Skip to main content
Top
Published in: Journal of the International Society of Sports Nutrition 1/2014

Open Access 01-12-2014 | Research article

Effects of dietary intervention in young female athletes with menstrual disorders

Authors: Karolina Łagowska, Karina Kapczuk, Zbigniew Friebe, Joanna Bajerska

Published in: Journal of the International Society of Sports Nutrition | Issue 1/2014

Login to get access

Abstract

Background

The aim of this study was to evaluate the influence of three months of dietary intervention on menstrual cycle in young female athletes with amenorrhea or oligomenorrhea.

Methods

From forty-five female professional athletes with menstrual irregularity that were recruited thirty-one, aged 18.1 ± 2.6 years, completed the study and were analyzed. Hyperprolactinemia, thyroid dysfunction, primary ovarian failure and hyperandrogenism were excluded in the study participants. The subjects started intense training at the age of 11.2 ± 3.5 years and continued during next 6.8 ± 3.3 years. Energy and nutrients intake, total energy expenditure, energy availability and body composition as well as serum concentrations of LH, FSH, 17 – beta estradiol and progesterone were measured at the beginning of the study and after three months of individualized dietary intervention.

Results

Following three months of dietary intervention significant increase in energy intake (2354 ± 539 vs. 258 8 ± 557 kcal, P = 0.004) and energy availability (28.3 ± 9.2 vs. 35.8 ± 12.3 kcal/kg FFM/d, P = 0.011) was observed as well as improved energy balance (−288 ± 477 vs. -51 ± 224 kcal/d, P = 0.002). Though no changes in BMI and body composition were noted but significant rise in LH concentrations (3.04 ± 1.63 vs. 4.59 ± 2.53 mIU/ml, P = 0.009) and LH to FSH ratio (0.84 ± 0.56 vs. 0.96 ± 0.52, P = 0.001) was achieved, but no restoration of menstrual cyclicity.

