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- Melin, Anna K., Assistant Professor, 1965-, et al.
(författare)
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Impact of Menstrual Function on Hormonal Response to Repeated Bouts of Intense Exercise
- 2019
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Ingår i: Frontiers in Physiology. - : Frontiers Media S.A.. - 1664-042X. ; 10, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Strenous exercise stimulates the hypothalamic-pituitary (HP) axis in order to ensure homeostasis and promote anabolism. Furthermore, exercise stimulates a transient increase in the neurotrophin brain-derived neurotrophic factor (BDNF) suggested to mediate the anxiolytic effects of exercise. Athletes with secondary functional hypothalamic amenorrhea (FHA) have been reported to have lower BDNF, and a blunted HP axis response to exercise as athletes with overtraining syndrome. Aim: The aim of the study was to investigate the hormonal and BDNF responses to a two-bout maximal exercise protocol with four hours of recovery in between in FHA and eumenorrheic (EUM) athletes. Methods: Eumenorrheic (n = 16) and FHA (n = 14) endurance athletes were recruited from national teams and competitive clubs. Protocols included gynecological examination; body composition (DXA); 7-day assessment of energy availability; blood sampling pre and post the two exercises tests. Results: There were no differences between groups in hormonal responses to the first exercise bout. After the second exercise bout IGFBP-3 increased more in FHA compared with EUM athletes (2.1 +/- 0.5 vs. 0.6 +/- 0.6 mu g/L, p = 0.048). There were non-significant trends toward higher increase in IGF-1 (39.3 +/- 4.3 vs. 28.0 +/- 4.6 mu g/L, p = 0.074), BDNF (96.5 +/- 22.9 vs. 34.4 +/- 23.5 mu g/L, p = 0.058), GH to cortisol ratio (0.329 +/- 0.010 vs. 0.058 +/- 0.010, p = 0.082), and decrease in IGF-1 to IGFBP-3 ratio (-2.04 +/- 1.2 vs. 0.92 +/- 1.22, p = 0.081) in athletes with FHA compared with EUM athletes. Furthermore, there was a non-significant trend toward a higher increase in prolactin to cortisol ratio in EUM athletes compared with athletes with FHA (0.60 +/- 0.15 vs. 0.23 +/- 0.15, p = 0.071). No differences in the hormonal or BDNF responses between the two exercise bouts as a result of menstrual function were found. Conclusion: No major differences in the hormonal or BDNF responses between the two exercise bouts as a result of menstrual function could be detected.
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- Melin, Anna K., 1965-, et al.
(författare)
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The LEAF questionnaire : a screening tool for the identification of female athletes at risk for the female athlete triad
- 2014
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group Ltd. - 0306-3674 .- 1473-0480. ; 48, s. 540-545
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Tidskriftsartikel (refereegranskat)abstract
- Background Low energy availability (EA) in female athletes with or without an eating disorder (ED) increases the risk of oligomenorrhoea/functional hypothalamic amenorrhoea and impaired bone health, a syndrome called the female athlete triad (Triad). There are validated psychometric instruments developed to detect disordered eating behaviour (DE), but no validated screening tool to detect persistent low EA and Triad conditions, with or without DE/ED, is available.Aim The aim of this observational study was to develop and test a screening tool designed to identify female athletes at risk for the Triad.Methods Female athletes (n=84) with 18–39 years of age and training≥5 times/week filled out the Low Energy Availability in Females Questionnaire (LEAF-Q), which comprised questions regarding injuries and gastrointestinal and reproductive function. Reliability and internal consistency were evaluated in a subsample of female dancers and endurance athletes (n=37). Discriminant as well as concurrent validity was evaluated by testing self-reported data against measured current EA, menstrual function and bone health in endurance athletes from sports such as long distance running and triathlon (n=45).Results The 25-item LEAF-Q produced an acceptable sensitivity (78%) and specificity (90%) in order to correctly classify current EA and/or reproductive function and/or bone health.Conclusions The LEAF-Q is brief and easy to administer, and relevant as a complement to existing validated DE screening instruments, when screening female athletes at risk for the Triad, in order to enable early detection and intervention.
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- Skouby, Sven O, et al.
