你能给个具体数值，让我更好理解吗？

Could you give me numbers to put context here?

男性和女性，只是随机比较吗？

Male versus female, just randomly?

大概是平均值。

Rough average.

差距至少有十五倍之多。

We're talking a minimum 15 fold difference.

这些波动的浓度非常非常低。

So these fluctuations are tiny of tiny concentrations.

在女性身上。

In women.

非常小。

It's very small.

对。

Yes.

当我们整体来看女性体内的性激素时，主要指的是雌激素、孕激素，还有促黄体生成素一定程度上。

So when we look at sex hormones broadly in women, we're looking at estrogen, progesterone, luteinizing hormone to some extent.

所以月经周期刚开始的时候，这些激素水平都很低。

And so at the beginning of the menstrual cycle, all of these hormones are low.

我得打断一下。

I gotta stop you right there.

大多数人根本不知道月经周期开始指的是什么。

Most people are not going to even know what the beginning of the menstrual cycle means.

其实我不只是说男性，女性也经常搞不清楚。

Specific In fact, I'm not even saying men because we get this a lot from women.

月经周期正式是从哪一天算起的？

What is officially the start of the cycle?

是出血的第一天吗？

Is that your first day of bleeding?

是排卵那天吗？

Is it ovulation?

到底哪一天才算第一天？

What is considered day one?

那你可以继续往下说。

And then you can keep going.

第一天就是出血的第一天。

Day one is the first day of bleeding.

也就是你的经期。

So that's your period.

有些人会把整个月经周期叫做经期。

And some people will refer to the menstrual cycle as their period.

月经周期是从一次经期的第一天，到下一次经期的第一天之间的整个过程。

The menstrual cycle is the whole thing from day one of your period to day one of your next period.

谢谢你的解释。

Thank you.

这种混淆太常见了。

It's extremely common confusion there.

是的。

Yeah.

继续往下说。

So keep going.

第一天就是。

So day one

你的月经，第一天。

So your menstruation, day one.

第一天来月经，这就是第一天。

Day one, you get your period, that's the first day.

这时候体内的激素水平都很低。

And all of the hormones are low.

但雌二醇会在这个阶段逐渐上升。

But estradiol starts to increase throughout this first phase.

当我们谈论月经周期的阶段时，其实可以分成更多阶段。

So when we talk about menstrual phases, we can divide it up into more than two.

但为了简便起见，我们还是先保持

But let's, for the sake of simplicity, we'll keep it

到第二天。

at two.

我们先从简单的说起。

Let's start with the simple.

好的。

Okay.

在教科书里的标准月经周期里，比如说28天，排卵发生在中间，把周期分成两个阶段：卵泡期和黄体期。

So in a textbook menstrual cycle, let's say it's twenty eight days and ovulation is in the middle and divides the cycle into two phases, the follicular phase and the luteal phase.

周期开始，也就是出血的第一天，所有激素水平都很低。

So the beginning of the cycle, day one of bleeding, all the hormones are low.

雌二醇开始上升，并在排卵前达到峰值。

Estrodiol starts to increase and then peaks just before ovulation.

排卵，也就是周期的中期，特点是黄体生成素突然激增。

Ovulation, so now we're mid cycle, is characterized by this spike in luteinizing hormone.

这个过程持续时间很短。

This is short.

这可能持续几个小时，也可能是一天或两天。

This can be a few hours, maybe a day, maybe two days.

这样一来，卵泡期就结束了，进入黄体期。

And that ends the follicular phase, and now we're into the luteal phase.

在黄体期，雌二醇会再次出现一个中等程度的高峰。

During the luteal phase, we have a secondary peak in estradiol that is moderate.

如果我们说第一次高峰出现在排卵前，达到最高点，那就是卵泡期后期。

So if we say our first peak is as high as it's going to get right before ovulation, so that's late follicular phase.

到了黄体期中期，会出现第二次中等高峰，同时孕酮也开始上升，并在黄体期中期达到峰值，之后两种激素逐渐下降，新一轮周期就此开始。

Now we have this secondary moderate peak in the middle of the luteal phase coupled with an increase in progesterone that peaks mid luteal phase, and then both hormones begin to decline and we start the cycle again.

是的。

Yeah.

为什么孕酮要在那个时候达到峰值？

What's the point of progesterone peaking at that time?

雌激素为什么会有这种起伏变化？

And what's the point of estrogen having that bicycle or rotation?

所有这些变化都是为了排卵和受精卵着床做准备，这都是生殖系统的功能。

So all of this is preparing for the release of an egg and implantation, and this is all reproductive function.

这个周期是卵巢周期，我们的身体在为怀孕做准备。

So this cycle is the ovarian cycle, and we are preparing for pregnancy.

我们排卵，然后可能着床，也可能不着床。

We are ovulating and then hopefully implanting or not.

如果卵子受精了，身体就会启动另一整套激素反应。

And then if the egg is fertilized, then we experience a whole other set of downstream hormone effects.

如果没有，子宫内膜就会脱落，然后一切重新开始。

Otherwise, we shed the lining and rinse and repeat.

对。

Yeah.

孕激素，对吧？

Progestation, right?

说的是孕酮。

That's progesterone.

我们的目标是促进妊娠。

We're trying to promote gestation is the idea.

睾酮在整个周期中起什么作用？

What's the role of testosterone across the month?

睾酮在一天之内的短期作用其实不大。

The role of testosterone acutely throughout the day, really not doing anything.

但它有助于排卵。

But it's supporting the release of the egg.

而且在排卵后也支持生育功能。

And it's supporting the fertility functions post ovulation.

