Prevalence Of Amenorrhea Research Articles

Cardiac involvement and its clinical significance in patients with anorexia nervosa.

The prevalence of cardiac involvement, except for sinus bradycardia, was notably low in our cohort. The presence of cardiac aberrations is correlated with several clinical variables: lower body mass index (BMI) and the presence of amenorrhea and hypotension at admission. Patients presenting with these variables may be at high risk for cardiac findings per echocardiography. Dividing the patients into high and low risk groups may enable targeted evaluation, while avoiding unnecessary cardiac investigations in low-risk patients. • Cardiac involvement in anorexia nervosa (AN) patients is a major concern, which contributes to morbidity and mortality. • It is unknown which patients are prone to develop this complication. • Cardiac complications in our cohort are less frequent compared to previous studies, and it is correlated with lower body mass index (BMI) at admission, and the prevalence of amenorrhea and hypotension.

O-250 Increased association of eating disorders in women with polycystic ovary syndrome

Abstract Study question Is an increased association of eating disorders (ED) in women with polycystic ovary syndrome (PCOS) than in women without PCOS? Summary answer Women with PCOS have an increased association of ED than women without PCOS. What is known already PCOS is one of the most common endocrinopathies in women. It has been reported to be associated with psychological distress and dissatisfaction with self-appearance due to clinical features of the syndrome, such as hyperandrogenism, metabolic disorders, obesity, and infertility, leading to lower self-esteem and an increased risk of developing ED. This association presents a clinical dilemma, as the primary treatment for PCOS emphasizes the importance of weight loss, leading to potential distress in patients and worsening ED behaviors. Study design, size, duration This was a cross-sectional study. The sample size was calculated with the formula for comparison of proportions in two independent groups, with a confidence level of 95% and power of 80%, obtaining a minimum sample size of 116 participants per group. We included a total of 643 women between July to August 2022. Participants/materials, setting, methods 643 women who attended a gynecological consultation in Murcia, Spain were included, 238 with PCOS and 450 controls. The information was collected online. The score of the EDE-Q questionnaire and the clinical epidemiological characteristics were compared between the groups. Pearson Chi-square was used for categorical variables, and Mann Whitney U test for quantitative variables. Statistical significance was considered with a P-value <0.05. The data were analyzed with the SPSS version 20. Main results and the role of chance We found an increased risk of presenting ED in women with PCOS than in women not reporting PCOS (27% vs 13.7%). The odds of presenting an abnormal EDE-Q score (>4) were greater in women with PCOS (odds ratio [OR] 2.325, 95% confidence interval [CI], 1.55, 3.47, P < 0.001) than in women without PCOS. Clinically significant elevated scores were observed in the PCOS group for all four subscales of ED, but with a more significant impact on the eating concern scale (OR 2.49, 95% CI, 1.47, 4.21, P < 0.001). We found more prevalence of binge episodes in the PCOS group (OR 1.8, 95% IC, 1.3, 2.5, P < 0.001). When evaluating the characteristic of women with diagnosis of PCOS, we observed a higher body mass index (30.4 vs 23.4 [95% CI, 0.89-1.4, P < 0.001]) and more prevalence of amenorrhea (100% vs 87%, P < 0.001) in women with ED diagnosis than in women without ED. Limitations, reasons for caution The limitations observed in our study were that the information was based on an online questionnaire, so there is a possible reporting bias or misunderstanding of the questions. Wider implications of the findings The present study shows that women with diagnosis of PCOS have an increased risk of presenting ED than women without PCOS. This is more prevalent in women with a longer period of amenorrhea and a higher body mass index. Trial registration number Not applicable

Prevalence of amenorrhea in elite female competitive climbers.

