What causes exercise induced amenorrhea?
Women who are elite athletes or who exercise excessively on a regular basis are at risk of developing athletic amenorrhoea. Causes are thought to include low levels of body fat and the effects of exercise-related hormones on the menstrual cycle.
What is the pathophysiology of amenorrhea?
Amenorrhea occurs if the hypothalamus and pituitary fail to provide appropriate gonadotropin stimulation to the ovary, resulting in inadequate production of estradiol or in failure of ovulation and progesterone production.
How does intense exercise affect menstrual cycle?
Intense exercise can interrupt the balance of hormones that drives your menstrual cycle. This can cause you to bleed when you are not on your period, have a lighter flow than normal, or stop having a flow at all. Young athletes, especially those who are eating very little, are well known to experience this.
What is the mechanism of stress induced amenorrhea?
Potential hormonal mediators of amenorrhea and infertility. Physical, emotional, or nutritional stress may increase CRH levels, which suppress GnRH release. Cortisol levels, which increase in the setting of stress and Cushing’s syndrome, also suppress GnRH release and likely decrease LH responsiveness to GnRH.
How does amenorrhea affect bone density?
Amenorrhea may herald the onset of estrogen deficiency, which can adversely affect peak bone mass and ultimate risk of osteoporosis. Recent findings: Adolescence is a critical period for bone accretion.
How much exercise can cause amenorrhea?
No specific threshold at which exercise leads to menstrual dysfunction has been defined because contributing physiological and psychological factors produce considerable individual variation. However, women who run more than 50 miles each week have a significantly increased incidence of amenorrhoea.
What is the pathophysiology of secondary amenorrhea?
There are three general causes of secondary amenorrhea: hormonal disturbance leading to a lack of a normal menstrual cycle, physical damage to the endometrium, which prevents its growth, or obstruction of the outflow path of the menstrual blood.
What happens during amenorrhea?
Amenorrhea is the absence of menstrual bleeding. During the menstrual cycle, hormones cause an ovary to produce and release an egg. The ovary also releases the hormones estrogen and progesterone. Estrogen primarily causes the womb lining to thicken, while progesterone prepares the womb for the implantation of an egg.
Does exercise reduce period flow?
Yes, exercise can be very beneficial to you and your menstrual cycle in many ways! Overall activity and exercise helps regulate the menstrual cycle and flow, which also may equate to less cramping and lighter periods.
What stimulates CRH release?
Stress
Stress induces the hypothalamic production and release of CRH, which then causes the activation of the CRH receptor (CRHR) type 1 (CRHR-1) in the anterior pituitary to stimulate ACTH release, as well as proopiomelanocortin (POMC) expression and processing.
Why does amenorrhea cause osteoporosis?
Amenorrhea may herald the onset of estrogen deficiency, which can adversely affect peak bone mass and ultimate risk of osteoporosis.
How long does it take for amenorrhea to affect bone density?
The largest increases in bone density occur during the first 6–12 months of therapy, and bone density may not return to normal, even after several years of normal menstrual function (25, 26).