High serum cortisol levels in exercise-associated amenorrhea.

Area of Science:

• Endocrinology
• Sports Medicine
• Reproductive Health

Background:

• Exercise-associated amenorrhea (EAM) is a condition affecting female athletes.
• The role of elevated cortisol in EAM requires further investigation.

Purpose of the Study:

• To investigate basal cortisol levels in women with exercise-associated amenorrhea.
• To explore the relationship between cortisol levels, menstrual function, and bone mineral density in athletes.

Main Methods:

• A 6-month prospective study involving 71 female participants categorized into amenorrheic athletes, eumenorrheic athletes, and nonathletes.
• Weekly blood samples were analyzed for cortisol, estradiol, progesterone, and prolactin.
• Lumbar bone mineral density was measured using dual-photon densitometry.

Main Results:

• Amenorrheic athletes exhibited significantly higher mean cortisol levels compared to eumenorrheic athletes and nonathletes (P < 0.01).
• Eight out of nine women with hypercortisolemia were amenorrheic athletes.
• Amenorrheic athletes showed lower bone mineral density than other groups (P < 0.01).

Conclusions:

• Elevated glucocorticoid (cortisol) levels may be an etiological factor in exercise-associated amenorrhea.
• Hypercortisolemia could contribute to reduced bone density in amenorrheic athletes.
• Amenorrheic athletes with high cortisol levels may face prolonged acyclic states and are at risk for osteoporosis.