所以，根据测量方式的不同，你可能会发现睾酮水平在黄体期会稍微高一点。

So you'll see, maybe depending on how we're measuring it, some phase based differences in testosterone where it would be slightly higher in the luteal phase.

还是为了支持——如你所说——妊娠。

Again, trying to support, as you say, you know, the gestation.

对。

Yeah.

所以你会看到，成年后睾酮水平会随着年龄增长逐渐下降。

That is why you'll start to see decline in testosterone levels throughout the adult lifespan.

我们是从一个较低的水平，降到更低。

Again, we're going from a low to a lower.

是的。

Yeah.

但在成年女性身上，睾酮水平最高的时期通常在18到25岁之间，之后每十年都会有所下降。

But in adult women, your highest testosterone will be, you know, in the 18 25, and then it will decrease sort of in each decade of life.

随着年龄增长，睾酮水平下降，这么说公平吗：对男性的影响比对女性更大？

And that drop of testosterone through age is Is it fair to say that's probably more impactful for men than it is for women?

男女都会经历明显的下降。

So they're both going to see so much of a drop.

但如果男性在十年内睾酮下降25%到50%，女性也出现同样的降幅，除了性欲这类因素外，男性在症状上会不会比女性更明显？

But if you were to have a 25 or 50% drop over a decade in a male and you have that in a female, is it fair or not fair to say it's symptomology wise, the man would probably feel that difference more than the female outside of libido and things like that.

我这么说对吗？

Or am I wrong in suggesting that?

是的。

Yeah.

当然了。

I mean, absolutely.

也正因如此，我们根本没有证据表明女性体内那种所谓正常范围内的睾酮水平会影响运动表现，因为它们本身就非常低。

And that's also why we really don't have any evidence to suggest that testosterone levels, you know, in that kind of, quote, normal range in women have anything to do with exercise performance because they are so low.

它们主要只是支持生殖功能。

They are just supporting reproductive function.

关于更年期使用睾酮疗法，确实有一些讨论。

And there's some chatter about testosterone therapy for menopause.

但睾酮水平在更年期过渡期间并不会真正下降。

But testosterone doesn't actually decrease during the menopause transition.

我们谈论的只是随着年龄增长而出现的轻微整体下降。

So we're talking about just overall age related decline at a small level.

是的，某些情况下它被批准用于治疗性欲低下，但也就仅限于此了。

And yes, it is approved under certain circumstances for low libido, but that's really it.

所以对于女性来说，睾酮对肌肉增长或维持的作用几乎可以忽略不计，除非我们讨论的是超生理剂量的睾酮。

And so the contribution of testosterone to muscle growth or muscle maintenance with age is really a non factor in women, unless, of course, we talk about testosterone at super physiological levels.

对，没错。

Yeah, of course.

一旦你用到药理剂量，一切就都不一样了。

You're you're going at dosages, pharmacologically, everything changes.

我们通常会避免使用，因为副作用实在太多。

Which we would tend to avoid because of the plethora of unwanted side effects.

本期节目由David赞助。

Today's episode is sponsored by David.

David做的蛋白棒，我以前从没吃过这样的。

David makes protein bars unlike any I have ever encountered.

每根含有28克蛋白质，只有150卡路里，糖分却是零。

They have an amazing 28 grams of protein, only 150 calories and zero grams of sugar.

没错。

That's right.

28克蛋白质，其中75%的热量都来自蛋白质。

28 grams of protein and 75% of its calories come from that protein.

这比市面上第二高的蛋白棒还要高出50%。

This is 50% higher than the next closest protein bar.

说实话，这是我这辈子吃过最好吃的蛋白棒，完全没得比。

Honestly, it's the best tasting bar I've ever had in my life by a mile.

他们最新推出的David Braun蛋白棒，味道也一样惊艳。

And their newest bar, the David Braun's bar tastes incredible as well.

我经常提到，为了维持肌肉健康、促进恢复和保持瘦体重，建议每磅体重摄入一克蛋白质。

While I often talk about the importance of getting one gram of protein per pound of body weight for things like muscle health and recovery and the promotion of lean body mass and sanctity.

但对大多数人来说，真正做到每磅体重一克蛋白质其实非常困难。

The reality of that is for most people getting that one gram of protein per pound of body weight is really challenging.

不过，David的产品让这件事变得很简单。

However, David makes that easy.

他们的蛋白棒味道真的特别棒。

Their bars taste incredible.

金条含有28克蛋白质，热量只有150卡。

The gold bar is packed with 28 grams of protein with just 150 calories.

铜条则有20克蛋白质，同样只有150卡。

And the bronze bar has 20 grams of protein also with just 150 calories.

我几乎每天都会吃一根，出门旅行时背包里也总带着两到三根。

I eat one almost every single day and always have two or three with me in my backpack when I'm traveling.

我说的‘总带着’，真的是字面意思的总带着。

And I like literally mean always.

听起来可能有点奇怪，但我经常拿它当甜点吃。

It probably sounds funny, but I eat them as dessert all the time.

你试过之后，就完全明白我在说什么了。

When you try them, you'll know exactly what I mean.

如果你也想试试这种蛋白棒，可以去 davidprotein.com/perform。

If you're interested in trying these bars for yourself, you can go to davidprotein.com/perform.

再次提醒，网址是 davidprotein.com/perform。

Again, that's davidprotein.com/perform.

我们在这儿聊聊，正常女性体内雌激素和睾酮的水平差距有多大。

While we're here, order of magnitude difference in a normal female of estrogen versus testosterone.