Elite competitive sport climbers exhibit a high strength-to-weight ratio and are reported in the literature to be lighter and leaner than their athletic counterparts. Current research regarding nutrition among climbers is sparse but suggests that they may be at high risk for low energy availability and Relative Energy Deficiency in Sport (RED-S). The prevalence of amenorrhea, one of the primary indicators of RED-S, is unknown in this athletic population. The purpose of this study was to determine the prevalence of current (previous 12 months) amenorrhea among elite level competitive sport climbers.MethodsAn anonymous online survey was distributed via email to 1,500 female climbers registered as competitors within the International Federation of Sport Climbing to assess the prevalence of amenorrhea over the past 12 months.ResultsA total of 114 female sport climbers answered all survey questions regarding menstrual function and 18 athletes (15.8%) presented with current amenorrhea. The majority of the athletes (72%; n = 82) were categorized with eumenorrhea. An additional 14 athletes (12.3%) provided information that indicated irregular cycles, but answers to all menstrual cycle questions were not congruent to elicit a classification of amenorrhea and these athletes were categorized with a menstrual status of unsure. The average BMI for climbers with eumenorrhea was 20.8 ± 1.8 kg/m2 and 19.9 ± 2.4 kg/m2 for those with amenorrhea. A higher percentage of climbers with amenorrhea revealed they currently struggle with an eating disorder compared to those without amenorrhea (13.5 vs. 22.2%, respectively).ConclusionThis study indicates that some female climbers competing at the World Cup level do have menstrual disturbances with relatively normal BMIs and some currently struggle with one or more eating disorders. Even though World Cup competitions use BMI critical margins to screen competitors, this research highlights the need for more medical supervision of competitive elite female sport climbers in order to protect their overall health, including menstrual function. Further research is required to clarify how many climbers suffer from endocrine abnormalities related to RED-S. With more scientific evidence in this area practitioners will be better equipped to educate the athlete and coach with evidence-based nutrition recommendations.

Menstrual Pattern and Common Menstrual Disorders among Adolescent Girls

Background and Aim: The adolescent is the time period between puberty and psychophysical maturity where endocrinological, metabolic and somatic changes occur, the most frequent menstrual disorders during adolescent are; polymenorrhe, oligomenorrhea, dysmenorrhea. The present study aimed to assess the menstrual pattern and common menstrual disorders among adolescent girls. Methodology: This descriptive cross-sectional study was carried out on 75 adolescent girls in the Department of Gynecology, Sindh Government hospital Landhi from August-2021 to January 2022. All the adolescent girls with minimum and maximum menarche age of 9 years and 16 years respectively were enrolled in this study. Girls with chronic disease and hormonal use were excluded. Only already menstruating girls were asked to participate. Informed consent was taken from each participant. A self-administered structured questionnaire was used to gather information such as socioeconomic status, demographic details, contraceptive pills usage, smoking habits, and anthropometrics. The girl’s menstrual pattern was associated with menarche age, average bleeding days, weight, recent menstrual intervals, and complications such as amenorrhea, secondary amenorrhea, menorrhagia, dysmenorrhea, and premenstrual syndrome. SPSS version 25 was used for data analysis. Results: Mean age at menarche was 11.82±2.10 years with a range from 9 to 16 years. The menstrual cycles mean length was 31.6±5.8 days. The incidence of irregular menstruation, prolonged menstrual bleeding, and dysmenorrhea were 69.3% (n=52), 8% (n=6), and 22.6% (n=17) respectively. Of the total 52 irregular menstrual cycles, the prevalence of amenorrhea, oligomenorrhea, and polymenorrhea was 5.3% (n=4), 42.7% (n=32), and 21.3% (n=16) respectively. There were no significant associations found between menstrual irregularities and other factors such as age at menarche, BMI, physical activity, age, fat intake, and nutritional status. Out of 6 prolong menstrual bleeding; the incidence of medical disease, anemia, and ovarian cysts was three, two, and one case respectively. Conclusion: Our study found that irregular menstrual cycle and dysmenorrhea has higher prevalence among adolescent girls. Oligomenorrhea was the prevalent irregular menstrual problem. Irregular menstruation has no significant association with age, BMI, age at menarche, nutritional status, and physical activities. Prolong bleeding cycle was due to medical disease, anemia, and ovary cyst. Educational program and proper health information promotion should be arranged to minimize the possible consequences and complications caused by menstruation of adolescent’s girls. Also, adolescent girls should record their menstrual frequency and regular prospective after menarche to minimize these sequelae. Keywords: Menstrual Pattern, Adolescent girls, Dysmenorrhea,

A systematic approach to imaging the pelvis in amenorrhea.