Conclusions

This report provides further support for the role of energy deficiency in menstrual disorders among young female athletes and the benefits of an adequate energy intake and energy availability on hormones concentration. Continuation controlled dietary intervention is needed to assess the extent to which long-term improvement in the nutritional status results in improvements in the hormonal status of female athletes, to an extent that would allow the regulation of the menstrual cyclity.
Appendix
Available only for authorised users
Literature
1.
go back to reference Mudd LM, Fornetti W, Pivarnik JM: Bone mineral density in collegiate female athletes comparisons among sports. J Athl Train. 2007, 42 (3): 403-408.PubMedCentralPubMed Mudd LM, Fornetti W, Pivarnik JM: Bone mineral density in collegiate female athletes comparisons among sports. J Athl Train. 2007, 42 (3): 403-408.PubMedCentralPubMed
2.
go back to reference Klentrou P, Plyley M: Onset of puberty, menstrual frequency, and body fat in elite rhythmic gymnasts compared with normal controls. Br J Sports Med. 2003, 37: 490-494.PubMedCentralCrossRefPubMed Klentrou P, Plyley M: Onset of puberty, menstrual frequency, and body fat in elite rhythmic gymnasts compared with normal controls. Br J Sports Med. 2003, 37: 490-494.PubMedCentralCrossRefPubMed
3.
go back to reference Torstveit MK, Sundgot-Borgen J: Participation in leanness sports but not training volume is associated with menstrual dysfunction: a national survey of 1276 elite athletes and controls. Br J Sports Med. 2005, 39: 141-147.PubMedCentralCrossRefPubMed Torstveit MK, Sundgot-Borgen J: Participation in leanness sports but not training volume is associated with menstrual dysfunction: a national survey of 1276 elite athletes and controls. Br J Sports Med. 2005, 39: 141-147.PubMedCentralCrossRefPubMed
4.
go back to reference Miller SM, Kukuljan S, Turner AI, van der Pligt P, Ducher G: Energy deficiency, menstrual disturbances, and low bone mass: what do exercising Australian women know about the female athlete triad?. Int J Sport Nutr Exerc Metab. 2012, 22 (2): 131-138.PubMed Miller SM, Kukuljan S, Turner AI, van der Pligt P, Ducher G: Energy deficiency, menstrual disturbances, and low bone mass: what do exercising Australian women know about the female athlete triad?. Int J Sport Nutr Exerc Metab. 2012, 22 (2): 131-138.PubMed
5.
go back to reference Feldmann JM, Belsha JP, Eissa MA, Middleman AB: Female adolescent athletes’ awareness of the connection between menstrual status and bone health. J Pediatr Adolesc Gynecol. 2011, 24 (5): 311-314.CrossRefPubMed Feldmann JM, Belsha JP, Eissa MA, Middleman AB: Female adolescent athletes’ awareness of the connection between menstrual status and bone health. J Pediatr Adolesc Gynecol. 2011, 24 (5): 311-314.CrossRefPubMed
6.
go back to reference Christo K, Prabhakaran R, Lamparello B, Cord J, Miller KK, Goldstein MA, Gupta N, Herzog DB, Klibanski A, Misra M: Bone metabolism in adolescent athletes with amenorrhea, athletes with eumenorrhea and control subjects. Pediatrics. 2008, 121: 1127-1136.PubMedCentralCrossRefPubMed Christo K, Prabhakaran R, Lamparello B, Cord J, Miller KK, Goldstein MA, Gupta N, Herzog DB, Klibanski A, Misra M: Bone metabolism in adolescent athletes with amenorrhea, athletes with eumenorrhea and control subjects. Pediatrics. 2008, 121: 1127-1136.PubMedCentralCrossRefPubMed
7.
go back to reference Nicholas JF, Rauh MJ, Barrack MT, Hava-Shoshana Barkai HS, Pernick Y: Disordered eating and menstrual irregularity in high school athletes in lean-build and nonlean-build sports. Int J Sport Nutr Exerc Metab. 2007, 17: 364-377. Nicholas JF, Rauh MJ, Barrack MT, Hava-Shoshana Barkai HS, Pernick Y: Disordered eating and menstrual irregularity in high school athletes in lean-build and nonlean-build sports. Int J Sport Nutr Exerc Metab. 2007, 17: 364-377.
