Body weight, exercise and menstrual status among ballet dancers in training

Abraham, Suzanne; Beumont, P. J. V.; Fraser, I. S.; Llewellyn‐Jones, Derek

doi:10.1111/j.1471-0528.1982.tb03649.x

Cited by 120 publications

(57 citation statements)

References 10 publications

(8 reference statements)

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“…Pierwsze objawy to opóźniony wiek menarche i brak postępu dojrzewania, następnie skąpe i rzadkie miesiączki, po czym dochodzi do zaniku miesiączkowania. Zaburzenia te mogą występować u 69% sportowców tych dyscyplin [44][45][46]. Skutki odległe, takie jak zaburzenia płodności i osteoporoza, powinny być omówione z pacjentką, a u młodocianych z jej opiekunem prawnym.…”

Section: Podwzgórzowy Brak Miesiączki Jako Konsekwencja Wysiłku Fizycunclassified

“…Initial signs of the condition include delayed menarche and lack of progress through puberty, followed by oligomenorrhoea, and eventually complete loss of menses. These disorders can be observed in up to 69% of female athletes practicing the abovementioned disciplines [44][45][46]. The long-term consequences of the condition, such as fertility disorders and osteoporosis, should be discussed with a patient or her legal guardian, if underage.…”

Section: Hypothalamic Amenorrhoea As a Consequence Of Physical Exercimentioning

confidence: 99%

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Czynnościowy podwzgórzowy brak miesiączki – trudności diagnostyczne, monitorowanie i leczenie

Sowińska-Przepiera

Andrysiak‐Mamos

Jarząbek-Bielecka

et al. 2015

Endokrynologia Polska

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Functional hypothalamic amenorrhoea (FHA) is associated with functional inhibition of the hypothalamic-pituitary-ovarian axis. Causes of FHA can be classified into the three groups: 1) stress-related factors, 2) consequences of weight loss and/or underweight, and 3) consequences of physical exercise or practicing sports. Diagnosis of FHA should be based on a history of menstrual disorders. During physical examination, patients with FHA present with secondary and tertiary sex characteristics specific for the pubertal stage preceding development of the condition and with the signs of hypoestrogenism. Laboratory results determine further management of patients with amenorrhea, and thus their correct interpretation is vital for making appropriate therapeutic decisions. Treatment of chronic anovulation, menstrual disorders, and secondary amenorrhea resulting from hypothalamic disorders should be aimed at the elimination of the primary cause, i.e. a decrease in psycho-emotional strain, avoidance of chronic stressors, reduction of physical exercise level, or optimisation of BMI in patients who lose weight. If menses do not resume after a period of six months or primary causative treatment is not possible, neutralisation of hypoestrogenism consequences, especially unfavourable effects on bone metabolism, become the main issue. Previous studies have shown that oestroprogestagen therapy is useful in both the treatment of menstrual disorders and normalisation of bone mineral density. StreszczenieCzynnościowy brak miesiączki pochodzenia podwzgórzowego (FHA) polega na zahamowaniu czynności osi podwzgórze-przysadka-jajniki. Przyczyny FHA można podzielić na trzy grupy: 1) czynniki związane ze stresem, 2) następstwa utraty masy ciała i/lub występowania niskiej masy ciała, oraz 3) konsekwencje wysiłku fizycznego lub uprawiania sportu. Dla rozpoznania FHA istotne są dane z wywiadu na temat występowania zaburzeń cykli miesiączkowych. W badaniu fizykalnym pacjentek z FHA stwierdza się występowanie drugoi trzeciorzędowych cech płciowych zależnie od stadium zaawansowania pokwitania przed wystąpieniem schorzenia oraz objawy hipoestrogenizmu. Wyniki badań laboratoryjnych dostarczają informacji, na podstawie których decyduje się o sposobie leczenia, a ich właściwa interpretacja ma kluczowe znaczenie w podejmowaniu właściwych decyzji terapeutycznych. Leczenie przewlekłego braku jajeczkowania, zaburzeń cyklu miesiączkowego i wtórnego braku miesiączki wynikającego z zaburzeń podwzgórzowych powinno być ukierunkowane na usunięcie pierwotnej przyczyny, czyli obniżenie napięcia psychoemocjonalnego, unikanie czynników wywołujących przewlekły stres, zmniejszenie wysiłku fizycznego i poprawę wskaźnika masy ciała u odchudzających się pacjentek. Jeśli miesiączkowanie nie występuje przez okres ponad 6 miesięcy lub gdy pierwotne leczenie przyczynowe nie jest możliwe, głównym problemem terapeutycznym staje się neutralizacja następstw hipoestrogenizmu, a zwłaszcza jego niekorzystnego wpływu na metabolizm kostny. W dotychczasowych badaniach wyk...