你没给我具体数字，但能大概说说，雌激素比睾酮高出多少吗？

You're not giving me exact number here, but give me a rough idea how like how much more.

还有一个问题，男性体内也有雌激素吗？

And then secondary question is, do men have estrogen?

男性确实有雌激素。

Men do have estrogen.

我可没有。

Not me.

当然，其他男性是有的，对吧？

Of course, like other men, though, right?

每个人的情况都不一样。

So it's not the same in everybody.

如果按教科书上的标准来说，那雌激素水平会有一个明显的高峰。

The But extent to which it if we're saying text textbook, then it's a big peak.

从零直接跳到七百、八百。

We're going from zero to 700, 800.

我甚至见过一千的。

I've even seen a thousand.

至于睾酮，你讲的是

And for testosterone, you're talking

根本没这么大的增幅。

Nowhere near that kind of increase.

就零零星星涨那么一两点。

Like, a couple of points here and there.

对。

Right.

所以我说

So I

睾酮水平太低了，市面上大多数检测方法都测不出女性体内的这种低浓度。

mean, testosterone is so low that most of the assays available aren't even sensitive enough to detect these levels in women.

天啊，这里头有一大堆事要说，因为以前在Vitality，我们根本没把睾酮纳入女性检测项目。

Man, there's a whole line to go down here because for a long time at Vitality, we did not include testosterone in the female panel.

我们最近才开始加，实在是被催得没办法了。

We only recently started doing it because of so much blowback.

但我真的担心这些检测结果的准确性，毕竟浓度太低了。

But I actually am legitimately concerned about the accuracy of those assays because the concentration is so low.

是的。

Yeah.

数值很重要。

And the number matters.

我们当时就说，不行，不能加。

We were like, No, can't.

我对那些商业检测机构也不放心，不管规模多大，我都会仔细看他们用的技术，但大多数都不靠谱。

I do not trust Even these commercially available large testing facilities, like, I really at those considerations, depending on the technology they're using, and most are not.

所以，迫于公众要求，我们还是加了进去，但心里其实很不情愿。

And so we, by public demand, put it in there, but it was against our our goodwill of being like, okay.

行吧。

Fine.

你想要就行。

You want it.

但话又说回来。

But nonetheless.

好吧。

Okay.

从教科书上来看，确实是这样。

So that is happening textbook wise.

但现实中，这到底是个什么情况？

Now, me through reality, what this actually looks like.

首先，你说月经周期总是28天？

First of all, tell me that the cycle is always twenty eight days.

排卵总是在第14天，然后就这样对吧？

The ovulation is always day 14 and then so forth, right?

没那么回事。

Not so much.

啊，不是的。

Ah, no.

你总能看到的那种激素波动图，我只见过一次。

The diagram that you always see of these hormone fluctuations, I've seen it once.

真的就只见过一次。

Literally once.

你只在现实生活中见过一次这种变化。

You've seen it play out in real life one time.

没错。

Correct.

是的。

Yeah.

你一定会惊讶于女性之间的差异，甚至同一个人在不同周期之间的变化也很大。

So you'd be astounded by the variability between women and even in some cases within the same person, but from one cycle to the next.

所以女性的周期差异非常大，有人的周期是21天，这对她来说就是正常的。

So we have variability all over the place, meaning you could have a twenty one day cycle and that's normal for you.

每次都正好是21天。

It's always twenty one days.

也有人的周期是35天，这对她来说也是正常的。

Or you could have a thirty five day cycle and that's normal for you.

每次都正好是35天。

It's always thirty five days.

说到排卵，也就是把周期分成不同阶段，有些人排卵早，有些人排卵晚，这意味着各个阶段的长度并不一致。

Now, when we talk about ovulation, which again divides the cycle into those phases, some people are early or later ovulators, meaning you have unequal length phases.

比如我有个研究对象，她的周期是30天，但每次都固定在第9天排卵。

So for example, I had a participant in one of my studies who had a thirty day cycle ovulated on day nine regularly.

这对她来说完全正常。

That was normal for her.

另一个人也是30天的周期，却总是稳定在第19天排卵。

Another person, thirty day cycle, ovulated consistently on day 19.

如果你不实际去检测，这些你根本无从知晓。

And you don't know any of this unless you're actually testing.

就拿我来说，我们做过很多个周期的排卵追踪，还检测了雌二醇、孕酮和黄体生成素的水平。

So in my case, we were doing many cycles of ovulation tracking and then hormone testing for estradiol, progesterone, luteinizing hormone.

但你会发现，这些激素波动的模式和时间点差异非常大。

But what you learn is the patterns, the timing of these hormone fluctuations are very variable.

当你把激素曲线画出来，有些人峰值很小，有些人却特别高。

And then when you plot the hormones, some people have these small peaks and some people have these huge peaks.

所以不仅波动的时间不确定，波动的幅度也不一样。

So it's not only the timing of the fluctuations, it's the magnitude of the fluctuations.

完全没有规律可言。

And there's no consistency.

比如，雌二醇峰值低，并不代表孕酮峰值也低。

Like, just because you have a smaller estradiol peak doesn't mean you have a smaller progesterone peak.

各种情况都有，完全没法预测。

So it's all over the place, and none of this is predictable.

这使得研究变得极其困难。

And it makes it incredibly difficult to do research.

但当你明白这一点后，再对女性们普遍建议‘你该这么做’的时候——

But also, when you understand that, then speaking practically and broadly to women and saying like, Hey, do this.

你正处于这个阶段。

You're in that phase.

不，你并没有。

No, you're not.

你根本不知道自己处在哪个阶段。

You have no idea what phase you're in.