This is a pictorial review on the radiological approach to patients with amenorrhea using a level-based framework. The prevalence of amenorrhea is 3 to 4% with wide-ranging causes involving multiple clinical disciplines. Normal menstruation depends on complex coordinated hormonal functions of the hypothalamic-pituitary-ovarian axis exerting its effect on an intact uterine end-organ and outflow tract. A disruption of any of these factors may result in amenorrhea. Categorizing the causes of primary and secondary amenorrhea into uterine, ovarian/gonadal, and intracranial levels provides a logical framework for its evaluation. A systematic level-based approach by targeted ultrasound of the pelvic structures is suggested, with different aims in primary versus secondary amenorrhea. Pelvic sonographic findings of various conditions within the uterine and ovarian/gonadal levels are illustrated. Conditions due to an intracranial cause result in downstream effects on the uterus and ovaries and can often be suspected based on a combination of clinical assessment, ultrasound findings, and laboratory investigations. By correlating pelvic ultrasound findings with underlying pathology, the clinical radiologist is able to provide useful diagnostic information in the management of these patients.

Female Runners With Multiple Bone Stress Injuries Have Smaller Bone Area Compared To Healthy Runners

Bone stress injury (BSI) is an overuse injury reported in up to 20% of female runners. Many runners sustain recurrent BSI. However, the role of impaired bone properties and other risk factors in those with recurrent BSI remain to be characterized. PURPOSE: To identify bone features that distinguish women with a history of multiple BSI. METHODS: We enrolled 41 female runners, ages 18-30, with a history of 1 lower extremity BSI (1 BSI; n=15), ≥ 3 lower extremity BSI (multi BSI; n=12), or no BSI (n=14), for this cross-sectional study. We collected high-resolution peripheral quantitative CT (HR-pQCT) scans of the distal tibia, areal bone mineral density (aBMD) by dual-energy x-ray absorptiometry, bone material strength index (BMSi) using microindentation (Osteoprobe), and questionnaires. RESULTS: There were no differences between groups in age, BMI, age of menarche, or aBMD. Multi BSI had higher Eating Disorder Examination Questionnaire (EDE-Q) scores and prevalence of amenorrhea than no BSI (p<0.05). Adjusting for height and weight, multi BSI had smaller total tibial bone area (p=0.049, Fig.), and a trend for greater total and trabecular volumetric BMD (vBMD; p=0.07, p=0.09, respectively) compared to no BSI. 1 BSI had higher BMSi compared to no BSI and multi BSI (p=0.04), and lower cortical porosity compared to no BSI (p=0.048). Among the cohort, BMSi was significantly associated with cortical porosity (p=0.04), but not with cortical vBMD, cortical tissue mineral density, or aBMD. EDE-Q score was inversely associated with total bone area (p=0.02). CONCLUSIONS: Our findings suggest runners with multi BSI have smaller bones and higher EDE-Q scores than no BSI. Total and trabecular vBMD appear to be higher in multi BSI compared to no BSI, though due to the small sample size, differences were not significant. Collectively, our findings suggest several bone properties and eating behaviors distinguish women with multi BSI and 1 BSI from no BSI.

Long-term outcome of endometrial ablation therapy with Cavaterm Thermal Balloon in patients with abnormal uterine bleeding

Objective:The purpose of this study was to evaluate the long-term outcome of endometrial ablation (EA) therapy with Cavaterm Thermal Balloon in patients with abnormal uterine bleeding (AUB).Material and MethodsThe retrospective cross-sectional study was performed on 209 patients who referred to Shahid Sadoughi Hospital in Yazd, Iran between March 2010 and September 2017 with AUB undergoing EA therapy. The data was collected by a questionnaire from the medical records of patients and phone call. The primary and secondary outcomes post EA therapy (from six months to seven years post-operatively) were assessed in patients.Results:The mean age of participants was 45.9±5.9 years and the mean follow-up duration was 21.2±13.2 months. The rate of treatment response was 95% in the first six months and 92.1% thereafter. The prevalence of amenorrhea was 41.2%. The patient satisfaction rate at the end of follow-up duration was 81.3%. Dysmenorrhea completely resolved in 32.6%. Moreover, 1.4% of patients became pregnant during follow-up. By the end of follow-up, four (1.9%) patients had a hysterectomy due directly to treatment failure.Conclusion:This study showed that EA surgery with Cavaterm Thermal Balloon was an effective treatment for AUB. The procedure was safe and was associated with a very low rate of postoperative adverse events. The patient satisfaction rate was favorable.