8.
go back to reference Hind K: Recovery of bone mineral density and fertility in a former amenorrheic athlete. J Sports Sci Med. 2008, 7: 415-418.PubMedCentralPubMed Hind K: Recovery of bone mineral density and fertility in a former amenorrheic athlete. J Sports Sci Med. 2008, 7: 415-418.PubMedCentralPubMed
9.
go back to reference Rickenlund A, Eriksson MJ, Schenck-Gustafsson K, Hirschberg AL: Amenorrhea in female athletes is associated with endothelial dysfunction and unfavorable lipid profile. J Clin Endocrinol Metab. 2005, 90 (3): 1354-1359.CrossRefPubMed Rickenlund A, Eriksson MJ, Schenck-Gustafsson K, Hirschberg AL: Amenorrhea in female athletes is associated with endothelial dysfunction and unfavorable lipid profile. J Clin Endocrinol Metab. 2005, 90 (3): 1354-1359.CrossRefPubMed
10.
go back to reference Nattiv A, Loucks AB, Manore MM, Sanborn CF, Sundgot-Borgen J, Warren MP: American College of Sports Medicine. The female athlete triad. Position stand. Med Sci Sports Exerc. 2007, 39: 1867-1881.CrossRefPubMed Nattiv A, Loucks AB, Manore MM, Sanborn CF, Sundgot-Borgen J, Warren MP: American College of Sports Medicine. The female athlete triad. Position stand. Med Sci Sports Exerc. 2007, 39: 1867-1881.CrossRefPubMed
11.
go back to reference Heyward VH, Wagner DL: Applied body composition assessment. 2003, Champaign, IL: Human Kinetics Heyward VH, Wagner DL: Applied body composition assessment. 2003, Champaign, IL: Human Kinetics
12.
go back to reference Harris JA, Benedict FA: A Biometric Study of Basal Metabolic Rate in man. 1919, Washington, DC: Carnegie Institute of Washington, DC (Pub No 279), 370-373. Harris JA, Benedict FA: A Biometric Study of Basal Metabolic Rate in man. 1919, Washington, DC: Carnegie Institute of Washington, DC (Pub No 279), 370-373.
13.
go back to reference Szponar L, Wolnicka K, Rychlik E: Album fotografii produktów i potraw. 2000, Wydawnictwo IŻŻ: Warsaw Szponar L, Wolnicka K, Rychlik E: Album fotografii produktów i potraw. 2000, Wydawnictwo IŻŻ: Warsaw
14.
go back to reference Kunachowicz H, Nadolna I, Przygoda B, Ivanow K: Tables of Nutritional Value of Foodstuffs and Dishes. 3rd extended and updated edition. 2005, Warsaw: Instytut Żywności i Żywienia Kunachowicz H, Nadolna I, Przygoda B, Ivanow K: Tables of Nutritional Value of Foodstuffs and Dishes. 3rd extended and updated edition. 2005, Warsaw: Instytut Żywności i Żywienia
15.
go back to reference Manore MM, Kam LC, Loucks AB: The female athlete triad: components, nutrition issues, and health consequences. J Sports Sci. 2007, 25: 61-71.CrossRef Manore MM, Kam LC, Loucks AB: The female athlete triad: components, nutrition issues, and health consequences. J Sports Sci. 2007, 25: 61-71.CrossRef
16.
17.
go back to reference Jarosz M, Bułhak-Jachymczyk B: Normy Żywienia Człowieka. Podstawy prewencji otyłości i chorób niezakaźnych. 2008, Warsaw: Instytut Żywności i Żywienia: Wydawnictwo Lekarskie PZWL Jarosz M, Bułhak-Jachymczyk B: Normy Żywienia Człowieka. Podstawy prewencji otyłości i chorób niezakaźnych. 2008, Warsaw: Instytut Żywności i Żywienia: Wydawnictwo Lekarskie PZWL
18.
go back to reference Łagowska K, Jeszka J, Bajerska J: The evaluation of nutritional habits, nutritional status triathlon with and without menstrual disorders. Med Sportiva. 2010, 14 (4): 204-208.CrossRef Łagowska K, Jeszka J, Bajerska J: The evaluation of nutritional habits, nutritional status triathlon with and without menstrual disorders. Med Sportiva. 2010, 14 (4): 204-208.CrossRef
19.
go back to reference Łagowska K, Jeszka J: Are young female athletes at risk of amenorrhoea? Analysis of body composition, nutritional and endocrine factors. ACTA Sci Polonorum. 2011, 10 (2): 227-232. Łagowska K, Jeszka J: Are young female athletes at risk of amenorrhoea? Analysis of body composition, nutritional and endocrine factors. ACTA Sci Polonorum. 2011, 10 (2): 227-232.
