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Summary
Female athletes may experience menstrual dysfunction due to intense training, low body fat, and stress. Treatment may involve hormone therapy to prevent health issues like osteoporosis and fractures.
Area of Science:
- Sports Medicine
- Endocrinology
- Gynecology
Background:
- Menstrual dysfunction, including delayed menarche, irregular menses, and secondary amenorrhea, is prevalent in female athletes undergoing prolonged training.
- Key predisposing factors include significant loss of body fat and emotional stress.
- Physiological changes such as hypoestrogenism, altered follicle-stimulating hormone (FSH) to luteinizing hormone (LH) ratio, and elevated serum testosterone, prolactin, catecholamines, and opioids are common.
Purpose of the Study:
- To review the causes and implications of menstrual dysfunction in female athletes.
- To discuss the potential impact of the menstrual cycle on athletic performance.
- To provide recommendations for the management of exercise-induced menstrual dysfunction.
Main Methods:
- Literature review of studies on athletic amenorrhea and menstrual cycle.
- Analysis of hormonal profiles and physiological changes associated with intense physical activity.
- Examination of current guidelines regarding training during menstruation and management of persistent dysfunction.
Main Results:
- Menstrual dysfunction in athletes shares common causes with the general population.
- There is ongoing debate regarding performance variations across the menstrual cycle, though premenstrual tension can impair capacity.
- Current data do not support prohibiting athletic training during menstruation.
Conclusions:
- A gynecologic examination is crucial before attributing menstrual dysfunction solely to physical exercise.
- For persistent amenorrhea (≥1 year), estrogen-progesterone therapy is recommended to mitigate risks of vascular issues, osteoporosis, and stress fractures, while preserving endometrial and ovarian function.