Does Exercise Induces Amenorrhea?
Exercise induced amenorrhea means menstrual abnormality called amenorrhea, which is caused due to strenuous exercise. Exercise induced amenorrhea primarily occurs in athletic women with variable frequency. Frequency may vary depending on the type of the sport and level of the competition.
What generally happens is that athletic women are not able to ovulate so they can't have a period. But it doesn't mean that if a women doesn't get period she doesn't ovulate. Ovulation doesn't always stop in the case of exercise induced amenorrhea. Even athletic women suffering from Exercise induced amenorrhea can become pregnant. The women with exercise induced amenorrhea seem to have lost normal pulsatility of LH and FSH may be because of environmental and metabolic stresses.
The exact cause of exercise induced amenorrhea is unknown, but is considered to be caused by hypothalamic dysfunction. In a normal menstrual cycle, hypothalamus releases gonadotropin-releasing hormone (GnRH) ever 60 to 90 minutes. GnRH stimulates the secretion of follicle-stimulating hormone (FSH) and Luteinizing hormone (LH) from the pituitary. In young athletes the pulse frequency of GnRH may slow down, disrupting the menstrual cycle and resulting in exercise induced amenorrhea.
Exercise induced amenorrhea is not only caused by exercise but there are some other factors like hormonal imbalance, energy deficiency, stress and poor nutrition that can cause exercise induced amenorrhea. Excessive exercise without adequate energy intake can cause energy drain, which can further lead to exercise induced amenorrhea. Some athletic women starve her body to maintain an ideal weight required for the sport. Such women can suffer from an exercise induced amenorrhea not due to their weight but due to the energy drain caused by starving.
In physically active women, energy deficiency can disrupt the reproductive system, which can lead to amenorrhea. Some studies show that calorie deficiency caused either due to poor diet or due to the expenditure of calories through exercise disrupts pulse frequency of LH and triggers bone demineralization. This can lead to an exercise induced amenorrhea. Demineralization of bone begins as early as 5 days after the energy drain. Therefore even treating exercise induced amenorrhea with estrogen and progesterone replacement therapy may not stop the changes in bone formation if the woman is weak.
Some researches were conducted on several athletic women to see that whether only exercise affects the reproductive system. Researches showed that exercising women with energy balanced diet didn't experience any symptoms of amenorrhea. Whereas in women with unbalanced diet the disruption in LH pulsatility was seen. Therefore it is a clear fact that exercise induced amenorrhea is not caused by exercise alone.
An increased calorie intake is the best and simplest way of preventing or treating exercise induced amenorrhea. An increased calorie intake helps in treating exercise induced amenorrhea by restoring normal menses and normal LH pulsatility. Thus a proper diet with calorie supplementation can prevent the disruption of LH pulsatility.