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Cited by 120Ovarian function and disordersHypothalamic control of reproductive hormonesAdrenal Hormones and Disorders

Hyperandrogenicity is an alternative mechanism underlying oligomenorrhea or amenorrhea in female athletes and may improve physical performance

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Rickenlund, Anette, Carlström, Kjell, Ekblom, B.jörn, Brismar, Torkel B., von Schoultz, B.o, Lindén Hirschberg, Angelica·2003·Fertility and Sterility
DOI 10.1016/s0015-0282(02)04850-1
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Abstract

Objective To evaluate endocrine mechanisms underlying oligomenorrhea or amenorrhea in female athletes.Design Cross-sectional study.Setting Women's health clinical research unit at a university hospital.Patient(s) Age- and BMI-matched groups of athletes active in endurance sports with and without menstrual disturbances and regularly cycling sedentary controls.Intervention(s) Groups were compared with respect to endocrine status, body composition, and physical performance.Main outcome measure(s) Identification of a subgroup of oligomenorrheic or amenorrheic athletes with increased androgen levels and anabolic body composition.Result(s) A subgroup of 8 of 25 athletes with menstrual disturbances had significantly higher serum levels of free and total testosterone, androstenedione, LH-FSH ratio, and lower SHBG levels than did all other groups. Other oligomenorrheic or amenorrheic athletes had normal values comparable to those in regularly menstruating athletes and controls. The hyperandrogenic subgroup showed a more anabolic body composition, with higher total bone mineral density and upper-lower fat mass ratio than did oligomenorrheic or amenorrheic athletes with normal androgen levels. The hyperandrogenic subgroup had the highest VO2 max and the highest performance values in general.Conclusion(s) Menstrual disturbances in female athletes are often explained as a consequence of hypothalamic inhibition and caloric deficiency. We suggest that essential hyperandrogenism is an alternative mechanism underlying oligomenorrhea or amenorrhea in some female athletes and may imply an advantage for physical performance.

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Authors
Rickenlund, A., Carlström, K., Ekblom, B. J., Brismar, T. B., von Schoultz, B. O., & Lindén Hirschberg, A.
Affiliations
Karolinska University Hospital (SE)
Corresponding author
Rickenlund, Anette
ORCID
Venue
Fertility and Sterility
Publisher
Elsevier BV
Published
2003-04
Volume
79
Issue
4
Pages
947-955
ISSN
0015-0282 (ISSN-L)
DOI
10.1016/s0015-0282(02)04850-1
OpenAlex
W2023629620
Semantic Scholar
21c8713dd02b6f62e61831f774182d6a764d6592
Cited by
120
References
27
Citations by year
2026: 6 · 2025: 4 · 2024: 4 · 2023: 6 · 2022: 9 · 2021: 4 · 2020: 6 · 2019: 6 · 2018: 8 · 2017: 7 · 2016: 8 · 2015: 6 · 2014: 5 · 2013: 5 · 2012: 3
FWCI
3.62
Type
journal article
Language
en
Open access
Licence
Locations
  • Fertility and Sterility (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
hyperandrogenism, oligomenorrhea, amenorrhea, female athletes, menstrual irregularity, testosterone, androstenedione, LH/FSH ratio, sex hormone-binding globulin, bone mineral density, physical performance, endurance sports, hypothalamic inhibition, energy deficiency
MeSH terms
Adult, Amenorrhea, Androstenedione, Body Composition, Cross-Sectional Studies, Female, Humans, Insulin, Insulin-Like Growth Factor I, Oligomenorrhea, Physical Endurance, Sex Hormone-Binding Globulin, Sports, Testosterone, Transcortin, Bone Density, Hyperandrogenism, Dehydroepiandrosterone Sulfate

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