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Section: Podwzgórzowy Brak Miesiączki Jako Konsekwencja Wysiłku Fizycunclassified

Section: Hypothalamic Amenorrhoea As a Consequence Of Physical Exercimentioning

confidence: 99%

Czynnościowy podwzgórzowy brak miesiączki – trudności diagnostyczne, monitorowanie i leczenie

Sowińska-Przepiera

Andrysiak‐Mamos

Jarząbek-Bielecka

et al. 2015

Endokrynologia Polska

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“…Unfortunately, it has a significant shortcoming: a large and growing body of empirical data that disconfirms it. From the outset it was criticized on methodological and theoretical grounds, and there were reports that the association between fatness and fertility was not universal (1,253). A large body of data from both humans and animals now shows that it is relatively simple to dissociate fatness and reproductive function (141,200,248,250), indicating that while they tend to be correlated with one another, body fat content and fertility cannot be causally related.…”

Section: Primary Metabolic Cuesmentioning

confidence: 99%

Neuroendocrinology of nutritional infertility

Wade¹,

Jones²

2004

American Journal of Physiology-Regulatory, Integrative and Comp

228

166

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Natural selection has linked the physiological controls of energy balance and fertility such that reproduction is deferred during lean times, particularly in female mammals. In this way, an energetically costly process is confined to periods when sufficient food is available to support pregnancy and lactation. Even in the face of abundance, nutritional infertility ensues if energy intake fails to keep pace with expenditure. A working hypothesis is proposed in which any activity or condition that limits the availability of oxidizable fuels (e.g., undereating, excessive energy expenditure, diabetes mellitus) can inhibit both gonadotropin-releasing hormone (GnRH)/luteinizing hormone secretion and female copulatory behaviors. Decreases in metabolic fuel availability appear to be detected by cells in the caudal hindbrain. Hindbrain neurons producing neuropeptide Y (NPY) and catecholamines (CA) then project to the forebrain where they contact GnRH neurons both directly and also indirectly via corticotropin-releasing hormone (CRH) neurons to inhibit GnRH secretion. In the case of estrous behavior, the best available evidence suggests that the inhibitory NPY/CA system acts primarily via CRH or urocortin projections to various forebrain loci that control sexual receptivity. Disruption of these signaling processes allows normal reproduction to proceed in the face of energetic deficits, indicating that the circuitry responds to energy deficits and that no signal is necessary to indicate that there is an adequate energy supply. While there is a large body of evidence to support this hypothesis, the data do not exclude nutritional inhibition of reproduction by other pathways and processes, and the full story will undoubtedly be more complex than this. luteinizing hormone; estrous behavior; corticotropin-releasing hormone; neuropeptide Y; hindbrain OF NECESSITY, the physiological controls of reproduction and energy balance are closely intertwined. Living creatures require a steady stream of oxidizable substrates to fuel their many energy-consuming activities, including reproduction. But in nature, energetic demands and opportunities for meal taking can be erratic and sometimes unpredictable, necessitating the existence of physiological and behavioral strategies to maximize chances of individual survival and permit propagation of the species (21,22,200,208).A need to eat constantly is obviated by the presence of internal caloric buffers that store glycogen and fatty acids and provide sustenance in between meals and during brief fasts. When food is abundant, animals adjust their intakes to meet all demands and keep their storage depots full (or overfull in an increasing number of cases). However, a more likely scenario in nature and during human evolution is that food can be scarce or have a very high acquisition cost. In that case, animals adjust their energetic priorities, i.e., how they partition and use the available metabolic fuels (Fig.

