Athletic amenorrhoea. An update on aetiology, complications and management.
Level 5 - mechanism / opinion, no new human data
Narrative review without systematic search or meta-analytic methodology
PubMed 2646673 · doi:10.2165/00007256-198907020-00002
What was done
This narrative review synthesized research regarding the neuroendocrine mechanisms, risk factors (low body fat, training intensity, dietary issues), complications (accelerated bone demineralization, stress fractures), differential diagnosis, and management strategies (calcium and hormone replacement) in female athletes experiencing athletic amenorrhea.
What was found
Menstrual dysfunction in exercising females occurs most often in low-body-weight aerobic disciplines (e.g., running, gymnastics, aerobics). Hypoestrogenemia in amenorrheic runners was associated with bone mineral content comparable to predicted levels for 52-year-old women. Bone loss was reported to occur most rapidly early after the cessation of menses at approximately 4% per year. While clinical trial data on hormone and calcium supplementation were noted as incomplete at publication, recommended interim management included 1,500 mg/day of calcium, consideration of estrogen/progesterone therapy, and ruling out other medical causes and eating disorders.
Why it matters
It highlights that exercise-induced amenorrhea is not a benign consequence of training, but an endocrine disorder driving early, clinically significant skeletal demineralization.
Limits
The paper is a non-systematic narrative review from 1989. The abstract reports no formal search criteria, study counts, effect size estimates with confidence intervals, or prospective trial validation for the recommended treatment regimens.
Cited by
- supports Women have approximately 10% to 13% essential body fat, and dropping below this range causes significant health complications.