Prevalence of Amenorrhea Among Undergraduate Females at BUITEMS: A Cross-Sectional Study

An amenorrhoeic female is characterized when she has missed her menses for two or more months consecutively in a row. Such menstrual-related issue is prevalent in young females that are reproductively active and requires medical attention otherwise complications like infertility, psychosocial developmental delays, and osteoporosis, fractures, etc might result in such adolescent females at a very early age. Therefore it is crucial to diagnose and identify amenorrhea and its contributing factors in young females’. The obtained results of our study suggested that amenorrhea is prevalent among adolescent females that suffer from a high level of stress due to academic burden, hormonal imbalance, dietary deficiency, and premenstrual symptoms.

Physical health and symptoms of relative energy deficiency in female fitness athletes.

IntroductionCompeting in aesthetic sports increases the risk of low energy availability and associated health impairments. Fitness physique sport is a popular, but understudied aesthetic sport. We evaluated health and symptoms of relative energy deficiency in sport (RED‐s) in female fitness athletes (FA) and female references (FR) during a competitive season.MethodsTotally, 25 FA and 26 FR, mean (SD) age of 28.9 (5.7), were included. Assessments were at baseline (T1), 2‐weeks pre‐competition (T2), and 1‐month post‐competition (T3), by dual‐energy x‐ray absorptiometry scan, indirect calorimetry, diet registration, The Low Energy Availability in Females Questionnaire, The Beck Depression Inventory, and Eating Disorder Examination Questionnaire (EDE‐Q).ResultsA history of eating disorders was reported by 35% FA and 12% FR. There were no between‐group differences at T1, besides less mean (99% CI) fat mass (FM) of 3.1 kg (−0.4, 6.5) in FA (P = .02). At T2, FA had lower BW of 6.7 kg (−12.0, −1.3), fat mass of −9.0 kg (−12.5, −5.5), and resting heart rate of −8.0 beats per minute (−14.5, −1.5) compared to FR (P ≤ .006). FA reduced resting metabolic rate by −191 kcal (−11, −371) and increased symptoms of gastrointestinal dysfunction (GD) by 1.4 points (0.3, 2.5) and prevalence of amenorrhea from 8% to 24%, (P < .003). At T3, there was a between‐group difference in fat mass, and a high number of FA with amenorrhea and GD.ConclusionManifestation of symptoms of RED‐s, some with persistence one‐month post‐competition, raises concern for the health of FA and those complying with the fit body ideal.

Uptake of risk-reducing salpingo-oophorectomy among female BRCA mutation carriers: experience at the National Cancer Center of Korea.

The aim of this study was to identify the uptake rate of risk-reducing salpingo-oophorectomy (RRSO) and the factors affecting this rate among female BRCA1 or BRCA2 mutation carriers at the National Cancer Center of Korea. Between April 2007 and December 2014, 450 women underwent BRCA gene testing, and 97 women were found to have BRCA1/2 mutations. Through the review of medical records, 42 candidates for RRSO were identified. Of these, 22 underwent RRSO. Demographic, clinical, and consultation-related factors were compared between the RRSO and non-RRSO groups. The uptake rate of RRSO was 52.4 %. The mean time interval between genetic testing and surgery in the RRSO group was 7.3 months (range 0.6-33.9). The prevalence of amenorrhea was greater in the RRSO group than in the non-RRSO group (59.1 % vs. 20.0 %; P = 0.010). More women in the RRSO group were consulted with gynecologic oncologists (95.5 % vs. 60.0 %; P = 0.008). In multivariate analyses, amenorrhea at the time of genetic counseling (OR 16.44; 95 % CI 1.16-232.82; P = 0.038) and consultation with gynecologic oncologists (OR 30.78; 95 % CI 1.34-707.21; P = 0.032) were identified as factors affecting the carrier's decision to undergo RRSO. One patient in the non-RRSO group (5.0 %) developed primary peritoneal carcinoma, which was diagnosed 4.6 years after genetic testing. The uptake rate of RRSO among BRCA1/2 mutation carriers was affected by the presence of amenorrhea and consultation with gynecologic oncologists. Gynecologic oncologists with clinical experience with ovarian cancer should play a major role in aiding carriers' decision-making concerning RRSO.

