A case report of recovery of menstrual function following a nutritional intervention in two exercising women with amenorrhea of varying duration
Open Access
- 3 January 2013
- journal article
- Published by Taylor & Francis Ltd in Journal of the International Society of Sports Nutrition
- Vol. 10 (1), 34
- https://doi.org/10.1186/1550-2783-10-34
Abstract
Increasing caloric intake is a promising treatment for exercise-associated amenorrhea, but strategies have not been fully explored. The purpose of this case report was to compare and contrast the responses of two exercising women with amenorrhea of varying duration to an intervention of increased energy intake. Two exercising women with amenorrhea of short (3 months) and long (11 months) duration were chosen to demonstrate the impact of increased caloric intake on recovery of menstrual function and bone health. Repeated measures of dietary intake, eating behavior, body weight, body composition, bone mineral density, resting energy expenditure, exercise volume, serum metabolic hormones and markers of bone turnover, and daily urinary metabolites were obtained. Participant 1 was 19 years old and had a body mass index (BMI) of 20.4 kg/m2 at baseline. She increased caloric intake by 276 kcal/day (1,155 kJ/day, 13%), on average, during the intervention, and her body mass increased by 4.2 kg (8%). Participant 2 was 24 years old and had a BMI of 19.7 kg/m2. She increased caloric intake by 1,881 kcal/day (7,870 kJ/day, 27%) and increased body mass by 2.8 kg (5%). Resting energy expenditure, triiodothyronine, and leptin increased; whereas, ghrelin decreased in both women. Resumption of menses occurred 23 and 74 days into the intervention for the women with short-term and long-term amenorrhea, respectively. The onset of ovulation and regular cycles corresponded with changes in body weight. Recovery of menses coincided closely with increases in caloric intake, weight gain, and improvements in the metabolic environment; however, the nature of restoration of menstrual function differed between the women with short-term versus long-term amenorrhea.Keywords
This publication has 42 references indexed in Scilit:
- Elevated PYY is associated with energy deficiency and indices of subclinical disordered eating in exercising women with hypothalamic amenorrheaAppetite, 2009
- The presence of both an energy deficiency and estrogen deficiency exacerbate alterations of bone metabolism in exercising womenBone, 2008
- Insulin regulates leptin secretion from 3T3–L1 adipocytes by a PI 3 kinase independent mechanismExperimental Cell Research, 2008
- Severity of energy-related menstrual disturbances increases in proportion to indices of energy conservation in exercising womenFertility and Sterility, 2007
- Long-term estrogen deficiency lowers regional blood flow, resting systolic blood pressure, and heart rate in exercising premenopausal womenAmerican Journal of Physiology-Endocrinology and Metabolism, 2007
- Evidence for a Causal Role of Low Energy Availability in the Induction of Menstrual Cycle Disturbances during Strenuous Exercise TrainingJournal of Clinical Endocrinology & Metabolism, 2001
- In Vitro Stimulation of the Prepubertal Rat Gonadotropin-Releasing Hormone Pulse Generator by Leptin and Neuropeptide Y through Distinct MechanismsEndocrinology, 2000
- High Frequency of Luteal Phase Deficiency and Anovulation in Recreational Women Runners: Blunted Elevation in Follicle-Stimulating Hormone Observed during Luteal-Follicular TransitionJournal of Clinical Endocrinology & Metabolism, 1998
- Bone Mineral Content of Amenorrheic and Eumenorrheic AthletesThe New England Journal of Medicine, 1984
- Menstrual Cycles: Fatness as a Determinant of Minimum Weight for Height Necessary for Their Maintenance or OnsetScience, 1974