20.
go back to reference Hoch AZ, Pajewski NM, Moraski L, Carrera GF, Wilson CR, Hoffmann RG, Schimke JE, Gutterman DD: Prevalence of the female athlete triad in high school athletes and sedentary students. Clin J Sport Med. 2009, 19 (5): 421-428.PubMedCentralCrossRefPubMed Hoch AZ, Pajewski NM, Moraski L, Carrera GF, Wilson CR, Hoffmann RG, Schimke JE, Gutterman DD: Prevalence of the female athlete triad in high school athletes and sedentary students. Clin J Sport Med. 2009, 19 (5): 421-428.PubMedCentralCrossRefPubMed
21.
go back to reference Tomten SE, Høstmark AT: Energy balance in weight stable athletes with and without menstrual disorders. Scand J Med Sci Sports. 2006, 16 (2): 127-133.CrossRefPubMed Tomten SE, Høstmark AT: Energy balance in weight stable athletes with and without menstrual disorders. Scand J Med Sci Sports. 2006, 16 (2): 127-133.CrossRefPubMed
22.
go back to reference Hoogenboom BJ, Morris J, Morris C, Schaefer K: Nutritional knowledge and eating behaviors of female, collegiate swimmers. N Am J Sports Phys Ther. 2009, 4 (3): 139-148.PubMedCentralPubMed Hoogenboom BJ, Morris J, Morris C, Schaefer K: Nutritional knowledge and eating behaviors of female, collegiate swimmers. N Am J Sports Phys Ther. 2009, 4 (3): 139-148.PubMedCentralPubMed
23.
go back to reference Quah YV, Poh BK, Ng LO, Noor MI: The female athlete triad among elite Malaysian athletes: prevalence and associated factors. Asia Pac J Clin Nutr. 2009, 18 (2): 200-208.PubMed Quah YV, Poh BK, Ng LO, Noor MI: The female athlete triad among elite Malaysian athletes: prevalence and associated factors. Asia Pac J Clin Nutr. 2009, 18 (2): 200-208.PubMed
24.
go back to reference Woolf K, Manore MM: B-vitamins and exercise: does exercise alter requirements?. Int J Sport Nutr Exerc Metab. 2006, 16 (5): 453-484.PubMed Woolf K, Manore MM: B-vitamins and exercise: does exercise alter requirements?. Int J Sport Nutr Exerc Metab. 2006, 16 (5): 453-484.PubMed
25.
go back to reference Mallinson RJ, Williams NI, Olmsted MP, Scheid JL, Riddle ES, De Souza MJ: A case report of recovery of menstrual function following a dietary intervention in two exercising women with amenorrhea of varying duration. J Int Soc Sports Nutr. 2013, 10 (1): 34-PubMedCentralCrossRefPubMed Mallinson RJ, Williams NI, Olmsted MP, Scheid JL, Riddle ES, De Souza MJ: A case report of recovery of menstrual function following a dietary intervention in two exercising women with amenorrhea of varying duration. J Int Soc Sports Nutr. 2013, 10 (1): 34-PubMedCentralCrossRefPubMed
26.
go back to reference Loucks AB, Verdun M, Heath EM: Low energy availability, not stress of exercise, alters LH pulsatility in exercising women. J Appl Physiol. 1998, 84: 37-PubMed Loucks AB, Verdun M, Heath EM: Low energy availability, not stress of exercise, alters LH pulsatility in exercising women. J Appl Physiol. 1998, 84: 37-PubMed
27.
go back to reference Laughlin GA, Dominguez CE, Yen SS: Nutritional and endocrine-metabolic aberrations in women with functional hypothalamic amenorrhea. J Clin Endocrinol Metab. 1998, 83: 25-PubMed Laughlin GA, Dominguez CE, Yen SS: Nutritional and endocrine-metabolic aberrations in women with functional hypothalamic amenorrhea. J Clin Endocrinol Metab. 1998, 83: 25-PubMed
28.
go back to reference Thong FSL, McLean C, Graham TE: Plasma leptin in female athletes: relationship with body fat, reproductive, nutritional, and endocrine factors. J Appl Physiol. 2000, 88 (6): 2037-2044.PubMed Thong FSL, McLean C, Graham TE: Plasma leptin in female athletes: relationship with body fat, reproductive, nutritional, and endocrine factors. J Appl Physiol. 2000, 88 (6): 2037-2044.PubMed
29.