那我有几个问题。

So a couple of questions here then.

第一，怎么检测排卵呢？

One, how does somebody test their ovulation?

如果想弄清楚自己哪天排卵，每个月或者偶尔一次，月经周期倒是很容易判断，对吧？

If they wanna figure out what day they're ovulating, either every month or just once in a while, menses is obviously pretty easy to figure out, right?

如果你的周期是二十八天或三十一天，或者在三天到四天之间波动，这都很常见，也很正常，目前完全没必要觉得这不健康。

If you have a twenty eight day cycle or thirty one day, or if you're maybe balanced between a three or four day window, that's all common and normal and don't have any reason to think that's unhealthy at this point.

但排卵这件事呢——不管是排卵早、排卵晚，还是时有时无，有没有什么快速的方法能帮人检测出来？

But the ovulation, whether you're early or late ovulator or you're sporadic, Is there any quick ways people can test that?

最简单的方法是，不过我可不是建议每个人都这么做，没这个必要。

The easiest way and again, I I'm not suggesting that everyone should be doing this for any reason.

对。

Yeah.

但

But

你既然问了，我就说说。

I asked the question.

对。

Yeah.

就是一种尿液试纸，用来检测黄体生成素。

Is a urinary reactive strip that assesses luteinizing hormone.

所以这个检测能预测排卵即将发生，因为黄体生成素会在排卵前突然升高。

And so this predicts that ovulation will occur because luteinizing hormone spikes prior, like, just before ovulation.

但有时候黄体生成素虽然升高了，排卵却没完全完成。

But you can get a spike in luteinizing hormone and then get what is essentially like an incomplete ovulation.

要确认排卵是否真的发生了，最可靠的方法是做阴道超声检查。

So to confirm that ovulation actually occurred, then you would want gold standard would be an ultrasound, a vaginal ultrasound.

如果做不到这一点——大多数人也确实做不到——那就可以在黄体期中期测一下孕酮水平。

Secondary, if you can't do that, which most people can't, would be to take a progesterone value mid luteal phase.

因为如果没出现孕酮峰值，至少在医学界，我们会把这个周期归类为没有排卵的周期。

Because if you don't get that progesterone peak, then at least in the the science world, we would classify that as an anovulatory cycle.

也就是说，你根本没有排出卵子。

As in you didn't release an egg.

对。

Right.

明白了。

Alright.

所以市面上的这些试纸，还有没有其他需要注意的地方？

So any commercial kit, are there any other things to look for or paying attention to?

还是说我只要买一种黄体生成素试纸，大概从第十四天开始，往前推三四天，往后也推三四天，这样测就行？

Or can I just get a luteinizing hormone strip and predict what I think Maybe just start at day fourteen and then maybe do three or four days before that, three or four days after that, and then do it that way?

也就是说，假设你...

Is that, you know, assuming

是的，这些在任何药房都能买到。

Yeah, these are available at every drugstore.

很多人用它来备孕。

People use this for fertility purposes.

这其实就是排卵试纸。

So this is an ovulation test kit.

如果一个人的周期比较短，我一般会建议从第十天开始，为了保险起见，每天都测。

And typically if I had somebody who had a shorter cycle on average, I would say start at day ten just to be on the safe side and then do it every day.

如果周期比较长，那就可以稍微晚几天再开始。

On somebody who had a longer cycle, then maybe start a little bit later.

但问题就在于那些应用程序，它们总说你当前处于哪个阶段、现在是排卵期之类的。

But, and this is the problem with all those apps that say, you know, this is what phase you're in or this is you're fertile now.

它们默认周期长度和排卵时间有固定关系——周期短排卵就早，周期长排卵就晚，但实际情况并不总是这样。

They are assuming there is a relationship between cycle length and ovulation timing, meaning shorter cycle means earlier ovulation, longer cycle means later ovulation, and that's not always true.

对。

Yeah.

有些人周期短，有些人周期长，但每个人自己的时间规律是稳定的。

So we have people who have short cycles and longer cycles, and that they're consistent in their timeline.

你刚才已经举过这些例子了。

You gave those examples earlier.

没错。

Yeah.

然后

And then

还有些人的情况就比较不规律。

you have some people who are more sporadic.

你会不会说，周期长度大概在三天到四天的范围内？

Would you say like three to four day kind of range for cycle length?

如果超过这个范围，那就有点不对劲了。

Past that is maybe like, hey.

你的周期可能不太稳定，或许有什么问题。

You actually have inconsistent, maybe something happening there.

是的。

Yeah.

我通常觉得就在这区间内。

I would say it's it's typically in in that area.

三天。

Three.

明白了。

Okay.

在这个范围内，也有人每次排卵时间都很固定，要么总是早，要么总是中，要么总是晚。

So within that, then you also have people who ovulate at the same time, either early, mid, or late consistently.

还有一类人，周期长度是固定的，但排卵日却不稳定，经常变动。

And then you have also people that either can have any of the combinations, consistent cycle length, but inconsistent or fluctuating ovulation day.

也有人周期长度不规律，但排卵时间却相对稳定。

Or people with inconsistent cycle length, but consistent ovulation timeframe.

或者这几种情况的任意组合都有可能。

Or any combination of any of these variables.

这让这项研究变得特别有意思。

Which makes this research super fun.

好的。

Okay.

我想现在问一下，如果你能给我们讲讲你上一篇论文，可能会很有帮助。

So what I want to ask now is Actually, it might be cool if you just walked us through your last paper.

我真正想探讨的是，为什么这类研究这么难，为什么关于女性的研究这么少。

What I want to really get at here is why this type of research is so hard and why there isn't as much research in females.

