Title: Effects of exercise on sex steroid hormones (estrogen, progesterone, testosterone) in
eumenorrheic females. A systematic review and meta-analysis
Version: 1 Date: 10 Mar 2024
Reviewer:  Diego Fernando Afanador-Restrepo
Reviewer's report:
I appreciate the opportunity to review this manuscript. While I recognize the importance of the
topic worked on by the authors, I believe that the paper can be significantly improved.
Introduction:
Regarding the introduction, the English used is confusing, which affects the coherence of the
manuscript. I would appreciate it if the manuscript could specify the target population from the
introduction since, at times, it talks about athletes.
Material and Methods:
It is noteworthy that the authors followed the PRISMA guidelines. However, there are some
aspects that I would like to have clarified:
1. In section "2.1 Search strategy," the authors mention that they used different search strings
that yielded multiple results. This process is valuable for the construction of a strong search
string; however, they do not mention how they articulated the keywords with Boolean operators
to obtain the results that were later analyzed. Although a different string can be used in each
database, these should be reported in the manuscript. I suggested reviewing the explanation of
the PRISMA guide (https://www.bmj.com/content/372/bmj.n160).
2. In the screening process, there is a lack of explanations related to the process used for
the elimination of duplicate articles and the application of filters through automatic tools.
Additionally, there is no section related to the article selection process, mentioning who reviewed
the results of the search strings blindly and how they dealt with those cases where the blind
authors did not agree with the concept.
3. In the methodology, figures are cited that do not appear in the section. I suggest avoiding
citing figures or tables before their appearance in the manuscript to avoid confusion.
Results:
As previously mentioned, it is necessary to include information on automated filters used and
the process of eliminating duplicates. Additionally, I suggest that you also change the flowchart
to those suggested by the PRISMA 2020 guide.
Why in Table 1 do you refer to the population as "number of patients" if the methodology
established healthy women as a selection criterion?
Please include at the bottom of the table an explanation of the different abbreviations used or
terms such as BMI, nil, no, etc.
In the row "number of sessions," include that it is 3 times PER WEEK and include the total
number of sessions.
Considering the differences between the control groups, what criteria were followed to perform
the meta-analysis, and was the control group taken into account for inclusion in the meta-
analysis?
Figure 3 does not correspond to a funnel plot but to a forest plot. Please revise the following
statement: "The funnel plot was almost symmetrical as shown in fig. 3."
It would be important to include a section addressing the characteristics of the interventions,
their intensity, duration, frequency, and to analyze the heterogeneity between them qualitatively.
Discussion:
In the discussion, the authors focus on talking about the relationship between hormones and
performance; however, they do not address the results obtained in their review and meta-
analysis.
Finally, I must recommend a style review done by a native English speaker since many times it
was difficult to understand the manuscript. Additionally, it presents many informal phrases and
connectors, which affects the quality of the document.