Prevalence of Amenorrhea and Abortion in Spinal Cord Injured Women in Iran

Prevalence of Amenorrhea and Abortion in Spinal Cord Injured Women in Iran Although it has been shown that women with spinal cord injury(SCI) may experience short term amenorrhea in the acute or subacute phase after injury, the hypothalamic-pituitary axis mostly becomes normal through time. It seems that the occurrence of temporary amenorrhea does not affect the age of menopause in these patients. However spinal cord injured patients report lower rates of menstrual cramping, while other SCI-related complications such as increased spasticity, bladder spasm and dysautonomia are reported more frequent.

The gonadal effects of diabetes

The functional reproductive alterations seen in women with type 1 diabetes (T1D) have changed as therapy has improved. Historically, patients with T1D and insufficient metabolic control exhibited a high prevalence of amenorrhea, hypogonadism, and infertility. Recent publications have shown that in spite of intensive insulin therapy, some delay in the age of thelarche, pubarche and menarche is still observed in girls with T1D. In addition, ovarian hyperandrogenism may be observed during late adolescence and an increased prevalence of hirsutism and polycystic ovarian syndrome (PCOS) has been described in adult women with T1D. These endocrine abnormalities may be related to non-physiologic insulin replacement therapy and to hyperglycemia. Insulin is well known for its effects on carbohydrate metabolism, but this hormone also plays an important role in regulating ovarian function. Granulosa, theca and stromal ovarian cells may be affected by insulin deficiency or excess, which may be present in women with type 1 diabetes mellitus (T1D)[1]. Diabetes disrupts hypothalamic-pituitary-ovarian function, as documented by animal model studies which have helped to decipher the underlying basis of these conditions and have highlighted the variable contributions of defective leptin, insulin and kisspeptin signalling to the mechanisms of perturbed reproduction in T1D[2]. Effects of diabetes on gonadal function vary according to the age of the patient. Young girls during adrenarche exhibit an elevation of DHEAS, androstenedione, inhibin B and anti-mullerian hormone[3], an endocrine profile that is similar to the one observed in young girls in risk of developing polycystic ovarian syndrome later in life. During puberty a delay in pubertal development has been described which is followed by menstrual irregularities and hyperandrogenism during adolescence [1,4,5]. Despite these abnormalities in ovarian function, ovulatory functions is preserved in adolescents with type 1 diabetes[6]. Later in life, adult women with type 1 diabetes exhibit PCOS, polycystic ovaries at the ultrasonographic exam, menstrual irregularities and early decline in ovarian reserve[7-9]. Clearly, despite improvements in insulin therapy, T1D patients still suffer several significant clinical problems, such as pubertal delay, menstrual disturbances and hyperandrogenism which may ultimately lead to the development of PCOS in adulthood. (Fondecyt 1100123 y 1050452)

Effect of Lifestyle Intervention on Features of Polycystic Ovarian Syndrome, Metabolic Syndrome, and Intima-Media Thickness in Obese Adolescent Girls

Polycystic ovarian syndrome (PCOS) is associated with cardiovascular risk factors (CRF). Lifestyle intervention is regarded as therapy of choice even if studies in adolescent girls with PCOS are scarce. Our objective was to analyze the impact of lifestyle intervention on menses irregularities, hyperandrogenemia, CRF, and intima-media thickness (IMT) in adolescent girls with PCOS. Patients included 59 obese girls with PCOS aged 12-18 yr. Intervention was a 1-yr lifestyle intervention based on nutrition education, exercise training, and behavior therapy. Menses cycles, IMT, waist circumference, blood pressure, fasting lipids, insulin, glucose, testosterone, dehydroepiandrosterone sulfate, androstenedione, and SHBG were evaluated. In contrast to the 33 girls without weight loss, the 26 girls reducing their body mass index during the lifestyle intervention (by a mean of -3.9 kg/m(2)) improved most CRF and decreased their IMT (by a mean of -0.01 cm). Testosterone concentrations decreased (by a mean of -0.3 nmol/liter) and SHBG concentrations increased (by a mean of +8 ng/ml) significantly in girls with weight loss in contrast to girls with increasing weight. The prevalence of amenorrhea (-42%) and oligoamenorrhea (-19%) decreased in the girls with weight loss. The changes in insulin in the 1-yr follow-up were significantly correlated to changes in testosterone (r = 0.38; P = 0.002) and SHBG (r = -0.35; P = 0.048). A linear regression model with changes in IMT as dependent variable demonstrated a significant association with changes in blood pressure and weight status but not with changes in testosterone. Weight loss due to lifestyle intervention is effective to treat menses irregularities, normalize androgens, and improve CRF and IMT in obese adolescent girls with PCOS.

