Treatment of Athletic Amenorrhea with a Diet and Training Intervention Program

Abstract

The purpose of this study was to determine the effect of a 15-week diet and exercise intervention program on energy balance, hormonal profiles, body composition, and menstrual function of an amenorrheic endurance athlete. The intervention program reduced training 1 day/week and included the use of a sport nutrition beverage providing 360 kcal/day. Three eumenorrheic athletes served as a comparison group and were monitored over the same 15-week period. The amenorrheic athlete experienced a transition from negative to positive energy balance, increased body fat from 8.2 to 14.4%, increased fasting luteinizing hormone (LH) from 3.9 to 7.3 mlU/ml, and decreased fasting cortisol from 41.2 to 33.2 pg/dl. The eumenorrheic subjects showed a 0.4% reduction in body fat, a decrease in follicular phase levels of LH from 7.9 to 6.5 mlU/ml, and no change in cortisol. These results suggest that nonpharmacological treatment can contribute to reestablishing normal hormonal profiles and menstrual cyclicity in amenorrheic athletes.

A tríade da atleta: posicionamento oficial

“…Mulheres amenorréicas devem ser estimuladas a ingerir pelo menos 1.500mg de cálcio elementar por dia para assegurar um equilíbrio do cálcio 18,36 . A reversão da amenorréia já foi relatada após uma lesão, durante uma redução do treinamento e com um aumento da ingestão calórica 84,[112][113][114][115][116] . Entretanto, não há dados epidemiológicos disponíveis sobre a taxa de sucesso de qualquer alteração do estilo de vida ou tratamento para reverter a amenorréia, aumentar a massa óssea ou a fertilidade 97 .…”

“…Atletas amenorréicas que utilizam terapia de reposição hormonal em doses utilizadas para mulheres pós-menopausa demonstraram manutenção da DMO mas nenhum ganho 135 . Mulheres com amenorréia e perdas ós-seas mais leves podem preferir ajustar o treinamento e os padrões nutricionais para retornar ao seu ciclo reprodutivo normal 15,18,27,113,114,136 .…”

A Comparison of Body Composition between Eumenorrheic and Amenorrheic Adolescent Cross-Country Runners

“…Exactly how long has yet to be determined. However, a case study by Dueck, et al (1996) demonstrates the positive effects of treating athletic amenorrhea by increasing energy input and reducing training levels. A 19-year-old runner underwent a 15-week diet and training intervention.…”

“…Today, competitive female athletes train as hard as their male counterparts. However, female athletes have greater physiological issues compared to male athletes such as menstrual dysfunction, reproductive disorders, and musculoskeletal differences (Bungum & Vincent, 1997;Dueck, Matt, Manore, & Skinner, 1996). Because of these physiological differences, women are more at risk than male athletes to develop health problems from the same intense training levels of exercise duration, frequency, and intensity (Loucks, 1985).…”

“…One of the advantages of sport participation is that physical activity promotes strong bones and reduces the long-term risk of osteoporosis (Beck & Snow, 2003;Botwinick, et al, 1989); but for female athletes who suffer from athletic or exerciseassociated amenorrhea (EAA), increased physical activity actually puts them at greater risk of osteoporosis later in life Drinkwater, Breumner, & Chestnut, 1990;Dueck, Matt, Manore, & Skinner, 1996). Interestingly, increased physical activity is normally associated with increased bone density (Beck & Snow, 2003).…”