Hormone Regulation May Protect Female Elite Athletes

Athletes; Athletic women display a high prevalence of hypothalamic amenorrhea with a negative energy balance as a result of strenuous exercise and low food intake. The female athlete triad of amenorrhea, osteoporosis, and disorder eating is well document; also has been recognize by the American College of Sports Medicine since 1997. When energy intake is lower than require to meet energy demand; energy expenditures are redirect from the reproductive function to the maintenance of vital physiological functions.

Levels of metabolic hormones

In fact, low energy availability in exercising women appears to be the factor that impairs reproductive function and lowers luteinizing hormone (LH) pulse frequency. Thus, alter levels of metabolic hormones may provide cues to the reproductive system about energy status. In negative energy balance; these metabolic hormones communicate with the reproductive hormonal axis to slow or shut down the costly reproductive system. This is manifest by a disruption in reproductive hormone secretion and menstrual disturbances.

The ongoing energy deficit leads to severe menstrual dysfunction; including amenorrhea and oligomenorrhea. A review of more than 100 studies suggests that balancing hormone levels may reverse factors that increase heart disease risk in some female athletes. The review is publish ahead of print in the American Journal of Physiology Heart and Circulatory Physiology. The absence of menstruation (amenorrhea) is not uncommon in female elite athletes particularly in competitors of long-distance running, dance and gymnastics.

Not eating enough to support strenuous exercise and a high activity level leads to a negative energy balance, which in turn causes the brain to stop releasing the hormone GnRH. GnRH prompts the body to release follicle stimulating hormones that make ovulation possible. According to the international team of researchers who conduct the review; so disruption of ovulation may lead to estrogen deficiency, and “the resulting loss of estrogen may affect not only fertility; also but also cardiovascular function.”

Athletes with amenorrhea

When compared to athletes and a sedentary control group of women who menstruate regularly, athletes with amenorrhea had poorer blood vessel function. However, menstrual status improvement is associate with sustained improvement of blood vessel function. Athletes who don’t menstruate typically have higher levels of LDL “bad” cholesterol than those who have a regular cycle.

“Estrogen exerts multiple beneficial effects on the cardiovascular system through multiple pathways,” including the production of fats in the bloodstream, the research team explained. Research in post-menopausal women has show that normalizing estrogen levels may lower LDL levels. These results suggest that boosting estrogen may also help regulate cholesterol levels in young female athletes.

“Future research is required to determine the time course and the best interventions” for restoring hormone levels and energy balance to reverse risk factors in amenorrhoeic athletes, the researchers explained. “Can improvement in hormonal and energy balance reverse cardiovascular risk factors in amenorrhoeic athletes?” is published ahead of print in the American Journal of Physiology Heart and Circulatory Physiology.