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Understanding Exercise-Induced Amenorrhea: Impacts on Women's Reproductive Health

This study examines exercise-induced amenorrhea, a condition seen in women who engage in strenuous physical activity, centering on its effects on the reproductive system. Key findings highlight how intense exercise may lead to hypothalamic dysfunction, suppression of gonadotrophin-releasing hormone (GnRH), and subsequent reproductive hormone imbalances, resulting in issues like infertility, delayed menarche, and skeletal problems. The research utilized cynomolgus monkeys to analyze changes in hormone levels and menstrual cyclicity, revealing the cascade of physiological changes triggered by rigorous exercise.

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Understanding Exercise-Induced Amenorrhea: Impacts on Women's Reproductive Health

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  1. Exercise: A Bad Side? A Study of Exercise-Induced Amenorrhea

  2. Reproductive System STRESS

  3. The Energy Drain Theory

  4. What is happening? • Dysfunction of the hypothalamus • Suppression of the gonadotrophin-releasing hormone (GnRH) pulse generator

  5. What does that mean? • Normal Circumstances • Stimulation of LH and FSH by GnRH • Production of estrogen and progesterone • Suppression of Luteinizing Hormone (LH) • Prepubertal patterns • Delayed menarche • Amenorrhea

  6. What Results? • Infertility • Skeletal Problems

  7. Who is Prone?

  8. Longitudinal Changes in Reproductive Hormones and Menstrual Cyclicity in Cynomolgus Monkeys during Strenuous Exercise Training: Abrupt Transition to Exercise-Induced Amenorrhea Nancy I. Williams, Anne L. Caston-Balderrama, Dana L. Helmreich, David B. Parfitt, Connie Nosbisch, and Judy L. Cameron

  9. Background Information • Materials and Methods • Monkeys • Blood Samples • Reproductive Function • Exercise Training • Hormone Assays

  10. Determination of Changes • The occurrence of menses • Plasma concentrations of reproductive hormones • Body weight • Food intake • Daily mileage

  11. Data Analysis • Six Time Periods • Sedentary (Sed) • Cycle-2 • Cycle-1 • Amenorrhea 1 (AM1) • Amenorrhea 2 (AM2) • Amenorrhea 3 (AM3)

  12. Parameters Calculated • Levels of LH and FSH • E2 peak • Average E2 • P4 peak • Average P4

  13. Results

  14. Early Training Cycles

  15. Changes in Menstrual Cycle • Total height = Mean number of days in the entire menstrual cycle • Shaded portion = Follicular phase • Open portion = Luteal phase • Asterisks = Significant difference from Sed

  16. Changes in Reproductive HormonesExercising Monkeys vs. Control

  17. Data for an Individual

  18. Conclusions • Abrupt Amenorrhea • Earliest Changes • Cycle-2 • Decreased FSH • Cycle-1 • Increased cycle length • Impaired follicular development • Amenorrhea • Individual Variability

  19. Cascade of Events Strenuous Exercise suppression of gonadotrophin secretion lengthened time of follicular development impairment of the corpus luteum  complete cessation of menstrual cycles

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