go back to reference Kaiserauer S, Synder AC, Sleeper M, Zierath J: Nutritional, physiological and menstrual status of distance runners. Med Sci Sports Exerc. 1989, 21: 120-125.CrossRefPubMed Kaiserauer S, Synder AC, Sleeper M, Zierath J: Nutritional, physiological and menstrual status of distance runners. Med Sci Sports Exerc. 1989, 21: 120-125.CrossRefPubMed
30.
go back to reference De Souza MJ, Lee DK, VanHesst JI, Scheid JL, West SL, Williams NI: Severity of energy-related menstrual disturbances increases in proportion to indices of energy conservation in exercising women. Fertil Steril. 2007, 88: 971-975.CrossRefPubMed De Souza MJ, Lee DK, VanHesst JI, Scheid JL, West SL, Williams NI: Severity of energy-related menstrual disturbances increases in proportion to indices of energy conservation in exercising women. Fertil Steril. 2007, 88: 971-975.CrossRefPubMed
31.
go back to reference Dueck CA, Matt KS, Manore MM, Skinner JS: Treatment of athletic amenorrhea with a diet and training intervention program. Int J Sport Nutr. 1996, 6: 24-40.PubMed Dueck CA, Matt KS, Manore MM, Skinner JS: Treatment of athletic amenorrhea with a diet and training intervention program. Int J Sport Nutr. 1996, 6: 24-40.PubMed
32.
go back to reference Kopp-Woodroffe SA, Manore MM, Dueck CA, Skinner JS, Matt KS: Energy and nutrient status of amenorrheic athletes participating in a diet and exercise training intervention program. Int J Sport Nutr. 1999, 9: 70-88.PubMed Kopp-Woodroffe SA, Manore MM, Dueck CA, Skinner JS, Matt KS: Energy and nutrient status of amenorrheic athletes participating in a diet and exercise training intervention program. Int J Sport Nutr. 1999, 9: 70-88.PubMed
33.
go back to reference Arends JC, Cheung MY, Barrack MT, Nattiv A: Restoration of menses with nonpharmacologic therapy in collegiate athletes with menstrual disturbances: A 5 year Retrospective Study. Int J Sport Nutr Exerc Metab. 2012, 22 (2): 98-108.PubMed Arends JC, Cheung MY, Barrack MT, Nattiv A: Restoration of menses with nonpharmacologic therapy in collegiate athletes with menstrual disturbances: A 5 year Retrospective Study. Int J Sport Nutr Exerc Metab. 2012, 22 (2): 98-108.PubMed
34.
go back to reference Loucks AB, Thuma JR: Luteinizing hormone pulsatility is disrupted at a threshold of energy availability in regularly menstruating women. J Clin Endocrinol Metab. 2003, 88 (1): 297-311.CrossRefPubMed Loucks AB, Thuma JR: Luteinizing hormone pulsatility is disrupted at a threshold of energy availability in regularly menstruating women. J Clin Endocrinol Metab. 2003, 88 (1): 297-311.CrossRefPubMed
35.
go back to reference Loucks AB, Laughlin GA, Mortola JF, Girton L, Nelson JC, Yen SS: Hypothalamic-pituitary-thyroidal function in eumenorrheic and amenorrheic athletes. J Clin Endocrinol Metab. 1992, 75: 514-518.PubMed Loucks AB, Laughlin GA, Mortola JF, Girton L, Nelson JC, Yen SS: Hypothalamic-pituitary-thyroidal function in eumenorrheic and amenorrheic athletes. J Clin Endocrinol Metab. 1992, 75: 514-518.PubMed
36.
go back to reference Bruni V, Dei M, Morelli C, Schettino MT, Balzi D, Nuvolone D: Body composition variables and leptin levels in functional hypothalamic amenorrhea and amenorrhea related to eating disorders. J Pediatr Adolesc Gynecol. 2011, 24: 347-352.CrossRefPubMed Bruni V, Dei M, Morelli C, Schettino MT, Balzi D, Nuvolone D: Body composition variables and leptin levels in functional hypothalamic amenorrhea and amenorrhea related to eating disorders. J Pediatr Adolesc Gynecol. 2011, 24: 347-352.CrossRefPubMed
Metadata
Title
Effects of dietary intervention in young female athletes with menstrual disorders
Authors
Karolina Łagowska
Karina Kapczuk
Zbigniew Friebe
Joanna Bajerska
Publication date
01-12-2014
Publisher
BioMed Central
DOI
https://doi.org/10.1186/1550-2783-11-21

Other articles of this Issue 1/2014

Journal of the International Society of Sports Nutrition 1/2014 Go to the issue