Diagnostic approach of amenorrhea

A complete interaction in the hypothalamic-pituitary-ovary-uterus (H-P-O-U) axis must take place in order for normal menstruation occurs. If any of the components in the H-P-O-U axis are nonfunctional, amenorrhea could occur. The prevalence of amenorrhea not due to pregnancy or lactation is approximately 3% to 4% in reproductive women. Because there are many causes of amenorrhea, the clinicians should be concerned with array of potential diseases and disorders involving unfamiliar organ systems, some carrying morbid and even lethal consequences for the patients. To explore the causes of amenorrhea, thorough evaluation of H-P-O-U axis and endocrinologic profiles are needed. The etiologic diagnosis is almost always possible with proceeding step by step approaches.

The relation between athletic sports and prevalence of amenorrhea and oligomenorrhea in Iranian female athletes.

BackgroundIn 1992, the concept of female athlete triad was introduced to describe the interrelated problems of amenorrhea, eating disorders and osteoporosis seen in female athletes. To gain a clearer picture of amenorrhea/oligomenorrhea in Iran, one of the main components of the female athlete triad, we therefore established this study on the prevalence of amenorrhea/oligomenorrhea in elite Iranian female athletes, also evaluating the risk factors of these disorders in the same population.MethodsThis study performed as a cross-sectional study. All elite Iranian female athletes of 34 sports federation, including female athletes in national teams and medalists of Tehran were invited to participate. A total of 788 (95% response rate) returned the questionnaires and were examined. Younger athletes under the age of menarche were excluded. Each athlete completed a self-administered questionnaire, which covered the following questions about participant's demographic information, athletic history, history of injuries and menstrual pattern. In order to diagnose the causes of amenorrhea/Oligomenorrhea including polycystic ovary syndrome(PCOS), participants with amenorrhea/Oligomenorrhea underwent further investigation. They were evaluated by following Para clinic investigation, and an ultrasonographic study of ovary.ResultsThe age ranged from 13–37 (mean = 21.1, SD = 4.5). Seventy one (9.0%) individuals had amenorrhea/oligomenorrhea, among those, 11 (15.5%) had PCOS.There was also a positive association between amenorrhea/oligomenorrhea and the following: age under 20 OR; 2.67, 95%CI(1.47 – 4.85), weight class sports OR; 2.09, 95%CI(1.15 – 3.82), endurance sports OR; 2.89, 95%CI(1.22 – 6.84), late onset of menarche OR; 3.32 95%CI(1.04–10.51), and use of oral contraceptive pills OR; 6.17, 95%CI(3.00 – 12.69). Intensity of training sport or BMI were not risk factors.ConclusionThese findings support the previous findings in the literature that the prevalence of amenorrhea/oligomenorrhea is high in athletes. Furthermore, we provided the first report on the prevalence of PCOS in female athletes with amenorrhea/oligomenorrhea. Athletes would be greatly benefited by greater general awareness about the complications of amenorrhea/oligomenorrhea.To increase awareness of exercise-associated menstrual cycle irregularities, it is necessary to design complete and comprehensive education programs for female athletes, their parents, their coaches, and the relevant authorities.

Menstrual disturbance and galactorrhea in people taking conventional antipsychotic medications.

Endocrine disturbances are emerging as major side effects of antipsychotic medications. Of particular note is the profile of menstrual disturbance and galactorrhea as a consequence of hyperprolactinemia (A. Weick & P. M. Haddad, 2003), a sequela of antidopaminergic action at the hypothalamopituitary axis. Research into the clinical aspects of this sensitive issue is sparse. The authors completed a cross-sectional descriptive study of 50 patients on conventional antipsychotic medications. The prevalence of menstrual disturbance was 54%, and the prevalence of amenorrhea was 12%. Symptoms of galactorrhea were present in 32% of patients. A history of pregnancy and childbirth was noted to be significantly associated with the development of galactorrhea (p = .01). The authors hypothesized that pregnancy and lactation might sensitize the hypothalamopituitary axis for further development of hyperprolactinemia due to medications.

