Exercise and menstrual function

doi:10.1136/bmj.39043.625498.80

BMJ 2007;334:164-165 (27 January), doi:10.1136/bmj.39043.625498.80

Editorials

Exercise and menstrual function

Up to four fifths of women who exercise vigorously may havesome form of menstrual dysfunction

The first 150 words of the full text of this article appear below.

The risks to sportswomen of exercise relatedmenstrual dysfunction and impaired bone health are importantand under-recognised. Exercise related menstrual dysfunctionmay include any abnormality along the continuum of luteal phasedeficiency, annovulation, oligomenorrhoea, amenorrhoea, anddelayed menarche. Such dysfunction is multifactorial in origin,with a high degree of individual variation, but its main underlyingmechanism is hypothalamic inhibition with suppression of gonadotrophinreleasing hormone pulsatility (the frequency at which pulsesof the hormone are released by the hypothalamus).¹

This hypothalamic suppression has a varietyof causes in sportswomen, including the physical and psychologicalstress of training and competition, caloric deficiency, lowbody mass, low body fat,¹ ² inadequate leptinvalues,³ and altered peripheral hormone metabolism.¹ Relativehyperandrogenism and genetic influences may also have a role.¹The consequences can include musculoskeletal injuries (in particularstress fractures), infertility, and the general medical consequencesof hypo-oestrogenism.