Abstract
Menstrual disturbances are highly prevalent in elite sports women, and represent one of female athletes' serious medical conditions. Such menstrual dysfunctions are often explained by caloric deficiency in combination with intense exercise. However, recently essential hyperandrogenism like poly cystic ovary syndrome (PCOS) has been described as an alternative mechanism. PURPOSE: To assess menstrual status, hormone levels and polycystic ovaries in Olympic athletes in power, endurance and technical disciplines. METHODS: Ninety female athletes, all members of the Swedish Olympic troops, underwent a general and gynaecological health assessment including vaginal ultrasound for evaluation of ovaries. Blood samples were collected for hormone analyses. Groups of athletes within power (e.g. downhill skiing, taekwando), endurance (e.g. cross-country skiing, cycling) and technical disciplines (e.g. curling, archery) were compared. RESUITS: Endurance athletes had the lowest mean BMI (21.6 ±1.8 versus 22.7 ± 1.8 in power sports, p<0.05 and 21.8 ± 1.3 in technical sports, n.s.). Hormonal contraceptives (HC) were used by 51 % of the athletes with no difference between groups. In athletes not taking HC, 77.8% of athletes in endurance disciplines were found to have menstrual disturbance, compared to 13.3% in power sports (p<0.001) and 33.3% in technical disciplines (p=0.06). We found no differences in hormone levels between disciplines. However, levels of free testosterone were higher in athletes with menstrual disturbance compared to regularly menstruating athletes without and with HC. Furthermore, the frequency of PCOS was significantly higher among athletes with menstrual disturbance compared to eumenorrheic athletes. CONCLUSIONS: Menstrual dysfunctions were most prevalent in sportswomen in endurance disciplines, and essential hyperandrogenism, like PCOS, seems to be an important cause of menstrual disturbances in these Olympic athletes. The medical consequences of PCOS in elite women and its role for physical performance remain to be determined.
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