其实我们是有针对女性的研究的，但过去大家一直回避，原因是——

We have research in women, but historically people have avoided it because-

我整个职业生涯都避开了这个领域。

I avoided it for my entire career.

你只是不想跟女性打交道罢了。

Well, you just don't want to be around women.

但其他科学家避开它，是因为投稿时期刊总会问：你有没有控制月经周期的影响？

But other scientists have avoided it because when you go to publish, the journal says, well, you didn't control for the menstrual cycle.

你有没有对月经周期进行标准化处理？

You didn't standardize for the menstrual cycle.

这些受试者是不是在服用口服避孕药？

Or were these people on oral contraceptives or not?

所以你总会遇到这类问题。

And so you get a lot of those questions.

有时候论文就因为这个原因被拒了。

And sometimes papers get rejected for that reason.

所以为了标准化或者控制——其实‘控制’这个词太荒谬了，毕竟我们刚才已经讲过这么多变量了。

And so in order to standardize or control for for I mean, control is a ridiculous term given everything that we've just been over.

我们必须追踪月经周期，测量激素水平，并在整个研究中统一训练或测试的时间点，只招募月经周期规律的人。

It's important that we track cycles and measure hormones and standardize the timing of our training or testing throughout a study and only recruit people who have regular menstrual cycles.

没有人使用口服避孕药，而这类药物其实占了绝经前女性的一半。

Nobody is on an oral contraceptive, which is, you know, half of the premenopausal population.

如果必须这么做，这对通常资源有限的小型实验室来说，负担太重了。

So if we have to do that, this creates a huge burden on what are often small labs with limited resources.

如果你跟我说，我想研究女性的垂直跳跃能力。

So if you say to me, I want to do a study in women on, you know, vertical jump.

我说，好啊。

And then I say, great.

但顺便说一句，你得想办法找钱、找资源，提前几个月把她们叫来，做大量排卵监测。

But by the way, you need to find money and the resources to bring them in for several months in advance and do a ton of ovulation tracking.

我们还得在整个周期里反复抽血。

And then we're going to need to take bloods throughout the cycle.

然后把样本送出去，等激素检测的结果回来。

We're going send those out and get some hormone assessments back.

等你把她们找来，确认她们的周期正常、可预测且稳定之后，还得安排好时间，确保她们每次来实验室做测试或训练时，都处在周期的同一个阶段。每个人都要这样操作，还得根据每个人的周期单独安排。这时候你可能就想了：算了，我还是改用年轻男性做这个研究吧。

And then when you bring them in and make sure that they have a normal cycle that you can predict and it's consistent, then we have to schedule them so when they come in for their assessment or their training, they're in the exact same place in their cycle every time they come to the lab, and we have to do it for everybody, but we have to individualize it to their cycle, you're going to say, Maybe I'll do that study in young men.

你这研究时长得翻五倍，成本甚至可能翻十倍？

You're going to 5X the study length, if not 10X the cost?

对啊。

Yeah.

我们当然都希望有更多包含女性的研究，这是事实。

And there's a reality of saying, Yes, we all want more research that includes women.

但如果你设下这么高的门槛，不仅会把女性排除在外，简直让她们根本没法参与任何研究。

But if you're going to put up a wall like that, you're not only disenivizing, you're almost making it impossible to even include women in the studies.

不只是做专门针对女性健康的研究、回答女性特有的健康问题，就连把女性纳入普通研究都变得几乎不可能。

Not only doing women's specific research, answering women's health specific questions, but just even including you in the study becomes almost impossible.

问题是，多年来大家一直默认一种模糊的说法：‘也许会有影响’。

Well, the issue is for years, it's always just been this assumption, this sort of nebulous, Well, it could matter.

对。

Yeah.

当然。

For sure.

你知道的，我填过很多伦理审查表，上面都写着：为什么没有纳入女性？

You know many IRBs I filled out by saying, Why aren't women included?

理由都是月经周期。

Because of menstrual cycle.

比如，到底有什么

Like, what's has

运动科学研究里有个挺讽刺的现象，就是我们会把那些训练水平明显不一样的人放在一起研究。

to do with the the irony in exercise science research where we take people who are clearly not equally trained.

对。

Mhmm.

然后我们还接受那些明显有问题的饮食记录。

And we accept food logs that are obviously flawed.

接着又说，好吧，18岁和32岁的人本来就有差别，但我们还是全都要。

And we say, well, yeah, you know, there are differences between an 18 year old and a 32 year old, but we're gonna take them all.

是的。

Yeah.

我们愿意接受这种差异，因为人体本身就存在天然的变异性，这没什么问题。

And we're willing to accept that because there's inherent variability in and that's okay.

我们能接受这个，但说到月经周期，就不行了。

We accept that in the but but the menstrual cycle, it's like, nope.

完全被排除在外。

Totally gone.

也许它也该属于我们能接受的那些因素之一。

Possibly fall into that category of things that we accept.

对。

Yeah.

当我回顾自己的研究时，我其实想弄清楚一个问题：这到底有没有影响？

When we look at what I did, I actually wanted to answer the question, does it matter?

我不想随便找一个关于运动的笼统问题，然后硬把月经周期的控制塞进去。

I didn't wanna try to answer some other question about exercise in general and and slot in the control of the of the cycle.

因为正如你所说，如果我们需要根据月经周期阶段来统一测试和训练，把自然周期的人和使用激素避孕的人分开，还要按口服避孕药的代际、宫内节育器、贴片等进行分类

Because to your point, if we need to standardize testing and training around cycle phase, if we need to separate the naturally cycling people from the hormonal contraceptive users, if we need to standardize by oral contraceptive generation or IUD versus patch versus

没错。

Coffer.

