Abstract
Increasing numbers of women are becoming involved in strenuous exercise programs. While older studies did not find any major deleterious effects of exercise on reproductive function, 1-3 more recently such effects have been recognized. Amenorrhea, 4-6 shortened luteal phase, 7 and delayed menarche 8-9 have all been reported. It is clear from the article by Frisch et al in this issue ofThe Journal(p 1559) that premenarcheal exercise can influence the timing of menarche; but in general, little is known of the short-term and long-term consequences of exercise on reproductive function in women. Just what is it about exercise that can delay menarche and result in amenorrhea? Dr Frisch and her colleagues suggest that an altered lean-fat ratio might be the key mechanism responsible for the delay in menarche in young athletes. Since it is thought that conversion of androgens to estrogens occurs primarily in peripheral fat, an alteration
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