(författare)
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Climacteric medicine: European Menopause and Andropause Society (EMAS) statements on postmenopausal hormonal therapy
- 2004
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Ingår i: Maturitas. - : Elsevier BV. - 1873-4111 .- 0378-5122. ; 48:1, s. 19-25
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Tidskriftsartikel (refereegranskat)abstract
- Hormonal therapy (HT) is one of the most frequently prescribed drug regimens for women after the age of 50 years. HT has been developed progressively since the 1960s to provide estrogen to those women (a) who require relief of symptoms which have resulted from reduced circulating estrogen or (b) to act as an anti-resorptive agent to counteract the effect of the increased bone turnover which occurs with falling menopausal estrogen levels and which results in loss of bone mass leading to postmenopausal osteoporosis. However, a large number of women pass through the menopausal transition without experiencing distress as a result of the natural fall in estrogen hormone levels and since the introduction HT has been thought to be associated with a number of health benefits that have been tested in clinical trials but not substantiated. In women experiencing distressing climacteric symptoms double-blind randomised controlled clinical trials with a variety of HT regimens have shown that HT of any type provides symptom relief with no alternative treatment of similar effect. The dose and regimen of HT need to be individualised and in general the appropriate dose is dependent on the menopausal age. Women experiencing urogenital estrogen deficiency symptoms require long-term treatment which is most easily achieved with local estrogen. With the perspective provided by the most recent epidemiological findings not least from the estrogen only arm of the Women's Health Initiative Study (WHI) EMAS supports research activities generating HT with new compositions including lower doses and a wider range of progestins in order to positively affect the balance of clinical benefit and risk. Currently, however, individualized and appropriate prescription of the available HT products together with life-style management will sustain possibilities for beneficial effects on climacteric symptoms, quality of life and degenerative diseases after the menopause.
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- Tornberg, Åsa B.B., et al.
(författare)
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Reduced Neuromuscular Performance in Amenorrheic Elite Endurance Athletes
- 2017
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Ingår i: Medicine & Science in Sports & Exercise. - : Lippincott Williams & Wilkins. - 0195-9131 .- 1530-0315. ; 49:12, s. 2478-2485
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Secondary functional hypothalamic amenorrhea (SFHA) is common among female athletes, especially in weight-sensitive sports. The aim of this study was to investigate the link between SFHA and neuromuscular performance in elite endurance athletes. Methods Sixteen eumenorrheic (EUM) and 14 SFHA athletes from national teams and competitive clubs participated. Methods included gynecological examination, body composition (dual-energy x-ray absorptiometry), resting metabolic rate and work efficiency, exercise capacity, knee muscular strength (KMS) and knee muscular endurance (KME), reaction time (RT), blood sampling performed on the third to fifth days of the menstrual cycle, and 7-d assessment of energy availability. Results SFHA athletes had lower estrogen (0.12 0.03 vs 0.17 +/- 0.09 nmolL(-1), P < 0.05), triiodothyronine (T-3) (1.4 +/- 0.2 vs 1.7 +/- 0.3 nmolL(-1), P < 0.01), and blood glucose (3.8 +/- 0.3 vs 4.4 +/- 0.3 mmolL(-1), P < 0.001) but higher cortisol levels (564 +/- 111 vs 400 +/- 140 nmolL(-1), P < 0.05) compared with EUM athletes. SFHA had a lower body weight (55.0 +/- 5.8 vs 60.6 +/- 7.1 kg, P < 0.05), but no difference in exercise capacity between groups was found (56.4 +/- 5.8 vs 54.0 +/- 6.3 mL O(2)min(-1)kg(-1)). RT was 7% longer, and KMS and KME were 11% and 20% lower compared with EUM athletes. RT was negatively associated with glucose (r = -0.40, P < 0.05), T-3 (r = -0.37, P < 0.05), and estrogen (r = -0.43, P < 0.05), but positively associated with cortisol (r = 0.38, P < 0.05). KMS and KME correlated with fat-free mass in the tested leg (FFMleg; r = 0.52, P < 0.001; r = 0.58, P < 0.001) but were negatively associated with cortisol (r = -0.42, P < 0.05; r = -0.59, P < 0.001). FFMleg explained the differences in KMS, while reproductive function and FFMleg independently explained the variability in KME. Conclusions We found lower neuromuscular performance among SFHA compared with EUM athletes linked to a lower FFMleg, glucose, estrogen, T-3, and elevated cortisol levels.
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- Varga, Tibor V, et al.
(författare)
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Lipidomic profiles, lipid trajectories and clinical biomarkers in female elite endurance athletes
- 2020
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 10, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- We assessed whether blood lipid metabolites and their changes associate with various cardiometabolic, endocrine, bone- and energy-related comorbidities of Relative Energy Deficiency in Sport (RED-S) in female elite endurance athletes. Thirty-eight Scandinavian female elite athletes underwent a day-long exercise test. Five blood samples were obtained during the day - at fasting state and before and after two standardized exercise tests. Clinical biomarkers were assessed at fasting state, while untargeted lipidomics was undertaken using all blood samples. Linear and logistic regression was used to assess associations between lipidomic features and clinical biomarkers. Overrepresentations of findings with P < 0.05 from these association tests were assessed using Fisher's exact tests. Self-organizing maps and a trajectory clustering algorithm were utilized to identify informative clusters in the population. Twenty associations PFDR < 0.05 were detected between lipidomic features and clinical biomarkers. Notably, cortisol demonstrated an overrepresentation of associations with P < 0.05 compared to other traits (PFisher = 1.9×10-14). Mean lipid trajectories were created for 201 named features for the cohort and subsequently by stratifying participants by their energy availability and menstrual dysfunction status. This exploratory analysis of lipid trajectories indicates that participants with menstrual dysfunction might have decreased adaptive response to exercise interventions.
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