对。

Yep.

所有这些都要考虑。

All of it.

我们不是仅仅假设它可能有影响，所以就必须这么做。

We're not just assuming that maybe it could matter and therefore we must.

是的。

Yeah.

我们是在说，咱们来好好研究一下这个问题吧。

We're saying, hey, let's investigate this question.

咱们看看具体情况。

Let's see.

在周期的不同阶段，或者吃药和不吃药的时候，会有差异吗？

Are there differences in phase or, you know, on pill or off pill?

如果没有差异，那对很多实验室来说，门槛就低多了，他们可以说：哦，我不用特意安排受试者在某个周期阶段来参与实验。

And if not, then it reduces the barrier for so many labs to say, Oh, I don't need to worry about bringing them in during that cycle phase.

我不用去检测激素水平。

I don't need to detect bloods.

我不用去追踪排卵情况。

I don't need to track ovulation.

我只需要专心做我的研究就行了。

I can just do the science.

所以对我来说，这不仅仅是为了弄清楚这些激素的作用，以及它们是否会影响肌肉。

And so from my perspective, it wasn't just about learning the role of of of these hormones and and how, if at all, they affect muscle.

虽然从机制角度来看，这确实是个非常有趣的问题。

Although I think that is a really interesting question from a, you know, just a mechanistic perspective.

对我来说，真正令人兴奋的结果是：如果我们什么都没发现，那反而更有意义。

The interesting outcome for me was if we didn't find anything, then that's pretty exciting.

这其实是个好消息，因为这样一来，我们就有更多机会纳入女性参与者，或者使用混合性别的样本，省去了很多让研究人员和研究生在经费和操作上都头疼的复杂因素。如果你希望作为女性被纳入研究，这不正是你想要的吗？

That should be good news because, hey, we have more opportunities to include women or do mixed sex samples and all these layers of complexity that not only are challenging for the researchers, for the grad students from a financial perspective, but also if you're saying, I want to be represented as a woman.

是的。

Okay.

你有月经周期吗？还是在服用口服避孕药？

Well, do you have a menstrual cycle, or are you on an oral contraceptive?

那我是不是得把你排除在外？

And and am I am I gonna have to exclude you?

你真的想参加我的研究吗？

You really wanna participate in my studies?

不好意思。

Sorry.

你不行。

You can't.

对。

Yep.

这样下去根本推进不了。

That doesn't move us forward.

对。

No.

如果我们非得要求这么高的标准化，那进展简直慢得像蜗牛爬。

And I mean, we're moving at a snail's pace if we're requiring that level of standardization.

别光抱怨了，你倒是说说你上个项目具体是怎么做的？

So walk me through what you actually did for your last project rather than us kind of just whine and complain?

考虑到我们之前讨论过的各种变量，我们的想法是，让一位女性在黄体晚期、雌激素水平最高的时候做一系列测试，然后和她自己做对比。

Given all of that variability that we've discussed, the idea was let's compare one woman to herself by conducting a series of tests in that late follicular phase with peak estrogen.

对。

Yep.

然后再在黄体中期重复一次，那时候孕酮达到峰值，雌激素也会有第二次小高峰——很多人会忽略这一点。

And then repeating that in the mid luteal phase where we have that peak progesterone and that secondary estrogen peak, which some people often forget about.

我们实际上就是在比较这两种截然不同的激素水平状态。

But we're basically looking at these two distinct hormone profiles.

如果假设雌激素能促进肌肉合成，而孕激素会促进肌肉分解，那我们应当能观察到运动后蛋白质合成反应的差异。

And if there's the hypothesis that estrogen is anabolic for muscle and progesterone is catabolic, then we should see differences in the protein synthesis response to exercise.

所以我们做的是，用示踪剂测量了一周内整体的肌肉蛋白质合成情况。

So what we did was look at a week of integrated muscle protein synthesis using tracers.

也就是说，通常有两种方法可以测量肌肉蛋白质合成。

So meaning there are typically two ways where that you can measure muscle protein synthesis.

一种是通过静脉输注。

One is through an infusion.

你来实验室后，我会给你插上静脉点滴，注入一种标记过的示踪剂，它会在肌肉活检中被检测到。

So you're going to come to the lab and I'm going to hook you up to an IV and we're going to infuse a tracer that's labeled, that will show up in a muscle biopsy.

然后我们就能看到这个示踪剂被整合进肌肉的速度有多快。

And then we can look at the rate at which that tracer is incorporated into the muscle.

我们甚至可以在输液的同时让你做些运动。

And maybe we could do some exercise with the IV.

通常来说，这种测量要持续好几个小时。

And, you know, there's typically, this is like over a period of hours.

是的

Yeah.

而且你总是空腹状态。

And you're always fasted.

所以这是一个非常重要的研究模型。

And so there are it's an important model.

这个方法已经沿用很久了。

It's been around for a long time.

对

Yeah.

但它也有一些局限性。

But there are some limitations to it.

借助更现代的口服示踪剂，你可以直接喝下这些标记物，每天补充一次。

So using more modern orally ingested tracers, you can drink these labeled tracers essentially and top up every day.

当我们观察示踪剂在肌肉中的整体掺入速率时，它反映的是你全天的所有活动——包括饮食、睡眠和运动。

And so when we look at that integrated or that rate of incorporation of the tracer into the muscle, it's accounting everything you did, your meals, your sleep, your exercise, all of That's

这样更贴近真实生活情境。

more ecological validity here.

