Enhanced post-exercise hypotension in female athletes with menstrual disorders

To investigate whether the magnitude of post-exercise hypotension (PEH) is greater in female endurance athletes with oligomenorrhea/amenorrhea (OAA) compared with eumenorrheic (EA) athletes, and to examine the associated hemodynamic correlates.

Ten EA athletes (tested during the early follicular phase) and eight OAA athletes performed incremental cycle exercise to exhaustion. Brachial blood pressure (BP), cardiac output (CO), total peripheral resistance (TPR), and spontaneous baroreflex sensitivity (SBRS) were assessed at baseline and at 15 (P15), 30 (P30), and 60 (P60) min post-exercise in the supine position. Linear mixed-effects models were used to compare temporal responses between groups.

Both groups demonstrated significant PEH. Absolute systolic BP showed no between-group differences at baseline or during post-exercise recovery, whereas absolute diastolic BP (DBP) and mean arterial pressure (MAP) were higher at baseline in the OAA group. When expressed as changes from baseline, reductions in DBP and MAP at P60 were significantly greater in the OAA group than in the EA group (both p < 0.05). Post-exercise changes in CO and relative changes in TPR and SBRS demonstrated significant main effects of time (p < 0.05) but showed no significant between-group differences.

These findings suggest that chronic hypoestrogenism may augment PEH in female endurance athletes through mechanisms not fully explained by systemic TPR or SBRS.