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“…Uma teoria para explicar esse fenômeno é a de que a menstruação seja iniciada quando o peso atinge uma massa crítica, a qual as mulheres obesas alcancem primeiro e que seria de 48 kg ou aproximadamente 22% de gordura corporal 2 . Mulheres muito magras, com bulimia ou anorexia nervosa e atletas ou bailarinas submetidas a exercícios extenuantes apresentam irregularidades no ciclo menstrual 3 . Por outro lado, mulheres muito obesas também podem apresentar alterações na sua função reprodutiva, como observado na síndrome dos ovários policísticos 4 , freqüentemente associada à infertilidade, obesidade e hiperandrogenismo.…”

Section: Introductionunclassified

Avaliação dos efeitos do estradiol e do FSH nos níveis de leptina em mulheres com supressão da função hipofisária

Geber¹,

Sampaio²

2005

Rev. Bras. Ginecol. Obstet.

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216Rev Bras Ginecol Obstet. 2005; 27(4): 216-21Artigos Originais RESUMO Objetivo: identificar a correlação entre os níveis séricos de leptina e os níveis de estradiol e do hormônio folículo-estimulante (FSH) em mulheres com supressão da função hipofisária, e suas possíveis interferências no eixo reprodutivo. Métodos: estudamos prospectivamente 64 pacientes submetidas à hiperestimulação ovariana controlada com FSH recombinante para tratamento pela técnica de reprodução assistida, devido a fator masculino ou tubário, e 20 pacientes em uso de valerato de estradiol, para preparo endometrial, em tratamento de doação de óvulos, por falha de resposta ovariana em ciclo prévio. Todas as pacientes utilizaram análogo de GnRH no início do tratamento, de forma a obter a supressão da função hipofisária. Para a análise estatística dos resultados, foram utilizados os testes χ 2 , t de Student e correlação de Pearson, quando adequado. Os resultados foram considerados significativos quando p<0,05. Resultados: observamos que os níveis de leptina correlacionaram-se com o índice de massa corpórea, embora não tenham influenciado a taxa de crescimento desses hormônios. Identificamos correlação positiva entre os níveis médios de estradiol e leptina em ambos os grupos, com os níveis desta passando de 10,42 ng/mL para 15,68 ng/mL no grupo FSH e de 11,09 ng/mL para 14,5 ng/mL no grupo estradiol, com a elevação dos níveis de estradiol. As taxas de crescimento da leptina foram mais altas nas mulheres que apresentaram níveis mais elevados de estradiol sérico, isto é, que tiveram ciclos induzidos com FSH recombinante, do que nas que usaram valerato de estradiol (159,60±58,01 e 136,73±34,17, respectivamente). Conclusões: podemos concluir que o estradiol é importante regulador da produção da leptina, podendo ter seu efeito amplificado por seus elevados níveis séricos ou pela associação com o FSH. PALAVRAS-CHAVE:Leptina; Estradiol; Hormônio folículo estimulante; Infertilidade ABSTRACT Purpose: to identify the relationship between serum levels of leptin and the levels of estradiol and follicle-stimulating hormone (FSH) in women with pituitary suppression and to evaluate its possible interference on the reproductive axis. Methods: a total of 64 patients submitted to controlled ovarian hyperstimulation with recombinant FSH for assisted reproduction, due to a male or tubal factor, and 20 patients using estradiol valerate, for endometrial preparation in order to be submitted to oocyte donation treatment were studied. All patients used GnRH analogues before starting treatment in order to avoid premature LH surge. Data were analyzed statistically by the χ 2 test, Student's t-test and the Pearson correlation test, when appropriate, with the level of significance set at p<0,05. Results: it was observed that leptin levels correlated with body mass index (BMI) even though they had not influenced growth rate of these hormones. A positive correlation was observed between estradiol and leptin levels in both groups, as leptin levels increased from 10.42 to 15....

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Body weight, exercise and menstrual status among ballet dancers in training

Cited by 120 publications

References 10 publications

Czynnościowy podwzgórzowy brak miesiączki – trudności diagnostyczne, monitorowanie i leczenie

Czynnościowy podwzgórzowy brak miesiączki – trudności diagnostyczne, monitorowanie i leczenie

Neuroendocrinology of nutritional infertility

Avaliação dos efeitos do estradiol e do FSH nos níveis de leptina em mulheres com supressão da função hipofisária

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