Lane · Archivos de medicina del deporte : publicacion de la Federacion Espanola de Medicina del Deporte 2019 · narrative review · n=?

Reproductive Dysfunction from Exercise Training: The "Exercise-Hypogonadal Male Condition".

Level 5 - mechanism / opinion, no new human data

Narrative review discussing clinical concepts and mechanism-based reasoning without systematic methodology or primary human data.

PubMed 32724267 · record verified 2026-08-26

What was done

This narrative review summarizes existing literature on exercise-induced reproductive dysfunction in men, drawing conceptual parallels to athletic amenorrhea and the Female Athlete Triad in women. It focuses on the hypothalamic-pituitary-gonadal (HPG) axis, low energy availability, and testosterone suppression associated with chronic endurance training.

What was found

No quantitative findings or numerical estimates are reported in the abstract. Chronic endurance exercise training is described as causing persistently reduced basal free and total testosterone concentrations without concurrent elevations in luteinizing hormone (LH), a state termed the "Exercise-Hypogonadal Male Condition" (EHMC). The authors note potential downstream effects on testosterone-dependent physiological processes and spermatogenesis, suggesting potential infertility risks.

Why it matters

It highlights a low-testosterone condition in heavily trained male endurance athletes that mirrors female relative energy deficiency presentations, alerting clinicians and endocrinologists to consider training load in male fertility evaluations.

Limits

As a narrative review, it provides no original empirical data, sample sizes, or systematic review methodology. The exact physiological mechanisms and the specific role of low energy availability in men remain incompletely characterized, and the prevalence and clinical severity of spermatogenic disruption were not quantitatively established.

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