没错。

Right.

是的。

Yeah.

你还是得从人的腿部取活检，直接测量。

You're still taking biopsies of people's leg, directly measuring it.

对。

Yes.

但你没去关注那三四个小时，甚至五小时的窗口期——我之前说过，这段时间可能并不能反映肌肉几周后的变化。

But you're not looking at this three or four hour or five hour window, which I said a little bit earlier may or may not actually represent what happened to the muscle weeks later.

没错。

Right.

但如果你看的是一整周的平均数据，那就更能准确预示两三个月后的情况。

But when you're looking at it on average across the week, that's far more indicative of what's going to happen in two or three months.

所以这是一个好得多的模型。

So a much better model.

在研究开始前的几个月里，我让参与者来进行筛选，想了解她们以往的月经周期情况。

In months leading up to the study, I had people come in for screening, we wanted to look at their historical cycles.

幸运的是，大多数人一直在记录自己的周期。

Luckily, most people are tracking their cycles.

所以，作为基线，你必须至少有六个月的月经记录，比如‘我什么时候来月经’，这样我才能判断你的周期是否足够规律，可以让你参与多个周期的测试，避免周期不规律影响我们的数据收集。

So a baseline, you had to have at least six months of this is when I got my period so that I could get a sense of you are regular enough in terms of the cycle length that we can have you come in over multiple cycles and your irregularity not throw off our data collection.

所以一开始，你就得筛选大量的人，首先要确保他们都没在服用避孕药。

So right off the gates, you're screening loads of people because you have to make sure, number one, none of them are on birth control.

而且至少一年都没用过。

And haven't been for at least a year.

也不能有孩子。

None have children.

对。

Yep.

我猜有孩子的人也不行，或者——

I'm sure children or even-

孕妇也不行吗？

No pregnant women?

不能是孕妇，也不能曾经怀过孕。

No pregnant or been pregnant ever.

也不能是更年期前后的女性。

No perimenopausal women.

也不能是更年期前后的女性。

No perimenopausal women.

为什么？

Why?

因为你研究的是月经周期，那就得有个统一的标准。

Because you're asking a menstrual cycle question, so then you have to have a standard.

这么一来，你已经排除了大约百分之七十五的人群了。

So you've already cut out, I don't know, seventy five percent of the population at that point.

从未生育过，月经周期规律，年龄在secondary范围内。

Never had a kid, regular menstrual cycle, secondary age range.

这样算下来，女性人群中可能有一半以上直接被排除在外了，甚至更多。

Maybe more of the female population gone right out the gates, if not higher.

而且不能有月经周期异常或

And no menstrual cycle dysfunction or

不能有子宫内膜异位症。

no No endometriosis.

不能有闭经。

No amenorrhea.

这些情况都不行。

None of those things.

你必须得有大概二十七到三十二天的稳定周期，连续六个月都得一致，其他所有变量也都不能有。

You have to have probably between a, I don't know, whatever, twenty seven and thirty two day cycle, and it has to be consistent across six months, and none of those other variables.

而且不能超重。

And you can't be obese.

你不能有其他健康问题。

You can't have other health conditions.

不能有任何疾病。

No disease.

必须完全健康。

Perfectly healthy.

年龄要在18到30岁之间，或者

And 18 to 32 years old or

18到30岁。

18 to 30.

18到30岁。

18 to 30.

是的，很好。

Yeah, great.

好的。

Okay.

所有筛查都完成了，那他们入选之后会发生什么？

All that screening done, and then what happens when they're enrolled?

然后我们会追踪他们的排卵情况。

And then we track their ovulation.

我会让你带回家一大堆我们之前说过的尿液试纸。

So I send you home with a ton of those urinary test strips that we discussed.

等你来月经的第一天，你就告诉我，然后我会安排你开始下一轮检测。

And then they tell me when they start their next cycle, then they get their next period.

我会告诉你：从这一天开始测试，每天尿在试纸上，等五分钟，然后拍张照发给我。

And then I tell them, Okay, I want you to start your testing on this day, and you're going to pee on it, and you're going to let it sit for five minutes, and you're going to text me a picture of it.

这个过程要持续好几个月，直到我能相当准确地预测你的排卵时间。

So there's many months of this until I know with a to a degree of certainty, like, I can predict your ovulation.

对。

Yeah.

因为这项试验的第一阶段，会在你预计排卵前一周开始。

Because phase one of this trial starts a week before your predicted ovulation.

所以你对每个参与者都要这样持续五到六个月吗？

So you're going to do that with every participant for five or six months?

是的。

Yes.

然后你才能开始做你的

And then you actually get to do your

然后我就可以做点别的了。

And then I get to do something.

当然，他们随时都可以退出。

And of course, they can drop out anytime.

那是当然。

Oh, always.

对的。

Yeah.

没错。

Yeah.

我一直在催他们把照片发给我，就是他们开始时的肌肉状态，还有整个过程中的变化。我们是随机安排顺序的，不是所有人都从卵泡期开始检测。

And I'm harassing them to text me the pictures of So their strips and all of when when we start and we did this in a in a randomized order, meaning not everybody started with that follicular phase testing.

哦，当然。

Was Oh, sure.

当然。

Sure.

是的。

Yeah.

但最终他们还是来了，我们抽了血，检测了激素水平。

But ultimately, they came in and we did blood hormones.

还做了静息状态下的肌肉活检，然后才开始让他们服用示踪剂。

We did a resting biopsy, and then we started the ingestion of the tracer.

接着我们做了单侧运动，对吧？

And then we did unilateral exercise, right?