Disordered Eating in Japanese and Chinese Female Runners, Rhythmic Gymnasts and Gymnasts

Eating Attitude Test-26 (EAT-26) and self-administered questionnaires were used to survey eating attitudes and menstrual irregularity of Japanese (J) and Chinese (C) collegiate female runners (RUNs), rhythmic gymnasts (RGYMs), gymnasts (GYMs), and nonathletic controls (NAs). Athletes were recruited from several outstanding colleges for physical education and sport in each country. The prevalence of disordered eating (DE) was significantly higher in Japanese athletes (21% in JRUNs, 19% in JRGYMs, and 15% in JGYMs) than Chinese athletes (4% in CRUNs, 2% in CRGYMs, and none in CGYMs). Also, the prevalence of amenorrhea was very low in CRUNs (1%), CRGYMs (0%), and CGYMs (0%), as compared with their respective Japanese counterparts (JRUNs 22%, JRGYMs 10%, JGYMs 8%). There was no significant difference in the prevalence of DE and amenorrhea between Japanese and Chinese NAs. Multivariate logistic regression analysis using 10 independent variables regarding anthropometrics, athletics, weight and diet concern, and nationality indicated that high frequency of dieting during a lifetime, high athletic level and being Japanese were significant risks for the development of DE in athletes. It is concluded that the low prevalence of DE in the Chinese in this study is partly explained by the lack of socioculturally- and socioeconomically-imposed desire to be thin as well as by the low frequency of dieting during their lifetime.

Prevalence of Amenorrhea in High School and Collegiate Cross-Country Runners

Drinkwater has found that women who always had regular menstrual cycles have higher lumbar densities. Since there is little published data on menstrual status of athletes, 72 female cross-country runners were evaluated from three teams in Michigan. A questionnaire, consisting of 15 questions, which had previously been tested for reliability was completed by the subjects. This identified past and current menstrual history and exercise pattern. Nutritional analysis using Nutritionist IV was completed. Three usual days of food intake were recorded by collegiate athletes. Results indicated that of the high school runners (age 14–17 years), a total of 59% responded they were either amenorrheic (AM) or oligomenorrheic (OL). Of this group, 54% (n=15) have had either a stress fracture or shin splints. The greatest number, 61% (n=17) consumed 2–4 cups of milk/day, whereas 21% (n=6), consumed ≤ cup milk/day. Only 3% consumed a calcium supplement. Analysis of collegiate data (n=44) (ages 18–22 years) revealed 19, and 33% were AM or OL, respectively. Evaluation indicated 50% were within acceptable body mass intake range. The mean miles ran per week was 31–40. There was low caloric intake and x of 1805±655 kcals; only 50% met carbohydrate recommendations. Mean fat and calcium intakes were 26 gm and 296 mg respectively. AM may result in low bone density at multiple skeletal sites. Optimal nutrition is vital to performance and the well-being of the female athlete.

Body composition and endocrine function in women with acquired immunodeficiency syndrome wasting.

