Does improving hematological iron status restore the menstrual cycle in female athletes?

Abstract

Summary Objectives The aim of this study was to assess whether a 12-week nonpharmalogical nutritional intervention NI aimed at improving iron status in female athletes can mitigate disorders in the menstrual cycle. Equipment and methods Forty-one female athletes with menstrual disorders and iron deficiency or anemia were recruited. Energy and nutrient intake, total energy expenditure, energy availability, morphological parameters and serum iron and ferritin level, as well as serum concentrations of LH and FSH were measured at the beginning of the study and after twelve weeks of NI. Results Twelve weeks of NI resulted in an increase in energy and several nutrients (energy: mean 527 kcal/d, protein: 17 g/d, carbohydrate: 98 g/d, calcium: 430 mg/d, vitamin D 2 μg/d, iron 5 mg/d, thiamin 0.5 mg/d, niacin, 3.4 mg, folate 163 μg/d, vitamin C 50 mg/d). After twelve weeks of NI, an improvement in iron status was observed in the athletes (as increases in hemoglobin: mean 0.43 g/dl, MCV: 2 fl, MCH: 1.04 fl, and serum iron level: 46 μg/l). Basis on hemoglobin, serum iron, ferritin and red cell indices (MCV, MCH, MCHC, RDW) results the number of subjects with iron deficiency, anemia declined and latent iron deficiency was observed (iron deficiency from 7 to 5, anemia from 9 to 5, latent iron deficiency from 25 to 15). Significant increases in the level of LH and the LH-to-FSH ratio were also seen (LH means 1.51 mlU/ml and LH-to-FSH ratio means 0.31). Conclusion A NI aimed at improving iron status in female athletes with simultaneous iron deficiency and anemia can also improve the level of the hormones responsible for maintaining a regular menstrual cycle.