Serena and Venus Williams medical records among those leaked by cyberespionage group Fancy Bear

A Russian cyber espionage group that calls itself Fancy Bears has hacked into the website of the World Anti-Doping Association, and among the first athletes to have their private medical records made public – all of them American women – are tennis stars Serena and Venus Williams.

The others are American gymnast Simone Biles, who won four gold medals at the Rio Olympics and Elena Delle Donne, a well-known basketball player.

That will, of course, just ratchet up all the doping rumours that the two tennis-playing sisters, among the most famous female athletes on the planet, have been subjected to throughout their long and distinguished careers.

If at first there was scepticism that the rather realistic-looking documents were fakes, which was put to rest Tuesday when WADA, the U.S. Anti-Doping Association and Venus Williams herself issued statements.

From WADA:

From USADA:

From Venus Williams:

A look at the documents so far released indicates that only two – Biles and Delle Donne – were for in-competition positive tests at the Olympics.

Biles showed a positive for methylphenidate, better known under the name “Ritalin” and highly overprescribed to kids who suffer from attention deficit disorder.

It also is, on a more serious note, notorious for being used by athletes as a performance enhancer to improve concentration and focus. Even students who don’t have ADD will use it to help them focus and study better, if they can get their hands on it.

Accompanying Biles' positive test document are multiple therapeutic use documents, which give her permission to take a drug called Focalin XR.

Delle Donne tested positive for amphetamine and its metabolites. The documents released show that she has four-year exemptions for both Adderall (another attention-deficit order drug) and hydrocortisone, an immunosuppressive drug often used for allergic reactions. She takes that one three times a day.

There are a total of 16 documents leaked involving the Williams sisters, but none of the documents reveal a positive drug test in Rio. And all of the therapeutic exemptions in the released documents are all expired, ranging from 2010 to 2015.

For Venus Williams, who has suffered for many years with the autoimmune disease Sjogren’s:

- Prednisone for a 12-day period in February 2010, a six-day period in Aug. 2011, a month-long period from mid-June to mid-July 2012 and another two-week period in Jan-Feb 2013
- Prednisolone from mid July to mid August 2012.
- Formoterol (inhaled) for a one-year period from Feb. 2010 to Feb. 2011, and on a separate document, from May 2010 to May 2011.
-Triamcinolone (intramuscular), once in Aug. 2011, again in late December 2011, early April 2012, mid-June 2012 and Jan. 2013

Prednisone and prednisolone are commonly used to treat autoimmune diseases, as is Triamcinolone (which is also for breathing disoeders); Formoterol is commonly used to treat asthma.

Venus Williams didn’t play from a walkover at the 2011 US Open until March of the following year, likely the worst period for her Sjogren’s disease.

For Serena, the following exemptions were listed:

- Methylprednisolone for six days in late November 2010.
- Hydromorphone (a morphine-based painkiller best known under the name Dilaudid), from Oct. 2010 to March 2011
- Oxycodone (painkiller) for five days in Oct. 2010

(From Wimbledon 2010 to just before Wimbledon 2011, Williams did not play. That period coincided with the incident where she cut her foot on some broken glass in July, then suffered a pulmonary embolism in March).

- Prednisone (20mg) for a week in March 2014, another week later in the month and two weeks in May.

(Williams won the Miami tournament in late March, but lost in the first round to Jana Cepelova in Charleston in early April. She won Rome in early May, but lost in the second round of the French Open that year to the then still fairly unheralded Garbine Muguruza).

-One 50 mg dose of prednisolone in Nov. 2014 (right after the WTA Tour finals) and a week of Oxycodone.

- Prednisolone, a double dose for three days then 20 mg per day for three days, June 5-10, 2015.

(Williams, who was so sick she hardly had a voice and was coughing incessantly, managed to win the French Open at the beginning of that time period; it’s a medication commonly prescribed for acute bronchitis).

If anything, the revelations for the Williams sisters offer a glimpse into exactly how careful athletes must be before taking ANY kind of medication – even the painkillers that are likely the bread and butter of any athlete over 30 still playing a high-level sport.

There is nothing in the documents leaked so far that indicate any positive tests – in competition or out – or any medications that would, on the surface, be performance-enhancing in the typically accepted way. In particular, the majority of the prescriptions are very short-term.

That's not to say, for a single second, that high-level athletes aren't encouraged to get therapeutic exemptions for medications that can help them perform better.

This is not a medical opinion, obviously. But it won’t stop the whispers and "I told you so"s. The sisters are still in New York, where Serena Williams is presenting a new fashion collection and sister Venus is along for support.

Medical experts will surely weigh in on all of these prescriptions, including length of prescription, dosage and other possible reasons for taking them, in the coming days.