The acquired immunodeficiency syndrome (AIDS) wasting syndrome is a devastating complication of human immunodeficiency virus (HIV) infection characterized by progressive weight loss and severe inanition. In men, the wasting syndrome is characterized by a disproportionate decrease in lean body mass and relative fat sparing. In contrast, relatively little is known about the gender-specific changes in body composition that characterize AIDS wasting in women. Three groups of women were studied to determine body composition and hormonal changes with respect to stage of wasting [nonwasting (NW; weight >90% ideal body weight; weight loss <10% of preillness maximum; n = 12), early wasting (EW; weight >90% ideal body weight; weight loss >10% of preillness maximum; n = 10), and late wasting (LW; weight <90%; n = 9)] and compared with a control group of 12, healthy, age-matched women. Weight loss averaged 6 +/- 6% (NW), 15 +/- 6% (EW), and 20 +/- 8% (LW) in the three groups. Lean, fat, and muscle masses were determined by dual energy x-ray absorptiometry and urinary creatinine excretion. Subjects were 36 +/- 5 yr of age (mean +/- SD) with a CD4 cell count of 379 +/- 239 cells/mm3. The body mass index was 24.4 +/- 2.6 kg/m2 (NW), 22.2 +/- 1.2 kg/m2 (EW), 18.2 +/- 2.0 kg/m2 (LW), and 24.3 +/- 2.6 kg/m2 (controls; P < 0.01, NW vs. EW; P < 0.0001, NW vs. LW). Lean body mass indexed for height was 15.7 +/- 2.4 kg/m2 (NW), 14.8 +/- 2.0 kg/m2 (EW), and 13.7 +/- 1.2 kg/m2 (LW) and was decreased significantly only in the LW group (P < 0.05 vs. NW). Muscle mass was 96% (NW), 94% (EW), and 78% (LW) of that predicted for height (P < 0.05, NW vs. LW). In contrast, fat mass indexed for height was decreased significantly among patients in both the EW and LW groups [8.7 +/- 1.9 kg/m2 (NW), 6.5 +/- 1.9 kg/m2 (EW), and 3.7 +/- 1.4 kg/m2 (LW); P < 0.05, NW vs. EW; P < 0.001, NW vs. LW). Expressed as a percentage of the value in nonwasting HIV-positive controls (NW), the relative loss of fat was greater than the loss of lean mass with progressive degrees of wasting [EW, 25% vs. 6% (fat vs. lean); LW, 58% vs. 13%]. The prevalence of amenorrhea was 20% among study subjects [17% (NW), 10% (EW), and 38% (LW)]. The percent predicted muscle mass was significantly lower in subjects with amenorrhea (74 +/- 8%) compared to that in eumenorrheic HIV-positive subjects (94 +/- 4%; P < 0.05). Estradiol levels were lower among subjects with amenorrhea (17.6 +/- 21.8 pg/mL) compared to eumenorrheic HIV-positive (48.9 +/- 33.6 pg/mL) and control (68.3 +/- 47.6 pg/mL) subjects and did not correlate with body composition. Mean free testosterone, but not total testosterone, levels were decreased in subjects with EW and LW compared to those in age-matched healthy controls, but not compared with those in NW [0.9 +/- 0.6 ng/dL (NW), 0.7 +/- 0.4 ng/dL (EW), 0.6 +/- 0.3 ng/dL (LW), and 2.0 +/- 2.4 ng/dL (controls); P < 0.05, EW vs. controls and LW vs. controls] and correlated with muscle mass (r = 0.37; P < 0.05). The percentages of women with free testosterone levels below the age-adjusted normal range were 33% (NW), 50% (EW), and 66% (LW). Dehydroepiandrosterone sulfate levels were also low in the subjects with LW compared to those in the control group [98 +/- 85 microg/dL (NW), 102 +/- 53 microg/dL (EW), 55 +/- 46 microg/dL (LW), and 132 +/- 68 microg/dL (controls); P < 0.05 LW vs. controls] and were correlated highly with free testosterone levels (r = 0.73; P < 0.00001) and also with muscle mass (r = 0.48; P < 0.01). These data demonstrate that women lose significant lean body and muscle mass in the late stages of wasting. However, in contrast to men, women exhibit a progressive and disproportionate decrease in body fat relative to lean body mass at all stages of wasting, consistent with gender-specific effects in body composition in AIDS wasting. (ABSTRACT TRUNCATED)

Amenorrhea in ballet dancers in the Netherlands.

The prevalence of amenorrhea was studied among 113 professional and student ballet dancers in the Netherlands (mean age 23.3 yr, SD 4.8). Sixty-one dancers not on oral contraceptives were included in the subsequent analyses. Six cases (prevalence 9.8 percent, 95 percent confidence interval: 2.4-17.2) with secondary amenorrhea (< or = 4 cycles per year; previous menstruation > or = 3 months prior to the study; menarche > or = 1 yr prior to the study) were found. Two dancers had primary amenorrhea (no menarche at the age of > or = 16). There was a negative correlation between the age of menarche and the number of menstrual cycles during the 12 months preceding the study (r = -0.46, P = 0.001). Body composition (four-compartment model), amount of dancing (recorded), resting energy expenditure (ventilated hood), dietary intake (recorded), and indices of eating disorders (Eating Disorders Inventory, EDI) were studied in 15 of the dancers, 5 amenorrheic and 10 eumenorrheic. No significant differences were found between the amenorrheic and eumenorrheic dancers. An explanation for the lower prevalence of amenorrhea in ballet dancers in the Netherlands, compared with U.S. dancers, was not obvious. Relatively low EDI scores (25.8, SD 14.5) in a subsample of 24 dancers could indicate less rigid emphasis on leanness and dieting.