因为我想比较的不仅是不同阶段之间的差异，还有静息腿和运动腿之间的区别。

Because I want to compare not only your phase to your phase, but your resting leg to your exercise leg.

这样我就能测出静息状态下的蛋白质合成情况。

So I can get a protein synthesis at rest.

那运动带来的反应有多大呢？

And then what's the magnitude of the response to exercise?

没错。

Yep.

他们在摄入示踪剂后当天就做了第一组单侧运动，之后还持续补充示踪剂。

They did their first set of unilateral exercise on that day after ingesting the tracer, and then they were taking the top up tracers.

之后几天，他们回来进行了第二轮运动，还是同一侧腿。

In subsequent days, they came back for a second bout of exercise, same leg.

接着他们再来一次，摄入另一种示踪剂，用来测量蛋白质分解情况。

And then they came in for ingestion of another tracer, which was used to measure protein breakdown.

最后一天，他们回来时我们做了两次活检。

And the final day they came back, we did two biopsies.

一次取自静息的腿，一次取自运动的腿。

So one on the resting leg and one on the exercise leg.

现在我们总共做了三次肌肉活检。

So now we're up to three biopsies.

还要每隔一小时抽一次血，连续五小时，用来分析反映全身蛋白质分解的衰减曲线。

And also hourly blood draws for five hours to try to assess this decay curve that is reflective of whole body protein breakdown.

现在我们要在另一个阶段重复整个流程。

Now, we're doing this all again in the other phase.

第一个阶段从你预计排卵前一周开始，捕捉雌二醇的峰值。

So one phase starts a week before your predicted ovulation to capture that estradiol peak.

另一个阶段则在黄体期中期启动，捕捉孕酮的峰值。

The other phase starts in the mid luteal phase to capture that progesterone peak.

第二次做时，我们需要先取两个基线活检样本，因为你之前已经服用了示踪剂，得重新建立基线。

The second time you do it, we have to take two baseline biopsies because now you've already ingested the tracer, so we need a new baseline.

然后你再进行运动。

And then we do the exercise.

之后你回来，再做两次活检。

You come back, two more biopsies.

所以总共要做七次活检。

So it's seven biopsies total.

想象一下，这是一个持续多年的项目。

So imagine that as a multiple year project.

是的。

Yes.

很多很多年。

Many, many years.

所以当外界的人在想，为什么女性研究这么少的时候？

So when the people out there are thinking about why isn't there more women's research?

为什么这么少？

Why isn't more?

这就是最主要的原因。

This is the biggest reason why.

当我们说这真的、真的、真的、真的很难时，指的就是这种状况。

When we say it's really, really, really, really hard, this is exactly what we're referring to.

如果月经周期很重要，对吧？

Well, if menstrual cycle is important, right?

所以我的研究就是想弄清楚，是否存在差异？

So my study was designed to say, Are there differences?

但很多以往关于月经周期的研究，问题就在于做了太多假设。

And if you're go and I mean, the problem with a lot of menstrual cycle research historically was they made a lot of assumptions.

他们想当然地认为，28天一个周期，排卵在中间。

They said, well, I've, you know, twenty eight day cycle, ovulation in the middle.

再随便找几个服用口服避孕药的人，反正也无所谓。

Let's throw in a couple people on oral contraceptives because Sure.

你说，能有多大差别？

You know, what's the difference?

然后就敢大言不惭地断言一些根本没测过的激素变化。

And then let's make bold claims about hormones that we didn't measure.

没错。

Right.

意思是，如果你想彻底回答这些问题

Meaning, if you want to answer these questions thoroughly

对的。

Yep.

而且要严谨地回答，那确实就得这么做。

And rigorously, then yes, this is what is required.

而且既然你的论文已经发表了，你现在可以给出答案了。

And to answer because your paper was published at this point, so you can answer.

没有差异。

No difference.

没什么不同。

No difference.

根本无关紧要。

It did not matter.

所以，关于我们必须在月经周期的某个阶段举重、或者不举重这类说法，我认为从科学角度来说，现在完全可以画上句号了——根本没有任何生理依据。当然，如果你个人觉得那样做让你更舒服、更喜欢，那当然没问题。

So the idea that we need to lift weights during a certain phase of our menstrual cycle or not lift or anything like that, I think we can fairly close the book in saying we just do not have any rationale physiologically, whether it makes sense for you personally because you feel better, you like it, those are fine.

这些是实际的、个性化的做法。你一开始就说，月经周期只是需要关注的众多因素之一。

Those are practical, individualized You said at the very beginning, menstrual cycle is one of the many, many things to pay attention to.

但它本身并不能成为必须标准化、调整或改变训练方式的理由。

But in and of itself is not a reason to have to standardize, to manipulate, to alter training or anything else.

所以我可以明确地说出这个结论。

So I'm comfortable definitively saying that.

你也能明确地说，这个问题已经可以盖棺定论了吗？

Are you comfortable definitively saying we're done with that question?

不仅从现有证据来看，没有生理学依据支持这种做法，而且也没有理由根据那些可能根本不符合你身体状况的理论阶段，做出大规模的预先调整。

Not only is there no physiological rationale based on the evidence, there's also no reason to make these broad preemptive changes based on these theoretical phases that may not even match your physiology

对。

Yeah.

这些调整反而会让训练变得过于复杂，逼你大幅减少训练量，或者频繁更换训练方式。

That end up overcomplicating your training and forcing you to drastically reduce your volume or switch up the type of exercise you're doing.

所以我认为，把任何这类做法纳入训练计划，都是个错误的选择。

So I I think by incorporating any element of this into your training is it's a bad idea.